腮腺良性肿瘤2种解剖面神经术式术后面神经损伤的临床研究

发布时间：2018-02-02 14:53

本文关键词： 腮腺良性肿瘤面神经神经电生理面神经损伤　出处：《临床耳鼻咽喉头颈外科杂志》2017年06期 　论文类型：期刊论文

【摘要】：目的:比较解剖面神经总干及面神经下颌缘支两种解剖显露面神经的术式对腮腺良性肿瘤术后面神经功能的影响。方法:将我院头颈外科2013-03-2015-09期间住院的55例腮腺良性肿瘤患者分为A组(解剖面神经总干)27例、B组(解剖面神经下颌缘支)28例,分别采用解剖面神经总干及分支的术式行肿瘤切除,采取主观及客观的评价方法,主观采用观察法,客观采用神经电生理的检测方法,比较两组患者术后面瘫及神经传导速度改变情况。结果:术后随访12个月,主观检测A组和B组2种解剖面神经的术式术后发生面神经损伤的概率分别为7.41%、25%,客观检测为14.81%、39.29%,B组患者的术后面神经损伤程度明显高于A组(P0.05)。结论:在直径5cm的腮腺良性肿瘤手术,采用解剖显露面神经总干的术式可明显减少面瘫症状的发生,具有很高的临床应用价值。
[Abstract]:Objective: to compare the effects of dissecting facial nerve and mandibular marginal branch of facial nerve on the function of facial nerve after parotid benign tumor. Fifty-five patients with benign parotid tumors who were hospitalized in our hospital during 2013-03-2015-09 in head and neck surgery were divided into group A (Group A). 27 cases of total facial nerve trunk were dissected. Group B (28 cases with mandibular marginal branch of anatomic facial nerve) were treated with total anatomical facial nerve trunk and branch operation respectively. Subjective and objective evaluation method and subjective observation method were adopted. Objective to compare the changes of facial paralysis and nerve conduction velocity between the two groups by the method of nerve electrophysiology. Results: the follow-up was 12 months. The probability of facial nerve injury in group A and group B were 7.41 and 25, respectively. Objective detection was 14.81% and 39.29% respectively. The degree of posterior nerve injury in group B was significantly higher than that in group A (P 0.050.Conclusion: in parotid benign tumor with diameter of 5 cm), the degree of nerve injury was significantly higher than that in group A. The operation of dissecting the total trunk of facial nerve can obviously reduce the occurrence of symptoms of facial paralysis and has high clinical application value.
【作者单位】：郑州大学附属郑州中心医院头颈外科;郑州大学附属郑州中心医院神经电生理科;
【分类号】：R739.8
【正文快照】： 腮腺肿瘤是口腔颌面部的常见肿瘤之一,约占涎腺肿瘤的80%[1],多位于腮腺浅叶,为良性肿瘤,手术是其主要的治疗方法[2]。腮腺肿瘤切除需解剖面神经,术后面瘫是最常见的并发症[3]。腮腺手术中对面神经的解剖,临床医师往往根据自己的习惯,分别采用由面神经总干解剖至分支的直接解

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