van der Lans Rik Johannes Leonardus, Lohuis Peter J F M, van Gorp Joost M H H, Quak Jasper J
Department of ENT & Head and Neck Surgery, Diakonessenhuis, Utrecht, Netherlands.
Department of Pathology, Diakonessenhuis, Utrecht, Netherlands.
Int Arch Otorhinolaryngol. 2019 Jan;23(1):83-87. doi: 10.1055/s-0038-1667006. Epub 2018 Oct 24.
chronic parotitis (CP) is a hindering, recurring inflammatory ailment that eventually leads to the destruction of the parotid gland. When conservative measures and sialendoscopy fail, parotidectomy can be indicated. to evaluate the efficacy and safety of parotidectomy as a treatment for CP unresponsive to conservative therapy, and to compare superficial and near-total parotidectomy (SP and NTP). retrospective consecutive case series of patients who underwent parotidectomy for CP between January 1999 and May 2012. The primary outcome variables were recurrence, patient contentment, transient and permanent facial nerve palsy and Frey syndrome. The categorical variables were analyzed using the two-sided Fisher exact test. Alongside, an elaborate review of the current literature was conducted. a total of 46 parotidectomies were performed on 37 patients with CP. Near-total parotidectomy was performed in 41 and SP in 5 cases. Eighty-four percent of patients was available for the telephone questionnaire (31 patients, 40 parotidectomies) with a mean follow-up period of 6,2 years. Treatment was successful in 40/46 parotidectomies (87%) and 95% of the patients were content with the result. The incidence of permanent and transient facial nerve palsy was 0 (0%) and 12 (26.1%), respectively. Frey syndrome manifested in 20 (43.5%) patients. Neither this study nor careful review of the current literature resulted in evident difference between SP and NTP regarding the primary outcome variables. parotidectomy is a safe and effective treatment for CP in case conservative therapy fails. There is no evidence of a distinct difference between SP and NTP regarding efficiency, facial nerve palsy or Frey syndrome.
慢性腮腺炎（CP）是一种具有阻碍性、反复发作的炎症性疾病，最终会导致腮腺破坏。当保守治疗和唾液腺内镜检查失败时，可考虑进行腮腺切除术。为了评估腮腺切除术作为治疗对保守治疗无反应的CP的疗效和安全性，并比较浅叶腮腺切除术和近全腮腺切除术（SP和NTP）。回顾性连续病例系列研究，纳入1999年1月至2012年5月间因CP接受腮腺切除术的患者。主要结局变量为复发、患者满意度、暂时性和永久性面神经麻痹以及味觉出汗综合征。分类变量采用双侧Fisher精确检验进行分析。同时，对当前文献进行了详细综述。共对37例CP患者进行了46次腮腺切除术。其中41例行近全腮腺切除术，5例行浅叶腮腺切除术。84%的患者可接受电话问卷调查（31例患者，40次腮腺切除术），平均随访期为6.2年。46次腮腺切除术中40次（87%）治疗成功，95%的患者对结果满意。永久性和暂时性面神经麻痹的发生率分别为0（0%）和12例（26.1%）。20例（43.5%）患者出现味觉出汗综合征。无论是本研究还是对当前文献的仔细回顾，均未发现SP和NTP在主要结局变量方面存在明显差异。腮腺切除术对于保守治疗失败的CP是一种安全有效的治疗方法。在疗效、面神经麻痹或味觉出汗综合征方面，没有证据表明SP和NTP之间存在明显差异。
