Department of Oral and Maxillofacial Surgery, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, China; Department of Oromaxillofacial-Head and Neck Surgery, School of Stomatology, China Medical University, Shenyang, China.
Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, Guangdong, Guangzhou, China.
Am J Otolaryngol. 2021 Mar-Apr;42(2):102893. doi: 10.1016/j.amjoto.2020.102893. Epub 2021 Jan 4.
To evaluate: 1) the efficacy of acellular dermal matrix (ADM) to prevent Frey's syndrome (FS) after superficial parotidectomy of benign tumors. 2) the effect of different follow-up intervals on the incidence of FS.
Fifty-five patients with benign parotid gland tumors underwent superficial parotidectomy were divided into two groups: Non-ADM group (n = 31, 56.3%) and ADM group (n = 24, 43.6%). The primary outcomes measure was the incidence of FS. The secondary outcomes were surgical site depression, infection, salivary sialocele, and salivary fistula. Subjective FS was evaluated using a clinical questionnaire submitted via WeChat at 3, 6, 12, 18, 24, and 32 months postoperatively. Objective FS was evaluated using Minor starch-iodine test at 6 and 12 months postoperatively.
There was a statistically significant difference in the incidence of subjective and objective FS when ADM compared with Non-ADM groups (P<0.05). The respective incidence of subjective FS at 3, 6, 12, 18, 24, and 32 months was 4.2%, 8.3%,20.8%, 20.8%, 20.8%, 20.8% in ADM group and 3.2%, 9.7%, 29%, 38.7%, 45.2% in Non-ADM group. The incidence of objective FS after 6 and 12 months was 4.2%, 8.3% in ADM group and 8.3% (2/24), 38.7% (12/31) in Non-ADM group respectively. Five patients in ADM group and 1 patient in Non-ADM group developed sialocele, and all patients resolved with conservative management. Surgical site depression was significantly higher in the Non-ADM group (15/31) compared with (5/24) in ADM (P=0.049). No cases of immune rejection, infection, hematoma, or salivary fistula were observed in ADM group.
The current study demonstrated that 1) ADM could reduce the incidence of FS in the patients undergoing superficial parotidectomy. 2) the peak onset of about 18 months appear to be acceptable follow-up for the development of FS.
评估 1）脱细胞真皮基质（ADM）预防良性肿瘤腮腺浅叶切除后 Frey 综合征（FS）的疗效。2）不同随访间隔对 FS 发生率的影响。
55 例良性腮腺肿瘤患者行腮腺浅叶切除术，分为两组：非 ADM 组（n = 31，56.3%）和 ADM 组（n = 24，43.6%）。主要结局指标为 FS 的发生率。次要结局为手术部位凹陷、感染、涎液瘘、涎液瘘。术后 3、6、12、18、24 和 32 个月通过微信提交临床问卷评估主观 FS。术后 6 和 12 个月行 Minor 淀粉-碘试验评估客观 FS。
与非 ADM 组相比，ADM 组在主观和客观 FS 的发生率方面有统计学显著差异（P<0.05）。ADM 组术后 3、6、12、18、24 和 32 个月主观 FS 的发生率分别为 4.2%、8.3%、20.8%、20.8%、20.8%和 20.8%，非 ADM 组分别为 3.2%、9.7%、29%、38.7%和 45.2%。ADM 组术后 6 个月和 12 个月客观 FS 的发生率分别为 4.2%、8.3%，而非 ADM 组分别为 8.3%（2/24）和 38.7%（12/31）。ADM 组有 5 例患者和非 ADM 组有 1 例患者发生涎瘘，所有患者均经保守治疗缓解。非 ADM 组手术部位凹陷发生率明显高于 ADM 组（15/31）（P=0.049）。ADM 组未发生免疫排斥、感染、血肿或涎瘘。
本研究表明 1）ADM 可降低腮腺浅叶切除术患者 FS 的发生率。2）约 18 个月的发病高峰似乎是 FS 发展可接受的随访时间。
