脱细胞异体真皮基质预防腮腺切除术后味觉出汗综合征和面部凹陷的临床研究

Clinical Study of Acellular Dermal Matrix to Prevent Frey’s Syndrome and Facial Deformity after Parotidectomy

目的评价脱细胞异体真皮基质(ADM)组织补片预防腮腺切除术后味觉出汗综合征和面部凹陷畸形的临床效果。方法将50例腮腺切除术的患者随机分成组织补片组和对照组,每组各25例。组织补片组腮腺切除术后在腮腺切除创面置入ADM组织补片,对照组行常规腮腺浅叶切除术。术后1年统计2组味觉出汗综合征的主观症状及客观测定阳性例数和患者对面部外形的满意例数。结果术后1年复查时组织补片组和对照组出现味觉出汗综合征主观症状的例数分别为1例和10例,客观测定阳性的例数分别为2例和16例,2组差异均有统计学意义(P<0.01);2组患者对面部外形的满意例数分别为22例和8例;差异有统计学意义(P<0.01)。结论ADM局部应用对预防腮腺术后味觉出汗综合征及面部凹陷畸形的发生有较好的作用。

Objective To evaluate the clinical effect of acellular dermal matrix （ADM） on preventing Frey＇ s syndrome and facial deformity after parotidectomy. Methods Fifty patients were randomized into two groups, while ADM group （25 patients） receiving acellular dermal matrix and control group （25 patients） without application of acenular dermal matrix. AU were evaluated after 1 year and questioned about gustatory sweating and facial contour deformity. Subjective assessment of Frey＇ s syndrome was documented when patients experienced gustatory sweating, even if they were not perturbed by the symptom. The Minor starch-iodine test was performed in each patient for objective assessment. Results The incidence of subjective Frey＇ s syndrome was observed in 1 patient in ADM group and 10 patients in control group. The incidence of objective Frey＇ s syndrome was noted in 2 patients in ADM group and 16 patients in control group. Both subjective and objective differences in incidence of Frey＇ s syndrome were statistically significant. The rate of satisfaction with the post-operation facial contour was 88% in ADM group and 32% in control group. There was significant difference between the two groups. Conclusion The application of acellular dermal matrix could effectly prevent Frey＇ s syndrome and facial deformity after parotidectomy.