面神经功能评价方法在不同腮腺术式中的研究  

An Evaluation Study of Facial Nerve Function in Different Parotid Surgical Methods

作　　者：陶峰 何等旗 杜洪亮[2] 于涛[2] 车银富 薛刚 

机构地区：[1]兰州大学口腔医学院,甘肃兰州730000 [2]兰州大学第一医院,甘肃兰州730000

出　　处：《口腔医学研究》2018年第1期52-55,共4页Journal of Oral Science Research

基　　金：甘肃卫生行业科研计划项目(编号:GSWST2010-04)

摘　　要：目的:在腮腺良性病变术中分别使用顺行法和逆行法解剖面神经,术后使用面神经肌电图(ENoG)及House-Brackmann(H-B)量表评价面神经功能损伤;探讨两种面神经解剖术式利弊及引入ENoG检查在评价面神经损伤预后的应用前景。方法:选择2016年4月~2017年5月期间收治于兰州大学第一医院口腔科的36例腮腺单侧良性病变患者,由同一医师于腮腺肿物切除术中分别采用经顺行法或逆行法解剖面神经。随后统计手术时间,面瘫发生情况,面神经恢复时间;使用ENoG结合H-B量表在同一时间点评估两种解剖术式组患者面神经损伤程度;研究两种评价方法之间的相关性。结果:在腮腺良性病变术中顺行法组患者面瘫发生率及面神经恢复时间均少于逆行法组;主观的H-B量表评价与客观的ENoG参数之间存在相关关系。结论:腮腺良性病变术中在面神经主干显露不受干扰的情况下,提倡采用顺行法解剖面神经;建议将ENoG检查引入面神经功能评价系统,作为面神经功能损伤评价的客观指标。Objective：To evaluate facial nerve injury of the anterograde exposing method and the retrograde exposing method of facial nerve in benign lesions of the parotid gland.The facial nerve function（ENoG）and the House-Brackmann（H-B）scale were used to evaluate the extent of the facial nerve injury.To investigate the pros and cons of two surgical methods and evaluate the applicative prospect of ENoG examination in prognosing the outcome of facial nerve injury.Methods：Included in this study were 36 patients with unilateral benign lesions of the parotid gland who were admitted to the Department of Stomatology of the First Hospital of Lanzhou University from April to May 2017.They all received parotidectomy by either anterograde or retrograde method of exposing facial nerve by the same surgeon.The extent of facial nerve injury was evaluated by ENoG and H-B scale,and the correlation between two evaluation methods was studied.Results：The incidence of facial paralysis and facial nerve recovery time were lower in the anterograde group than in the retrograde group.There was a correlation between subjective H-B scale and objective ENoG parameters.Conclusion：Parotidectomy by the anterograde method of exposing facial nerve is superior to the retrograde method with regard to the potentiality of facial nerve injury.It is suggested that ENGG should be introduced into facial nerve function evaluation system as an objective index for evaluating facial nerve injury.

关 键 词：面神经解剖 面神经功能评价 肌电图检查 

分 类 号：R782.2[医药卫生—口腔医学]