Laccourreye H, Laccourreye O, Cauchois R, Jouffre V, Ménard M, Brasnu D
Department of Otolaryngology-Head and Neck Surgery, Laënnec Hospital, University Paris V, France.
Laryngoscope. 1994 Dec;104(12):1487-94. doi: 10.1288/00005537-199412000-00011.
A 25-year experience with total conservative parotidectomy for primary benign pleomorphic adenoma (PBPA) of the parotid gland in a consecutive series of 229 patients has been reviewed. This study focuses on survival, morbidity, PBPA recurrence, postoperative facial nerve dysfunction, and Frey's syndrome. Surgical death was never encountered in this study. The overall incidence for postoperative hemorrhage, hematoma, seroma, skin necrosis, great auricular nerve schwannoma, and keloid scar was 1.7%, 6.1%, 4.8%, 0.9%, 15.7%, and 8.3%, respectively. Five-, 10-, 15-, and 20-year PBPA control actuarial rate was 99.6%. The overall incidence for temporary facial paresis and paralysis was 64.6% and 5.6%, respectively. Kaplan-Meier actuarial analysis demonstrated that paresis recovery was noted until the eighteenth postoperative month. The overall incidence for permanent facial paresis and paralysis was 3.9% and 0%, respectively. None of the following variables--sex, age, PBPA size, PBPA location, PBPA contact with the facial nerve, inadvertent PBPA spillage, or surgeon's experience--was statistically related to PBPA recurrence and facial nerve dysfunction. The overall incidence for Frey's syndrome was 65.9%. Kaplan-Meier actuarial analysis demonstrated the need for a minimal 5-year follow-up to assess Frey's syndrome incidence. The mean age was statistically lower in patients presenting with Frey's syndrome.
回顾了对连续229例腮腺原发性良性多形性腺瘤（PBPA）患者进行腮腺全保守切除术的25年经验。本研究聚焦于生存率、发病率、PBPA复发、术后面神经功能障碍及味觉出汗综合征。本研究中未出现手术死亡情况。术后出血、血肿、血清肿、皮肤坏死、耳大神经神经鞘瘤及瘢痕疙瘩的总体发生率分别为1.7%、6.1%、4.8%、0.9%、15.7%和8.3%。PBPA的5年、10年、15年和20年控制精算率为99.6%。暂时性面瘫和永久性面瘫的总体发生率分别为64.6%和5.6%。Kaplan-Meier精算分析表明，术后第18个月时可见面瘫恢复。永久性面瘫和永久性麻痹的总体发生率分别为3.9%和0%。以下变量——性别、年龄、PBPA大小、PBPA位置、PBPA与面神经的接触、PBPA意外溢出或外科医生的经验——均与PBPA复发及面神经功能障碍无统计学关联。味觉出汗综合征的总体发生率为65.9%。Kaplan-Meier精算分析表明，评估味觉出汗综合征发生率至少需要5年的随访。出现味觉出汗综合征的患者平均年龄在统计学上较低。
