Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, No. 1, Shuaifuyuan Road, Dongcheng District, Beijing, People's Republic of China.
Eur Arch Otorhinolaryngol. 2020 Jul;277(7):2011-2015. doi: 10.1007/s00405-020-05930-y. Epub 2020 Mar 25.
Styloidectomy is the mainstream treatment for Eagle's syndrome when conservative treatment fails. However, the clinical efficacy of tonsil-sparing styloidectomy remains controversial. This study aimed to evaluate postoperative pain after tonsil-sparing styloidectomy in patients with Eagle's syndrome.
This retrospective study enrolled 14 patients who underwent tonsil-sparing styloidectomy (TSS group) and 22 patients who underwent traditional tonsillect-styloidectomy (TTS group). Pain was evaluated using the 11-point numeric rating scale (NRS-11) at the following time points: on admission, 1 day after the operation, 3 days, postoperatively, 1 week postoperatively, 2 weeks, postoperatively, and 3 months, postoperatively.
The postoperative course was uneventful in both groups. Pain with movement was significantly reduced 3 months, postoperatively (1.28 ± 1.1), compared with the preoperative baseline level (4.78 ± 0.9) (P < 0.001). There was no significant difference in the rate at which pain decreased between the TSS group (n = 9/14; 64.3%) and the TTS group (n = 17/22; 77.3%) (P = 0.396). One week postoperatively, resting pain in the TSS group (4.36 ± 0.7) was significantly lower than that in the TTS group (5.41 ± 0.8) (P = 0.001); pain with movement in the TSS group (5.00 ± 0.8) was significantly lower than that in the TTS group (5.86 ± 0.7) (P = 0.002). Two weeks postoperatively, resting pain in the TSS group (1.14 ± 0.4) was also significantly lower than that in the TTS group (1.73 ± 0.6) (P = 0.003).
Tonsil-sparing styloidectomy is a safe and effective modality for treating Eagle's syndrome. Although there was no significant difference in surgical risk or long-term outcomes between tonsil-sparing styloidectomy and traditional tonsillect-styloidectomy, tonsil-sparing styloidectomy can alleviate perioperative pain.
对于保守治疗失败的鹰钩综合征，茎突切除术是主流治疗方法。然而，扁桃体保留茎突切除术的临床疗效仍存在争议。本研究旨在评估鹰钩综合征患者扁桃体保留茎突切除术后的术后疼痛。
本回顾性研究纳入了 14 例行扁桃体保留茎突切除术（TSS 组）和 22 例行传统扁桃体切除术-茎突切除术（TTS 组）的患者。采用 11 点数字评分量表（NRS-11）评估以下时间点的疼痛：入院时、术后 1 天、术后 3 天、术后 1 周、术后 2 周、术后 3 个月。
两组患者的术后过程均顺利。与术前基线水平（4.78±0.9）相比，术后 3 个月时运动时的疼痛明显减轻（1.28±1.1）（P<0.001）。TSS 组（n=9/14；64.3%）和 TTS 组（n=17/22；77.3%）的疼痛减轻率无显著差异（P=0.396）。术后 1 周时，TSS 组的静息疼痛（4.36±0.7）明显低于 TTS 组（5.41±0.8）（P=0.001）；TSS 组的运动时疼痛（5.00±0.8）明显低于 TTS 组（5.86±0.7）（P=0.002）。术后 2 周时，TSS 组的静息疼痛（1.14±0.4）也明显低于 TTS 组（1.73±0.6）（P=0.003）。
扁桃体保留茎突切除术是治疗鹰钩综合征的一种安全有效的方法。虽然扁桃体保留茎突切除术与传统扁桃体切除术-茎突切除术在手术风险或长期结果方面无显著差异，但扁桃体保留茎突切除术可减轻围手术期疼痛。
