经口腔前庭入路腔镜甲状腺术后下颌感觉功能障碍研究现状及展望  

Research status and prospect of mandibular sensory dysfunction after transoral endoscopic thyroidectomy vestibular approach

作　　者：孙一鸣 吴峰[1] 王松[1] 夏长军[1] SUN Yiming;WU Feng;WANG Song;XIA Changjun(Department of General Surgery Ward 1,The First Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450099,P.R.China;The First Clinical Medical College of Henan University of Traditional Chinese Medicine,Zhengzhou 450046,P.R.China)

机构地区：[1]河南中医药大学第一附属医院普外一区,郑州450099 [2]河南中医药大学第一临床医学院,郑州450046

出　　处：《中国普外基础与临床杂志》2024年第8期1012-1018,共7页Chinese Journal of Bases and Clinics In General Surgery

基　　金：河南省中医药科学研究专项课题(项目编号:2023ZY2011);国家中医优势专科建设项目[国中医药医政函(2024)90号]。

摘　　要：目的总结经口腔前庭入路腔镜甲状腺手术(transoral endoscopic thyroidectomy vestibular approach,TOETVA)后下颌感觉功能障碍的研究现状,探讨其潜在的治疗方法和现存的问题,为未来的临床治疗或研究提供思路与方法。方法检索国内外关于TOETVA手术后周围神经损伤及其治疗方法的文献并进行综述。结果颏神经损伤被认为是TOETVA术后下颌感觉功能障碍的主要原因,因缺乏统一的定义和评估标准,真实的发生情况尚不清楚。为减少颏神经损伤风险,采用颏神经显露法、口腔前庭联合入路对术中保护颏神经有一定优势。在治疗方面,有一些促进神经修复的方法值得关注,包括B族维生素、神经生长因子、物理疗法等。此外,一些中医辅助治疗对促进神经再生也有一定效果。结论术中应尽量避免颏神经及下颌组织损伤,对主诉明显的患者术后应积极治疗,制定客观、量化的下颌感觉功能障碍评价标准,以多学科的方式寻找一个有效的临床方案可能是未来的研究方向。Objective To summarize the research status of mandibular sensory dysfunction after transoral endoscopic thyroidectomy vestibular approach(TOETVA),and explore its potential treatment methods and existing problems,and provide ideas and methods for future clinical treatments or research.Method The domestic and foreign literatures about peripheral nerve injury and its treatment after TOETVA were searched and reviewed.Results Mental nerve injury was considered to be the main cause of mandibular sensory dysfunction after TOETVA.Due to the lack of unified definitions and assessment standards,the true incidence remained unclear.In order to reduce the risk of mental nerve injury,methods such as exposing the mental nerve and combining vestibular approaches during surgery had certain advantages.In terms of treatment,several methods promoting nerve repair were noteworthy,including B vitamins,nerve growth factors,physical therapy and so on.In addition,some auxiliary treatments of Traditional Chinese Medicine also showed effectiveness in promoting nerve regeneration.Conclusions It is essential to avoid damage to the mental nerve and mandibular tissues during surgery.For patients with significant complaints postoperatively,active treatment should be pursued.Establishing objective and quantifiable standards for evaluating mandibular sensory dysfunction and seeking effective clinical plans through a multidisciplinary approach may be the direction for future research.

关 键 词：经口入路腔镜甲状腺手术 并发症 感觉功能障碍 颏神经 周围神经损伤 

分 类 号：R653[医药卫生—外科学]