Stodulski Dominik, Skorek Andrzej, Mikaszewski Bogusław, Wiśniewski Piotr, Stankiewicz Czesław
Department of Otolaryngology, Medical University of Gdańsk, ul. Smoluchowskiego 17, 80-214, Gdańsk, Poland,
Eur Arch Otorhinolaryngol. 2015 Sep;272(9):2445-50. doi: 10.1007/s00405-014-3196-y. Epub 2014 Jul 9.
Dysfunction of the facial nerve is a common complication of parotidectomy. The functional deficit may be total or partial, and may include all or a single branch of the nerve. Despite a wide variety of the facial nerve grading systems, most of them have a limited utility in patients after parotidectomy. Therefore, existing scales assessing facial nerve function are compared to describe facial nerve outcomes after parotidectomy. The regional House-Brackmann, Sydney, and Yanagihara classification systems were utilized. The post-parotidectomy facial nerve grading system (PPFNGS) was created based on these three grading systems and also used for this study. The facial nerve function was assessed and recorded on the first postoperative day following conservative parotidectomy in 200 patients using all 4 scales by 3 otolaryngologists. The validity of the PPFNGS and existing facial nerve grading systems was examined by assessment of interrater agreement, intraclass correlation coefficient, internal consistency and construct validity. A deficit in the facial nerve function was found in 54 patients (27 %). Although results were consistent in all tested scales, the PPFNGS had a higher interrater agreement than the other three scales. PPFNGS is a new grading system designed for assessing the facial nerve function after parotidectomy in a quantitative and qualitative way and has a higher interrater agreement than other scales used to examine function of the 7th nerve.
面神经功能障碍是腮腺切除术常见的并发症。功能缺损可能是完全性或部分性的，可能累及神经的所有分支或单一分支。尽管有各种各样的面神经分级系统，但大多数在腮腺切除术后患者中的实用性有限。因此，对现有的评估面神经功能的量表进行比较，以描述腮腺切除术后的面神经结果。采用了区域House - Brackmann、悉尼和柳原分类系统。基于这三种分级系统创建了腮腺切除术后面神经分级系统（PPFNGS），并用于本研究。3位耳鼻喉科医生使用所有4种量表，对200例接受保守性腮腺切除术的患者术后第1天的面神经功能进行了评估和记录。通过评估评分者间一致性、组内相关系数、内部一致性和结构效度，检验了PPFNGS和现有面神经分级系统的有效性。54例患者（27%）存在面神经功能缺损。虽然所有测试量表的结果一致，但PPFNGS的评分者间一致性高于其他三种量表。PPFNGS是一种新的分级系统，旨在以定量和定性的方式评估腮腺切除术后的面神经功能，并且其评分者间一致性高于用于检查第7对脑神经功能的其他量表。
