Markey Jeff D, Morrel William G, Wang Steven J, Ryan William R
Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, CA, USA.
University of California-San Francisco, San Francisco, CA, USA.
Auris Nasus Larynx. 2018 Feb;45(1):123-127. doi: 10.1016/j.anl.2017.03.005. Epub 2017 Apr 24.
Compare the presence and degree of postoperative xerostomia following preservation or excision of the submandibular gland (SMG) during level IB neck dissection (ND) without adjuvant radiation.
Retrospective review with patient questionnaire administered to patients with pT1-2N0 oral squamous cell carcinoma (SCC) who underwent resection and ND with SMG preservation or SMG excision without postoperative radiation from 2011 to 2015. We analyzed an additional control group that was age and gender-matched and had not undergone oral resection or SMG excision. We compared the scores reported by the three groups from three questionnaires: University of Michigan Xerostomia Quality of Life (XeQoL), Short Form-8 (SF-8), and a xerostomia severity scale (XSS). Dry mouth severity (DMS) was calculated based on XSS scores among those complaining of any xerostomia.
Eleven SMG preservation group, 14 SMG excision group and 15 control group patients completed the survey. Complication and recurrence rates were comparable among experimental groups. No differences were identified between the two experimental groups for the XeQoL, SF-8, and XSS questionnaires (p=0.96, 0.87, 0.7). Control patients reported less xerostomia on XeQoL (p=0.046) and XSS (p=0.01) compared to the experimental groups combined with no statistical difference in SF-8 scores (p=0.25). No patients in either group developed regional recurrence in level IB.
SMG preservation, though technically and oncologically sound, does not appear in this study to reduce xerostomia. Oral resection with ND may result in some degree of xerostomia perception.
比较在未进行辅助放疗的IB区颈部清扫术（ND）期间保留或切除下颌下腺（SMG）后口干症的发生情况及程度。
对2011年至2015年间接受切除手术及ND且保留SMG或切除SMG但未进行术后放疗的pT1-2N0口腔鳞状细胞癌（SCC）患者进行回顾性研究，并通过患者问卷调查进行分析。我们另外分析了一个年龄和性别匹配且未接受口腔切除或SMG切除的对照组。我们比较了三组患者在三份问卷上的得分：密歇根大学口干症生活质量问卷（XeQoL）、简短健康调查问卷（SF-8）和口干症严重程度量表（XSS）。根据XSS得分计算有任何口干症状患者的口干严重程度（DMS）。
11名SMG保留组、14名SMG切除组和15名对照组患者完成了调查。实验组之间的并发症和复发率相当。在XeQoL、SF-8和XSS问卷方面，两个实验组之间未发现差异（p = 0.96、0.87、0.7）。与合并的实验组相比，对照组患者在XeQoL（p = 0.046）和XSS（p = 0.01）上报告的口干症状较少，而在SF-8得分上无统计学差异（p = 0.25）。两组中均无患者在IB区出现区域复发。
在本研究中，尽管从技术和肿瘤学角度来看保留SMG是合理的，但似乎并不能减少口干症。口腔切除联合ND可能会导致一定程度的口干感觉。
