Ikoma Ryo, Ishitoya Junichi, Sakuma Yasunori, Hirama Mariko, Shiono Osamu, Komatsu Masanori, Oridate Nobuhiko
Department of Otolaryngology, Yokohama City University Medical Center, Urafune-cho 4-57, Minami-ku, Yokohama 232-0024, Japan.
Department of Otolaryngology, Yokohama City University Medical Center, Urafune-cho 4-57, Minami-ku, Yokohama 232-0024, Japan.
Auris Nasus Larynx. 2014 Oct;41(5):479-84. doi: 10.1016/j.anl.2014.05.001. Epub 2014 May 29.
To investigate the clinical factors associated with temporary facial nerve dysfunction (TFND) following surgery for benign parotid gland tumors.
We reviewed the records of 175 patients with benign parotid gland tumors who underwent partial parotidectomy at Yokohama City University Medical Center in Japan. TFND was found in 33 patients (18.9%). We used two hypothetical lines in magnetic resonance imaging (MRI) images to define the tumor location (upper/lower or anterior/posterior) in the parotid gland. We then studied the associations of TFND with the following clinical factors: patient age, tumor size, histopathological diagnosis, and the location of the tumor within the parotid gland (superficial lobe/deep lobe; upper part/lower part; and anterior part/posterior part).
Tumors located in the upper parts, anterior parts or the deep lobes of the parotid gland had statistically higher incidences of TFND compared with tumors located in the lower parts, posterior parts or the superficial lobe (P<0.001, <0.001, <0.01, respectively). The odds ratio for the risk of TFND was significantly high if tumors were located in the upper parts, the anterior parts or the deep lobes with stepwise multivariate regression analysis. The other factors, including patient's age, tumor size, histopathology of the tumor, and inadequate surgeon's experience, were not apparent risks for TFND.
Parotid gland tumors located in the upper parts, the anterior parts or the deep lobes had a higher risk of TFND. The two hypothetical lines we used were shown to be useful to define the tumor location, eventually the risk of TFND.
探讨腮腺良性肿瘤手术后发生暂时性面神经功能障碍(TFND)的相关临床因素。
我们回顾了日本横滨市立大学医学中心175例接受腮腺部分切除术的腮腺良性肿瘤患者的病历。33例患者(18.9%)出现TFND。我们在磁共振成像(MRI)图像中使用两条假想线来确定腮腺内肿瘤的位置(上/下或前/后)。然后我们研究了TFND与以下临床因素的相关性:患者年龄、肿瘤大小、组织病理学诊断以及肿瘤在腮腺内的位置(浅叶/深叶;上部/下部;前部/后部)。
与位于腮腺下部、后部或浅叶的肿瘤相比,位于腮腺上部、前部或深叶的肿瘤发生TFND的发生率在统计学上更高(分别为P<0.001、<0.001、<0.01)。经逐步多因素回归分析,如果肿瘤位于上部、前部或深叶,TFND风险的优势比显著升高。其他因素,包括患者年龄、肿瘤大小、肿瘤组织病理学以及外科医生经验不足,均不是TFND的明显风险因素。
位于腮腺上部、前部或深叶的肿瘤发生TFND的风险较高。我们使用的两条假想线被证明有助于确定肿瘤位置,最终确定TFND的风险。