保留耳大神经在腮腺良性肿瘤中的临床研究

Clinical study of preserving the great auricular nerve in parotidectomy

目的讨论腮腺良性肿瘤手术中保留耳大神经的临床意义。方法将50例腮腺良性肿瘤患者随机分为两组,观察组25例行区域性切除术、术中保留耳大神经,对照组25例行腮腺浅叶或全叶及肿物切除术,术中不保留耳大神经。比较两组耳廓及周围皮肤的感觉障碍程度。结果观察组术后3个月耳廓区感觉损伤面积与对照组比较差异无统计学意义(P>0.05),而术后6个月和12个月损伤面积明显小于对照组(P<0.05)。观察组术后耳廓区感觉异常几率明显低于对照组,且观察组内出现暂时性局部麻木的病例神经功能恢复的速度也明显快于对照组(P<0.05)。结论保留耳大神经对腮腺肿瘤术后耳廓感觉功能恢复意义重大。

Objective To discuss the clinical significance of preserving the great auricular nerve in parotidectomy. Methods 50 patients with parotidectomy were randomly divided into two groups. Patients in observed group（25cases） were treated with local excision of benign tumor of the parotid gland, and the great auricular nerve were retained. Patients in control group（25cases） were treated with resection of superficial lobe of parotid gland or whole leaf and tumor, and the great auricular nerve were not retained. The sensory disturbance degree of auricle and its surrounding skin between the two groups were compared. Results There was no significantly difference in the injury area of auricle between the two groups at 3rd month after treatment（P 〉0.05）. The injury area of auricle in two groups at 6th month and 12 th month after the treatment were significantly smaller than those before treatment（P 〈0.05）. The injury area of auricle in observed groups at 3nd month, 6th month and 12 th month were significantly smaller than those in control groups（P 〈0.05）. The sensory abnormality rate of observed group were significantly lower than those of control groups（P 〈0.05）. The rate of nerve function recovery of observed group was also significantly faster than those of control group（P 〈0.05）. Conclusion It is important to preserve the great auricular nerve for the recovery of sensory function of the parotid gland after surgery.