Department of Maxillofacial Surgery, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China.
The Central Laboratory of The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China.
Int J Oral Maxillofac Surg. 2019 Jul;48(7):895-901. doi: 10.1016/j.ijom.2019.01.030. Epub 2019 Mar 11.
The purpose of this study was to compare the complications of patients treated for a benign parotid tumour (BPT) by extracapsular dissection (ECD) vs. partial superficial parotidectomy (PSP). A comprehensive literature investigation was conducted by searching electronic databases. A systematic review and meta-analysis of comparative studies were performed to assess ECD and PSP for the treatment of BPTs with fixed-effects models. The outcomes analysed were transient or permanent facial nerve injury, Frey syndrome, recurrence rate, infection, and salivary fistula/sialocele. A total of 1641 patients from seven studies (1120 ECD-treated and 521 PSP-treated patients) were included in this meta-analysis. Transient facial nerve injury (odds ratio (OR)=0.28, 95% confidence interval (CI): 0.11-0.71; p=0.008) and Frey syndrome (OR=0.12, 95% CI: 0.03-0.48; p=0.003) were less prevalent in the ECD group. The rates of permanent facial nerve injury (OR=0.77, 95% CI: 0.35-1.70; p=0.520), recurrence rate (OR=0.17, 95% CI: 0.02-1.75; p=0.14), infection (OR=0.70, 95% CI: 0.07-6.67; p=0.76), and salivary fistula/sialocele (OR=0.40, 95% CI: 0.06-2.66; p=0.350) were similar in both groups. Although there was a trend that ECD showed a reduced risk for complications, the present results are not sufficient to conclude that ECD is more beneficial than PSP.
本研究旨在比较囊外解剖(ECD)与部分腮腺浅叶切除术(PSP)治疗腮腺良性肿瘤(BPT)患者的并发症。通过检索电子数据库进行了全面的文献调查。采用固定效应模型对 ECD 和 PSP 治疗 BPT 的比较研究进行了系统评价和荟萃分析。分析的结果是暂时或永久性面神经损伤、Frey 综合征、复发率、感染和涎瘘/涎肿。这项荟萃分析共纳入了 7 项研究的 1641 例患者(1120 例 ECD 治疗和 521 例 PSP 治疗)。ECD 组暂时性面神经损伤(比值比(OR)=0.28,95%置信区间(CI):0.11-0.71;p=0.008)和 Frey 综合征(OR=0.12,95%CI:0.03-0.48;p=0.003)的发生率较低。ECD 组永久性面神经损伤的发生率(OR=0.77,95%CI:0.35-1.70;p=0.520)、复发率(OR=0.17,95%CI:0.02-1.75;p=0.14)、感染率(OR=0.70,95%CI:0.07-6.67;p=0.76)和涎瘘/涎肿(OR=0.40,95%CI:0.06-2.66;p=0.350)与 PSP 组相似。尽管 ECD 有降低并发症风险的趋势,但目前的结果还不足以得出 ECD 比 PSP 更有益的结论。