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局部麻醉下无区域阻滞且借助肌电图面神经监测的腮腺部分切除术——病例报告

Partial Parotidectomy under Local Anaesthesia without Regional Block Assisted by Electromyographic Facial Nerve Monitoring - A Case Report.

作者信息

Girotto Riccardo, De Feudis Francesco, Balercia Paolo

机构信息

Division of Maxillofacial Surgery, Department of Neurological Sciences, University Hospitals of Ancona, Ancona, Italy.

出版信息

Ann Maxillofac Surg. 2023 Jan-Jun;13(1):127-129. doi: 10.4103/ams.ams_89_22. Epub 2023 Jul 25.

DOI:10.4103/ams.ams_89_22
PMID:37711536
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10499286/
Abstract

THE RATIONALE

This study describes a partial parotidectomy (PP) under local anaesthesia (LA) without regional block (LAwRB) assisted by electromyographic monitoring of the facial nerve, to consolidate the feasibility, efficacy and safety of these procedures without general anaesthesia (GA).

PATIENT CONCERNS

An 82-year-old with a lump in the left parotid gland suspected for non-Hodgkin lymphoma (NHL) needed a histological examination to start chemotherapy.

DIAGNOSIS AND TREATMENTS

Because of multiple comorbidities, the authors performed a PP under LAwRB electromyographically guided by the NIM Vital (Medtronic)™.

OUTCOMES

The procedure was quick and did not require conversion to GA. The histopathological examination confirmed the NHL. No haematoma, sialocoele, earlobe numbness and transient or permanent facial palsy were observed.

TAKE-AWAY LESSONS: The electrophysiologic monitoring of the facial nerve improves the efficacy, safety and feasibility of parotid surgery under LA, avoiding adverse effects of GA, need of regional block and reducing hospital stay.

摘要

理论依据

本研究描述了在局部麻醉（LA）且无区域阻滞（LAwRB）的情况下，在面神经肌电图监测辅助下进行的腮腺部分切除术（PP），以巩固这些无全身麻醉（GA）手术的可行性、有效性和安全性。

患者情况

一名82岁的左侧腮腺肿块患者怀疑患有非霍奇金淋巴瘤（NHL），需要进行组织学检查以开始化疗。

诊断与治疗

由于多种合并症，作者在NIM Vital（美敦力）™肌电图引导下进行了LAwRB下的PP。

结果

手术过程迅速，无需转为GA。组织病理学检查确诊为NHL。未观察到血肿、涎瘘、耳垂麻木以及短暂或永久性面瘫。

经验教训

面神经的电生理监测提高了LA下腮腺手术的有效性、安全性和可行性，避免了GA的不良反应、区域阻滞的需求并缩短了住院时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8155/10499286/0b587c226b01/AMS-13-127-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8155/10499286/d34f057b40d2/AMS-13-127-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8155/10499286/9f5e66eac417/AMS-13-127-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8155/10499286/a49d9afb88cb/AMS-13-127-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8155/10499286/0b587c226b01/AMS-13-127-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8155/10499286/d34f057b40d2/AMS-13-127-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8155/10499286/9f5e66eac417/AMS-13-127-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8155/10499286/a49d9afb88cb/AMS-13-127-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8155/10499286/0b587c226b01/AMS-13-127-g004.jpg

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