沿下颌缘支逆行法解剖面神经对腮腺浅叶良性肿瘤患者术后生活质量的影响

doi:10.19439/j.sjos.2024.05.006

上海口腔医学 ›› 2024, Vol. 33 ›› Issue (5): 476-480.doi: 10.19439/j.sjos.2024.05.006

沿下颌缘支逆行法解剖面神经对腮腺浅叶良性肿瘤患者术后生活质量的影响

王磊, 陈颖溢, 袁青, 潘永海

康复大学青岛中心医院（青岛市中心医院）口腔科, 山东青岛 266042

收稿日期:2024-05-10 修回日期:2024-06-12 出版日期:2024-10-25 发布日期:2024-11-14
通讯作者: 潘永海,E-mail: pan_yonghai163.com
作者简介:王磊（1972-）,男,本科,主治医师 E-mail: wl20231227@163.com
基金资助:
山东省自然科学基金(ZR2020MH188)

Effect of retrograde dissection of the facial nerve along the mandibular margin on postoperative quality of life in patients with benign superficial parotid tumors

WANG Lei, CHEN Ying-yi, YUAN Qing, PAN Yong-hai

Department of Stomatology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences(Qingdao Central Hospital). Qingdao 266042, Shandong Province, China

Received:2024-05-10 Revised:2024-06-12 Online:2024-10-25 Published:2024-11-14

摘要/Abstract

摘要： 目的： 评估沿下颌缘支逆行法解剖面神经对腮腺浅叶良性肿瘤患者术后生活质量的影响。方法： 选择2020年1月—2023年1月在青岛市中心医院接受手术治疗的腮腺浅叶良性肿瘤患者116例。利用摸球法将患者随机分为2组,每组58例。对照组以顺行法解剖面神经,试验组沿下颌缘支逆行法解剖面神经。对比2组患者手术时间、术中出血量、切口长度和住院时间,记录2组患者术后1、3、7、14天的疼痛情况,术后15天及1、3、6个月时评估患者咀嚼功能;通过House-Brackmann面神经功能分级标准(H-B)和瘢痕美容评估与评级量表(scar cosmesis assessment and rating,SCAR)对患者术后3天和6个月的面部神经功能及美观程度进行评价,比较2组患者术前和术后6个月的生活质量,记录并发症（暂时性面瘫、耳周麻木、涎瘘和Frey综合征）发生情况。采用SPSS 28.0软件包对数据进行统计学分析。结果： 试验组手术时间显著高于对照组,术中出血量、切口长度和术后疼痛评分显著低于对照组,咀嚼效率、面神经功能、瘢痕美观度和生活质量显著高于对照组,且并发症发生率更低（P<0.05）。结论： 腮腺浅叶良性肿瘤术中采用沿下颌缘支的逆行法解剖面神经,有助于降低术中出血量和术后疼痛,改善患者生活质量。

关键词: 腮腺肿瘤, 面神经, 下颌缘支, 逆行解剖, 生活质量, 并发症

Abstract: PURPOSE: To assess the impact of retrograde dissection of the facial nerve along the mandibular margin on the postoperative quality of life in patients with benign superficial parotid tumors. METHODS: One hundred and sixteen patients who underwent surgical treatment for benign superficial parotid tumors at Qingdao Central Hospital from January 2020 to January 2023 were involved. The patients were randomly allocated into two groups, with 58 patients in each group using the touch ball method.The control group underwent antegrade dissection of the facial nerve during surgery, while the experimental group underwent retrograde dissection along the mandibular margin. Surgical duration, intraoperative blood loss, incision length and hospital stay between the two groups were compared. Postoperative pain levels were recorded at 1, 3, 7 and 14 days after surgery. Chewing function was assessed at 15 days, 1 month, 3 months and 6 months postoperatively. House-Brackmann scale (H-B) and scar cosmesis assessment and rating (SCAR) scale were used to evaluate facial nerve function and aesthetic outcomes at 3 days and 6 months postoperatively. The quality of life of the two groups of patients was compared before and 6 months after surgery. Complications were recorded including temporary facial paralysis, periaural numbness, salivate fistula and Frey syndrome. SPSS 28.0 software package was used for statistical analysis. RESULTS: The operative time of the experimental group was significantly higher than that of the control group, intraoperative blood loss, incision length and postoperative pain score of the experimental group were significantly lower than those of the control group. Masticatory efficiency, facial nerve function, scar aesthetics and quality of life of the experimental group were significantly higher than those of the control group, while the incidence of complications was significantly decreased than those of the control group(P<0.05). CONCLUSIONS: The use of retrograde dissection of facial nerve along the mandibular marginal branch during surgery for benign parotid gland is helpful to reduce intraoperative blood loss and postoperative pain, and improve patients' quality of life.

Key words: Parotid tumor, Facial nerve, Mandibular margin, Retrograde dissection, Quality of life, Complications

中图分类号:

R739.8

王磊, 陈颖溢, 袁青, 潘永海. 沿下颌缘支逆行法解剖面神经对腮腺浅叶良性肿瘤患者术后生活质量的影响[J]. 上海口腔医学, 2024, 33(5): 476-480.

WANG Lei, CHEN Ying-yi, YUAN Qing, PAN Yong-hai. Effect of retrograde dissection of the facial nerve along the mandibular margin on postoperative quality of life in patients with benign superficial parotid tumors[J]. Shanghai Journal of Stomatology, 2024, 33(5): 476-480.

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沿下颌缘支逆行法解剖面神经对腮腺浅叶良性肿瘤患者术后生活质量的影响

Effect of retrograde dissection of the facial nerve along the mandibular margin on postoperative quality of life in patients with benign superficial parotid tumors

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