Shan Xiao-feng, Lin Bo, Lu Xu-guang, Cai Zhi-gang, Yu Guang-yan
Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2014 Feb 18;46(1):48-52.
To analyze the benefits of facial nerve electromyographic monitoring during parotid tumor surgery.
In the study, 92 patients with parotid tumor who underwent surgery were surveyed. The study group consisted of 46 patients who underwent intraoperative electromyographic monitoring, and 46 patients served as the control group. The incidence of postoperative facial nerve weakness and the operation time were recorded.
In the primary parotid tumor resection,the operation time of the study group (6 cases)was (50.0 ± 9.1) min, that of control group (7 cases) was (42.9 ± 5.2) min (P = 0.064) when the facial nerve needed no dissecting; the operation time of the study group (32 cases)was (74.7 ± 28.0) min, that of control group (33 cases) was (75.6 ± 29.8) min (P = 0.893) when the facial nerve needed dissecting. For the patients with revision surgery, the mean operation time in the study group [(117.5 ± 37.8) min] was significantly lower than that of the control group [(175.0 ± 47.8) min], P < 0.05. In the study group, 8 patients suffered from postoperative facial nerve weakness because of tumor characteristics; in the control group, 6 patients suffered from postoperative facial nerve weakness, with 4 cases because of tumor characteristic, and 2 cases because of operator error.
The results suggest that continuous electromyographic monitoring of facial nerve during parotidectomy reduces the mean operation time in patients with revision surgery, but not the incidence of postoperative facial paralysis.
分析腮腺肿瘤手术中面神经肌电图监测的益处。
本研究对92例行腮腺肿瘤手术的患者进行了调查。研究组由46例行术中肌电图监测的患者组成,46例患者作为对照组。记录术后面神经麻痹的发生率和手术时间。
在原发性腮腺肿瘤切除术中,当面神经无需解剖时,研究组(6例)的手术时间为(50.0±9.1)分钟,对照组(7例)为(42.9±5.2)分钟(P = 0.064);当面神经需要解剖时,研究组(32例)的手术时间为(74.7±28.0)分钟,对照组(33例)为(75.6±29.8)分钟(P = 0.893)。对于行翻修手术的患者,研究组的平均手术时间[(117.5±37.8)分钟]显著低于对照组[(175.0±47.8)分钟],P < 0.05。研究组有8例患者因肿瘤特征出现术后面神经麻痹;对照组有6例患者出现术后面神经麻痹,其中4例因肿瘤特征,2例因手术操作失误。
结果表明,腮腺切除术中对面神经进行连续肌电图监测可缩短翻修手术患者的平均手术时间,但不能降低术后面神经麻痹的发生率。