腮腺良性肿瘤手术后的面神经并发症

Facial nerve morbidity following surgery for benign parotid tumours.

作者信息

Musani Mohammad Ayub, Zafar Abbas, Suhail Zahid, Malik Shoukat, Mirza Daud

机构信息

Department of ENT, Karachi Medical and Dental College, Karachi.

Department of ENT, Ziauddin University Hospital, Karachi.

出版信息

J Coll Physicians Surg Pak. 2014 Aug;24(8):569-72.

DOI:
Abstract

OBJECTIVE

To determine the frequency and severity of facial nerve dysfunction following surgery for benign parotid gland tumours.

STUDY DESIGN

A case series.

PLACE AND DURATION OF STUDY

ENT Department, Karachi Medical and Dental College and Abbasi Shaheed Hospital and Ziauddin University Hospital, from 1990 to 2010.

METHODOLOGY

Data was collected of all patients who were surgically managed for benign parotid tumours from 1990 to 2010. Data was reviewed for presentation of tumour, age and gender of the patient, site of tumour, nature and morphology of the tumour, primary or recurrent, surgical procedure adopted and the complications of the surgery especially the facial nerve dysfunction, its severity, complete or partial paresis and transient or permanent and time of recovery. RESULTS were described as frequency percentages.

RESULTS

Out of 235 patients, 159 (67.65%) were female and 76 (32.35%) were male. Age ranged from 18 to 70 years. Pleomorphic adenoma was the most common tumour (n=194, 82.6%), followed by Warthin's tumour. Superficial parotidectomy was done in 188 cases and extended parotidectomy in 47 cases. In the immediate postoperative period facial nerve function was normal in 169 (72%) patients and nerve dysfunction was observed in 66 (28%) patients. Complete paresis involving all the branches of facial nerve was seen in 25 (10.6%) patients and 41 (17.4%) patients were having incomplete dysfunction. Of these, 62 (26.3%) recovered and 04 (1.7%) had permanent facial nerve dysfunction. Marginal mandibular branch of facial nerve was involved in 57 (86.3%) cases.

CONCLUSION

The frequency of temporary and permanent facial nerve dysfunction was 26.3% and 1.7% respectively in 235 consecutive parotidectomies for benign parotid gland tumours. Higher frequency of facial nerve dysfunction was found in recurrent and deep lobe tumours.

摘要

目的

确定腮腺良性肿瘤手术后面神经功能障碍的发生率及严重程度。

研究设计

病例系列研究。

研究地点及时间

1990年至2010年期间,卡拉奇医科大学牙科学院、阿巴西·谢赫德医院及齐亚乌丁大学医院耳鼻喉科。

方法

收集1990年至2010年期间接受腮腺良性肿瘤手术治疗的所有患者的数据。回顾数据,内容包括肿瘤表现、患者年龄和性别、肿瘤部位、肿瘤性质和形态、原发性或复发性、采用的手术方式以及手术并发症,尤其是面神经功能障碍、其严重程度、完全或部分麻痹、短暂或永久性以及恢复时间。结果以频率百分比描述。

结果

235例患者中,159例(67.6%)为女性,76例(32.4%)为男性。年龄范围为18至70岁。多形性腺瘤是最常见的肿瘤(n = 194,82.6%),其次是沃辛瘤。188例行浅叶腮腺切除术,47例行扩大腮腺切除术。术后即刻,169例(72%)患者面神经功能正常,66例(28%)患者出现神经功能障碍。25例(10.6%)患者出现累及面神经所有分支的完全麻痹,41例(17.4%)患者存在不完全功能障碍。其中,62例(26.3%)恢复,4例(1.7%)出现永久性面神经功能障碍。面神经下颌缘支受累57例(86.3%)。

结论

在235例连续的腮腺良性肿瘤腮腺切除术中,暂时性和永久性面神经功能障碍的发生率分别为26.3%和1.7%。复发性和深叶肿瘤中面神经功能障碍的发生率更高。

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