保留耳大神经及枕小神经的功能性颈廓清术

Preservation of auricular magnum nerve and occipitalminor nerve in the functional neck dissectionfor head and neck cancer

目的观察在颈廓清术中保留耳大神经及枕小神经对病人术后耳廓及面颈部皮肤感觉功能及颈淋巴结复发转移癌的影响。方法将60例已确诊为头颈部恶性肿瘤需切除原发灶加功能性颈廓清术的病人随机分成保留耳大神经和枕小神经组(A组),与不保留耳大神经和枕小神经组(B组)进行前瞻性研究。结果术后A组病人主诉耳颞部麻木感明显低于B组(P<0.01),对温觉和痛觉敏感性明显高于B组(P<0.01),术后淋巴结再发转移癌A组为15.6％,B组为17.9％,两组无明显差异(P>0.05)。结论在颈淋巴结廓清术中,保留耳大神经和枕小神经可以保护病人的耳颞部皮肤感觉,减少麻木不适感,并不增加淋巴结转移癌的复发率。

Objective To abserve the sense of skin on the face and neck after the functional neck dissection with attempt to preserve the auricular magnum nerve and occipital minor nerve for patients with head and neck cancer, and to evaluate the recurrent rate of the lymph node. Methods Sixty patients with head and neck cancer were divided into 2 groups at random for the predictable research. Results The recurrent rate of the lymph node was 15.6% in group A and 17.9% in group B ( P >0.05). The sense of pain and heat could be tested in group A, but not in group B, P <0.01. Conclusion The preservation of the auricular magnum nerve and occipital minor nerve in the functional neck dissection for the head and neck cancer does not increase the recurrence of the lymph node, while it can protect the sense of ear and head of the patients.