Tirelli Giancarlo, Bergamini Pier Riccardo, Scardoni Alessandro, Gatto Annalisa, Boscolo Nata Francesca, Marcuzzo Alberto Vito
Hospital of Cattinara, University of Trieste, Ear, Nose, and Throat Clinic, Head and Neck Department, Trieste, Italy.
Struttura semplice di Deontologia e responsabilità professionale - Azienda Sanitaria Universitaria Integrata di Trieste - ASUITS, Trieste, Italy.
Head Neck. 2018 May;40(5):1016-1023. doi: 10.1002/hed.25078. Epub 2018 Feb 1.
The purpose of this study was to assess the efficacy of intraoperative nerve integrity monitoring (NIM) to prevent marginal mandibular nerve injuries during neck dissection.
This prospective study compared 36 patients undergoing NIM-assisted neck dissection from July 2014 to March 2015 to a cohort of 35 patients subjected to neck dissection over an identical period of time before the technique was introduced. We also assessed possible correlations between marginal mandibular nerve injuries and other factors, such as anthropometric measurements, presence of clinical neck metastases, type of neck dissection, and site of primary tumor.
The incidence of marginal mandibular nerve paralyses was significantly lower among the group of patients undergoing NIM-assisted neck dissection (P = .021). There was no significant difference in the duration of the procedure, and the technique resulted in a limited increase of cost. No other factor seemed to influence the onset of marginal mandibular nerve palsy.
In our opinion, NIM is a valuable aid for preventing marginal mandibular nerve injuries during neck dissection.
本研究旨在评估术中神经完整性监测（NIM）在预防颈部清扫术中下颌缘支神经损伤方面的疗效。
这项前瞻性研究将2014年7月至2015年3月期间接受NIM辅助颈部清扫术的36例患者与在该技术引入之前同一时期接受颈部清扫术的35例患者进行了比较。我们还评估了下颌缘支神经损伤与其他因素之间可能存在的相关性，如人体测量学指标、临床颈部转移的存在情况、颈部清扫术的类型以及原发肿瘤的部位。
在接受NIM辅助颈部清扫术的患者组中，下颌缘支神经麻痹的发生率显著较低（P = 0.021）。手术时间没有显著差异，并且该技术导致成本有限增加。没有其他因素似乎影响下颌缘支神经麻痹的发生。
我们认为，NIM是预防颈部清扫术中下颌缘支神经损伤的一项有价值的辅助手段。
