腮腺咬肌筋膜下翻瓣对Frey综合征预防作用对比研究

Clinical research on reservation of parotid masseter fascia in preventing Frey's syndrome

目的探讨腮腺浅叶切除术中腮腺咬肌筋膜下翻瓣对Frey综合征的预防作用。方法 2004年5月至2008年5月在大连大学附属中山医院口腔科,将62例行腮腺浅叶切除术的患者随机分为两组,一组32例采用传统腮腺咬肌筋膜上翻瓣,另一组30例采用腮腺咬肌筋膜下翻瓣,并通过随访调查及Minor试验检测,观察Frey综合征的发生率。结果采用保留腮腺咬肌筋膜即筋膜下翻瓣组,其Frey综合征主观症状的发生率和客观检查发生率分别为6.67%和16.67%,而不保留腮腺嚼肌筋膜即筋膜上翻瓣组,其Frey综合征主观症状的发生率和客观检查发生率分别为37.50%和65.62%,筋膜下翻瓣组Frey综合征发生率远低于传统手术组,其差异具有统计学意义(P<0.01)。结论在腮腺浅叶切除术中,保留腮腺咬肌筋膜对预防Frey综合征有明显效果。

Objective To investigate the prevention of Frey＇s syndrome by reservation of parotid masseter fascia during the superficial lobe parotidectomy.Methods Totally 62 patients who needed superficial lobe parotidectomy were divided into two groups randomly：32 patients（group A）had parotid masseter fascia reserved,while 30 patients（group B）had parotid masseter fascia unreserved in the operation.Observe the occurrence of Frey＇s syndrome through Minor tests.Results Follow-up lasted from 6 months to 3 years,and the occurrence of subjective symptoms and objective symptoms were 6.67% and 16.67% in group A,37.50% and 65.62% in group B.The occurrence of Frey＇s syndrome in group A was much lower than that in group B,the differences of two groups having statistical significance（P 0.01）.Conclusion Reserving the parotid masseter fascia in parotidecomy has a positive effect on the prevention of Frey＇s syndrome.