腮腺浅叶切除术后感觉丧失：一项前瞻性对照多中心试验。
Sensation loss after superficial parotidectomy: A prospective controlled multicenter trial.
作者信息
Grosheva Maria, Shabli Sami, Volk Gerd Fabian, Sommer Barbara, Ludwig Laura, Finkensieper Mira, Wittekindt Claus, Klussmann Jens Peter, Guntinas-Lichius Orlando, Beutner Dirk
机构信息
Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany.
Department of Otorhinolaryngology, Head and Neck Surgery, Jena University Hospital, Jena, Germany.
出版信息
Head Neck. 2017 Mar;39(3):520-526. doi: 10.1002/hed.24647. Epub 2017 Jan 9.
BACKGROUND
The purpose of this study was to evaluate the occurrence of hypoesthesia after superficial parotidectomy depending on preservation of posterior branch of the great auricular nerve (GAN).
METHODS
This prospective, controlled, double blind, multicenter trial included 130 patients. The posterior branch was preserved in 93 patients (GAN group), and ligated in 33 patients (non-GAN group). In 4 patients, GAN status was unknown. Included patients underwent sensory testing (TouchTest) and subjective evaluation at 6, 12, and 24 months after surgery.
RESULTS
Better improvement of sensation was present in the GAN group. After 12 months, 59% of the patients in the GAN-group showed positive test results in the lobule, versus 24% of the non-GAN group (p = .013). Additionally, after 24 months, 71% of the patients in the GAN-group showed a positive test in the antitragus, versus 31% in the non-GAN group (p = .045). Hypoesthesia equally limited quality of life in both groups (all p > .05).
CONCLUSION
Preservation of the posterior branch of the GAN led to significantly better improvement of sensation in the lobule and antitragus, and should be recommended during parotidectomy. © 2017 Wiley Periodicals, Inc. Head Neck 39: 520-526, 2017.
背景
本研究旨在评估根据耳大神经（GAN）后支的保留情况，腮腺浅叶切除术后感觉减退的发生率。
方法
这项前瞻性、对照、双盲、多中心试验纳入了130例患者。93例患者保留了后支（GAN组），33例患者结扎了后支（非GAN组）。4例患者的GAN情况未知。纳入的患者在术后6个月、12个月和24个月接受感觉测试（触觉测试）和主观评估。
结果
GAN组感觉改善更好。12个月后，GAN组59%的患者耳垂触觉测试结果为阳性，而非GAN组为24%（p = 0.013）。此外，24个月后，GAN组71%的患者对耳屏触觉测试为阳性，而非GAN组为31%（p = 0.045）。感觉减退对两组患者生活质量的限制程度相同（所有p > 0.05）。
结论
保留GAN后支可使耳垂和对耳屏的感觉改善明显更好，腮腺切除术时应推荐保留该神经。© 2017威利期刊公司。《头颈》39: 520 - 526, 2017。
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