腮腺切除术中两种解剖方式对面神经功能的影响分析

Analysis of the Influence of Two Anatomical Methods on Facial Nerve Function in Parotidectomy

目的:观察两种面神经解剖方式在腮腺切除术中对面神经功能的影响。方法:临床资料采集笔者所在医院口腔科在2015年1月-2018年11月收治的90例腮腺良性肿瘤患者,按不同手术方式分为两组,每组45例。对照组在腮腺切除术中行逆行法解剖,观察组在腮腺切除术中行顺行法解剖,比较两组手术情况、面神经功能及损伤情况、并发症情况。结果:观察组术后1周的面神经功能分级中Ⅱ级为66.67%,高于对照组的44.44%,Ⅳ、Ⅴ级分别为6.67%、0,均低于对照组的17.78%、13.33%(P<0.05);观察组下颌缘支损伤率(0)低于对照组(17.78%),差异有统计学意义(P<0.05);观察组术后并发症率(8.89%)低于对照组(24.44%),差异有统计学意义(P<0.05)。结论:顺行法面神经解剖在腮腺切除术中的效果更好,能减少面神经损伤,加快受损面神经恢复,且术后并发症少。

Objective:To observe the effects of two kinds offacial nerve anatomy on facial nerve function during parotidectomy.Method:The clinical data were collected from 90 patients with parotid benign tumors,who were admitted to our department from January 2015 to November 2018.They were divided into two groups according to different surgical methods,45 cases in each group.The control group underwent retrograde anatomy during parotidectomy,while in the observation group,antegrade anatomy was performed during parotidectomy,and the operationconditions,facial nerve function and injury,and complications were compared between the two groups.Result:In the observation group,the grade Ⅱ of facial nerve function was 66.67%,which was higher than that of the control group(44.44%),and the grade Ⅳ and the grade Ⅴ were 6.67%,0 respectively,which were also lower than those of the control group with 17.38% and 13.33%(P<0.05).The injury rate of the marginal mandibular branch in the observation group was 0,which was lower than that of the control group(17.78%)(P<0.05).The incidence of postoperative complications in the observation group(8.89%) was lower than that of the control group(24.44%)(P<0.05).Conclusion:The antegrade facial nerve anatomy is better in parotidectomy,which could reduce facial nerve injury,accelerate the recovery of damaged facial nerve,and have fewer postoperative complications.