Li Hao, Wu Po, Jiang Ji, Zhao Xiao-Li, Zheng Wei-Yin, Yang Shu-Yong
Dept. of Oral and Maxillofacial Surgery, The General Hospital of Western Theater Command, Chengdu 610021, China.
Hua Xi Kou Qiang Yi Xue Za Zhi. 2020 Feb 1;38(1):37-41. doi: 10.7518/hxkq.2020.01.007.
To propose and evaluate the clinical effect of midpiece facial nerve dissection through transparotid approach in regional parotidectomy.
A total of 136 patients with benign parotid tumors were categorized into three groups according to the way of facial nerve dissection: anterograde dissection from main trunk (anterograde, n=70), retrograde dissection from distal branches (retrograde, n=34), and midpiece dissection through transparotid approach (middle dissection, n=32). Surgery duration, facial nerve injury, salivary fistula, earlobe sensation, Frey's syndrome, and aesthetic evaluation were compared.
The surgery duration in the middle dissection group was significantly shorter than that in the other two groups. The proportion of salivary fistula was higher in the anterograde group (9 cases, 12.9%; P<0.05) compared with that in the other groups. Postoperative facial nerve injury was similar between the middle dissection (1 case, 3.1%) and anterograde groups (3 cases, 4.3%) with lower injury rate compared with the retrograde group (7 cases, 20.6%). The anterograde group had more cases of hypoesthesia of the earlobe (12 cases, 17.1%; P<0.05) than the other two groups. Aesthetic score was higher in the anterograde and middle dissection groups compared with that in the retrograde group (P<0.05).
Midpiece facial nerve dissection is technically feasible and clinically viable in regional parotidectomy.
提出并评估经腮腺入路在区域性腮腺切除术中进行面神经中段解剖的临床效果。
将136例腮腺良性肿瘤患者根据面神经解剖方式分为三组：从主干顺行解剖（顺行组，n = 70）、从远端分支逆行解剖（逆行组，n = 34）以及经腮腺入路进行中段解剖（中段解剖组，n = 32）。比较手术时间、面神经损伤、涎瘘、耳垂感觉、味觉出汗综合征及美学评价情况。
中段解剖组的手术时间显著短于其他两组。顺行组涎瘘比例（9例，12.9%；P<0.05）高于其他组。中段解剖组（1例，3.1%）与顺行组（3例，4.3%）术后面神经损伤情况相似，损伤率低于逆行组（7例，20.6%）。顺行组耳垂感觉减退的病例数（12例，17.1%；P<0.05）多于其他两组。顺行组和中段解剖组的美学评分高于逆行组（P<0.05）。
在区域性腮腺切除术中，面神经中段解剖在技术上可行且临床效果良好。
