腮腺肿瘤术后面神经功能损伤的电生理研究  

Electrophysiology of facial nerve function injury after parotid tumor surgery

作　　者：钱磊[1,2] 张练平[1,2] 贾国栋[1,2] 左莉[1,3] 李旗[1,3] 

机构地区：[1]上海交通大学附属第一人民医院松江分院 [2]上海市松江区中心医院口腔科,上海201600 [3]上海市松江区中心医院神经内科

出　　处：《山西医科大学学报》2014年第9期894-898,共5页Journal of Shanxi Medical University

基　　金：上海市松江区科学技术攻关基金资助项目(2011)

摘　　要：目的比较腮腺肿瘤术后不同年龄组、不同神经分支面神经功能变化的差异。方法选择术前无面瘫、术中瘤体与面神经无粘连、且无误伤面神经的腮腺肿瘤患者纳入研究组,按年龄<50岁、50岁-<60岁、≥60岁分为三组,每组7例。全部病例行保留面神经的腮腺切除术,术后2周行健、患侧颞支、颧支、颊支、下颌缘支神经电图(electroneurography,EN0G)检测,计算患侧波幅损失百分比、潜伏时延长百分比,对不同年龄组、不同神经分支的波幅损失百分比、潜伏时延长百分比进行分析比较,当差异有统计学意义时行多重比较。结果不同年龄组之间波幅损失百分比差异有统计学意义(P<0.05),且<50岁年龄组波幅损失百分比明显低于其他两组;不同神经分支之间波幅损失百分比差异无统计学意义(P>0.05);不同年龄组之间、不同神经分支之间潜伏时延长百分比差异均无统计学意义(P>0.05)。结论腮腺手术中,年龄是影响面神经功能的因素之一,青壮年患者神经功能损失程度低于老年患者;不同神经分支功能损失程度尚无差别。Objective To compare the difference of changes of facial nerve function between different age groups and between different facial nerve branches after parotid tumor surgery.Methods The patients with parotid tumor who had no preoperative facial paralysis,no close contact of tumor with facial nerve,and no incorrect injuries of facial nerve intraoperatively were enrolled in this study and divided into three groups according to the age：＜50 years old group,50-＜60 years old group,≥60 years old group（n =7 in each group）.All of them underwent a conservative parotidectomy with facial nerve preservation.Electroneurographic examination was carried out for facial nerve branches including the temporal branches,zygomatic branches,buccal branches,and marginal mandibular branches on the affected sides and normal sides at 2 week after the operation.The percentages of reduction of evoked potential amplitude and the percentages of extension of latency on the affected sides were calculated according to the value of normal sides and compared between different age groups and between different facial nerve branches.When statistical significant differences were obtained,the multiple comparison was complemented with SNK test.Results Significant difference was obtained in the percentages of reduction of evoked potential amplitude among different age groups（P ＜ 0.05）,and the percentages of reduction of evoked potential amplitude were lower in ＜ 50 years old group than in the other two groups.No significant difference was found in the percentages of reduction of evoked potential amplitude among different facial nerve branches （P ＞ 0.05）,and in the percentages of extension of latency between different age groups and between different facial nerve branches （P ＞ 0.05）.Conclusion The age is one of factors to influence the facial nerve function in parotidectomy.And the degree of loss of facial nerve function of young adults is lower than that of the aged.There is no difference in the degree of loss of facial nerve

关 键 词：腮腺切除术 面神经损伤 肌电描记术 年龄 面神经分支 

分 类 号：R739.8[医药卫生—肿瘤]