术中面神经肌电监测对腮腺切除术后面神经麻痹发生率的影响Meta分析

Effect of Intraoperative Facial Nerve Electromyography Monitoring on Incidence of Facial Nerve Paralysis after Parotidectomy:A Meta-Analysis

目的:通过Meta分析,分析术中面神经肌电监测对腮腺切除术后即刻面神经麻痹和持续面神经麻痹发生率的影响。方法:检索1970年至2020年12月发表的与主题相关的文献,对符合纳入标准的临床研究,应用Stata16.0软件进行Meta分析,比较术中进行面神经肌电监测(监测组)和不进行面神经肌电监测(对照组)对术后面神经麻痹发生率的影响。结果:共纳入14篇临床研究。Meta分析结果显示:术中面神经监测组术后即刻面神经麻痹的发病率低于对照组(27.7%vs.38.2%,P<0.05);但2组术后持续性面神经麻痹的发生率差异无统计学意义(5.1%vs.9.8%,P>0.05)。纳入的文献中包括4篇随机对照研究,Meta分析结果显示,监测组和对照组的术后即刻面神经麻痹和持续面神经麻痹的发生率差异均无统计学意义(42.3%vs.51.7%,5.6%vs.11.8%,均P>0.05)。结论:术中面神经电生理监测可减少术后即刻面神经麻痹的发生风险,但是对持续性面神经麻痹没有显著影响。但由于纳入的随机对照研究数量较少,后续尚需进一步分析。

Objective:To evaluate using meta-analysis the effect of parotidectomy on the incidence of immediate postoperative facial nerve paralysis and chronic facial nerve paralysis.Methods:A meta-analysis was conducted including relevant articles published from 1970 to December 2020.Studies meeting the inclusion criteria were analyzed by Stata 16.0 software.The effect of intraoperative facial nerve monitoring(monitoring group) versus no facial nerve monitoring(control group) on the incidence of postoperative facial nerve paralysis were compared.Results:Fourteen clinical studies were included.Meta-analysis showed that the incidence of immediate postoperative facial nerve paralysis in the monitoring group was lower than that in the control group(27.7% vs.38.2%,P<0.05),but there was no significant difference in the incidence of postoperative chronic facial nerve paralysis(5.1%vs.9.8%,P>0.05).Four randomized controlled studies were included in this investigation.Meta-analysis showed that there was no significant difference between the monitoring group and control group in the incidence of immediate postoperative facial nerve paralysis and that of postoperative chronic facial nerve paralysis(42.3% vs.51.7%,5.6% vs.11.8%,both P>0.05).Conclusion:Intraoperative facial nerve electrophysiological monitoring can reduce the risk of immediate postoperative facial paralysis,but it has no significant effect on subsequent chronic facial nerve paralysis.However,since only a small number of randomized controlled trials were studied,further analysis is necessary.