腮腺手术中面神经解剖术式与面神经功能损伤的临床研究

目的:探讨腮腺手术中不同的面神经解剖术式与面神经功能损伤之间的相关性。方法:通过对120例临床腮腺肿瘤患者进行随机分3组,分别采用不同的面神经解剖术式,观察面神经功能损伤的发生率及恢复时间。结果:经面神经总干的顺行法、经颧支或下颌缘支的逆行法面神经解剖术式,其神经功能损伤的发生率及神经功能恢复时间分别是:5%,2.58月;12.5%,2.82月;70%,6.52月。前2种术式之间,神经损伤发生率及恢复时间差异均无显著性,而前2种术式与经下颌缘支的逆行法之间比较,神经损伤的发生率(P<0.01)及恢复时间(P<0.05)差异均存在显著性。结论:经面神经总干及颧支解剖面神经,运用逆行和顺行解剖法相结合,是一种较好的减少面神经损伤的手术方式。

A clinical study of facial nerve dissection and functional injury in parotidectomy

Objective: To study the correlation between the different facial nerve dissection method and the functional injury of the nerve in parotidectomy.Methods: 120 cases of parotid tumor were randomly divided into 3 groups,anterograde dissection of facial nerve through the trunk,retrograde dissection through zygomatic branch and retrograde dissection through marginal mandibular branch were conducted in group A,B and C respectively.Then,the ratio of functional injury of facial nerve and functional recovery period were observed.Results: The ratios of functional injury of facial nerve and functional recovery period of the patients in A,B and C groups were 5% and 2.58 months,12.5% and 2.82 months,70% and 6.52 months respectively.There was no statistical significance between the group A and B,however,there were statistical significance in the ratio of factional injury(P<0.01) and recovery period(P<0.05) between group C and A or B.Conclusion: Combining anterograde and retrograde methods of dissecting facial nerve through the trunk and zygomatic branch of facial may be a better choice to reduce the functional damage of facial nerve in parotidectomy.