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  

Comparison of two approach for facial nerve surgery on facial nerve injury in the parotid benign tumor

作　　者：吕继连[1] 张瑞[1] 张帅[2] 

机构地区：[1]郑州大学附属郑州中心医院头颈外科,郑州450007 [2]郑州大学附属郑州中心医院神经电生理科

出　　处：《临床耳鼻咽喉头颈外科杂志》2017年第6期456-460,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

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(P<0.05)。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。Objective：To compare the function of facial nerves in patients with parotid benign tumors underwent surgery with retrograde method to expose nerve trunk or the marginal mandibular branch.Method：Fifty-five hospital patients from March 2013 to september 2015 were involved in this study and divided into group A（facial nerve trunk exposure,27cases）,B group（facial nerve mandible branch exposure,28cases）.Facial nerve injury in two groups was evaluated by observation of abnormal facial performance and electrophysiological techniques.Result：After a follow up of 1year,the postoperative incidence of facial nerve injury in group A and group B were7.41%and 25%,respectively,which was evaluated by observation of abnormal facial performance.Moreover,the rates were 14.81%,30.29%,respectively,which was evaluated by electrophysiological techniques.The rate of postoperative facial nerve injury in group B of patients with was significantly higher than that of group A（P〈0.05）.Conclusion：Operation with facial nerve trunk exposure can obviously reduce the occurrence of symptoms of facial paralysis in diameter5cm of the parotid benign tumor surgery,is suitable for clinical application.

关 键 词：腮腺良性肿瘤 面神经 神经电生理 面神经损伤 

分 类 号：R745.1[医药卫生—神经病学与精神病学]