Kumar Pankaj, Gupta Ajay, Aggarwal Nitish, Vijay Saurabh, Kumar Pallika
Dept. of E.N.T, Head and Neck surgery, Dr Baba Saheb Ambedkar Medical College and Hospital, Delhi, India.
Dept. of E.N.T, Head and Neck surgery, Dr Baba Saheb Ambedkar Medical College and Hospital, Room no. 2279, Bhagawan Mahavir Marg, Sector 6 Rd, Rohini, Delhi, 110085 India.
Indian J Otolaryngol Head Neck Surg. 2023 Sep;75(3):2000-2005. doi: 10.1007/s12070-023-03690-9. Epub 2023 Apr 24.
Salivary gland tumors represent 3-10% of all head and neck neoplasms. Most of the tumours are benign with parotid gland being most commonly affected. Surgical intervention in the form of parotidectomy forms the mainstay of treatment. Among the various postoperative complications that may occur after parotidectomy, facial nerve weakness is the most dreaded one for both the surgeon as well as the patient. In the literature, the incidence of transient facial weakness after parotid surgery ranges from 10 to 68%, and long-term dysfunction ranges from 0 to 19%. Apart from injury mechanisms such as nerve division, stretch, thermal injuries, ischemia, several other risk factors such as tumour size, disease duration etc. have also been identified for post parotidectomy facial nerve dysfunction which vary considerably from study to study. Thus, facial nerve injury despite being a common and dreaded complication is also a preventable one. We in our institute conducted a retrospective study from January 2018 to December 2021 to evaluate the incidence of facial nerve weakness and possible predictive factors among 60 patients who underwent superficial parotidectomy for benign tumours and found that when it comes to benign tumours surgical technique rather than tumour factors are more important in preventing nerve injury. Undertaking this study was important in order to emphasize the importance of extensive preoperative planning and better surgical practices among budding head and neck surgeons in our country.
涎腺肿瘤占所有头颈部肿瘤的3%-10%。大多数肿瘤是良性的，最常累及腮腺。腮腺切除术形式的手术干预是主要治疗方法。在腮腺切除术后可能发生的各种术后并发症中，面神经麻痹对外科医生和患者来说都是最可怕的。在文献中，腮腺手术后短暂性面神经麻痹的发生率为10%-68%，长期功能障碍的发生率为0%-19%。除了诸如神经切断、牵拉、热损伤、缺血等损伤机制外，还确定了其他一些危险因素，如肿瘤大小、病程等，这些因素在腮腺切除术后面神经功能障碍中的作用因研究而异。因此，面神经损伤尽管是一种常见且可怕的并发症，但也是可以预防的。我们所在机构在2018年1月至2021年12月进行了一项回顾性研究，以评估60例因良性肿瘤接受腮腺浅叶切除术患者的面神经麻痹发生率及可能的预测因素，发现对于良性肿瘤，手术技术而非肿瘤因素在预防神经损伤方面更为重要。开展这项研究很重要，以便强调我国初露头角的头颈外科医生进行广泛术前规划和更好手术操作的重要性。
