Chen Su, Huang Yun-Cong, Su Ze-Kang, Yang Fan, Lubamba Grace Paka, Gupta Anand, Alkebsi Khaled, Zhang Zhi-Yan, Zhang Zhuang, Xia Hui, Zhang Yong-Qing, Li Chun-Jie, Xuan Ming, Tang Xiu-Fa, Zhu Gui-Quan
State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China.
School of Public Health, Chengdu Medical College, Chengdu, 610500, China.
Clin Oral Investig. 2025 Jan 7;29(1):49. doi: 10.1007/s00784-024-06118-y.
This study investigates the clinical and patient-reported outcomes of full-endoscopic parotidectomy compared to the conventional approach.
Between July 2021 and December 2023, patients who underwent parotidectomy were prospectively enrolled and assigned to either the full-endoscopic parotidectomy group (Group I) or the conventional surgery group (Group II). Clinical outcomes were evaluated, and patient-reported outcomes were assessed using a Visual Analogue Scale and five FACE-Q scales.
A total of 293 patients were prospectively included, with 146 in the full-endoscopic group and 147 in the conventional group. Blood loss was significantly lower in the full-endoscopic group (regression coefficient, 0.61; 95% CI, 0.15 to 1.07), as was the rate of immediate facial paralysis (0.76; 95% CI, 0.25 to 1.27). The full-endoscopic group also showed superior outcomes on the Visual Analogue Scale (- 0.14; 95% CI, - 0.23 to - 0.05) and FACE-Q scales for Appearance-Related Psychosocial Distress (1.15; 95% CI, 0.59 to 1.71), Social Function (- 0.37; 95% CI, - 0.59 to - 0.15), Satisfaction with Facial Appearance (- 0.44; 95% CI, - 0.64 to - 0.23), Psychological Function (- 0.39; 95% CI, - 0.58 to - 0.20), and Satisfaction With Outcome (- 0.42; 95% CI, - 0.66 to - 0.19).
Full-endoscopic parotidectomy yields less blood loss and a reduced incidence of immediate facial paralysis compared to conventional surgery. Patients undergoing full-endoscopic parotidectomy reported better aesthetic and psychological outcomes.
The combined analysis of clinical and patient-reported outcomes is valuable in guiding surgical planning. These findings provide valuable insights for patients considering full-endoscopic parotidectomy and underscore the importance of addressing functional, aesthetic, and psychological aspects for both patients and healthcare providers.
本研究调查全内镜下腮腺切除术与传统手术方法相比的临床及患者报告结局。
在2021年7月至2023年12月期间，前瞻性纳入接受腮腺切除术的患者，并将其分为全内镜下腮腺切除术组（I组）或传统手术组（II组）。评估临床结局，并使用视觉模拟量表和五个面部质量量表评估患者报告结局。
共前瞻性纳入293例患者，全内镜组146例，传统组147例。全内镜组的失血量显著更低（回归系数，0.61；95%可信区间，0.15至1.07），即刻面瘫发生率也更低（0.76；95%可信区间，0.25至1.27）。全内镜组在视觉模拟量表（-0.14；95%可信区间，-0.23至-0.05）以及面部质量量表的外貌相关心理困扰（1.15；95%可信区间，0.59至1.71）、社会功能（-0.37；95%可信区间，-0.59至-0.15）、对面部外貌的满意度（-0.44；95%可信区间，-0.64至-0.23）、心理功能（-0.39；95%可信区间，-0.58至-0.20）和对结局的满意度（-0.42；95%可信区间，-0.66至-0.19）方面也显示出更好的结局。
与传统手术相比，全内镜下腮腺切除术失血量更少，即刻面瘫发生率更低。接受全内镜下腮腺切除术的患者报告了更好的美学和心理结局。
临床及患者报告结局的综合分析对指导手术规划很有价值。这些发现为考虑接受全内镜下腮腺切除术的患者提供了有价值的见解，并强调了对患者和医疗服务提供者而言解决功能、美学和心理方面问题的重要性。
