Risk Factors of Postoperative Facial Palsy for Benign Parotid Tumors: Outcome of 1,018 Patients
Risk Factors of Postoperative Facial Palsy for Benign Parotid Tumors: Outcome of 1,018 Patients
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DOI：
10.1002/lary.29623
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发表时间：
2021-05-18
期刊：
影响因子：
2.6
通讯作者：
Tochizawa, Takeshi
中科院分区：
文献类型：
--
作者：
Kawata, Ryo;Kinoshita, Ichita;Tochizawa, Takeshi
目的探讨腮腺良性肿瘤术后面瘫的发生率及其危险因素、病理和临床结果。研究设计回顾性分析。方法对1999~2020年间在我科接受腮腺良性肿瘤首次手术的患者进行回顾性分析。最常见的肿瘤是多形性腺瘤(614例)，其次是沃辛瘤(234例)。采用细针抽吸细胞学检查和冰冻切片活检进行肿瘤组织病理学检查。术后面神经麻痹的总发生率为19.5%；大直径肿瘤或深叶肿瘤患者的面神经麻痹发生率明显较高。所有病例术后面瘫均在术后24个月内改善。无永久性面瘫病例。结论腮腺良性肿瘤切除术后，尽管保留了面神经，但术后面神经麻痹仍有规律发生。大肿瘤或深叶肿瘤患者的瘫痪发生率高。尽管这些患者面瘫的风险很高，而且肿瘤的性质是良性的，但我们建议手术而不是随访观察，因为术后面瘫的风险可能会随着肿瘤的生长而增加。重要的是向所有患者提供关于术后并发症风险的准确解释，以获得手术的适当知情同意。证据水平4喉镜，2021年
Objective The aim of this study was to evaluate the rate of postoperative facial palsy in benign parotid tumors, as well as its risk factors, pathology, and clinical results.Study Design Retrospective analysis.Methods We performed a retrospective analysis of data from patients whose initial operation for a benign parotid tumor had been performed in our department between 1999 and 2020.Results We included 1,018 patients in this study. The most common tumor observed was pleomorphic adenoma (614 patients), followed by Warthin tumor (234 patients). Fine-needle aspiration cytology and frozen section biopsy were used to identify the tumor histopathology. The overall rate of postoperative facial nerve palsy was 19.5%; the rate was significantly higher in patients with large-diameter tumors or deep lobe tumors. Postoperative facial palsy improved within 24 months of surgery in all cases. There were no cases with permanent facial palsy.Conclusions Postoperative facial nerve palsy developed regularly after surgery to remove benign parotid tumors despite preservation of the nerve. Palsy rate was high in patients with large tumors or deep lobe tumors. Despite the high risk of facial palsy in these patients and the benign nature of the tumor, we recommend surgery rather than follow-up observation, as the risk of postoperative facial palsy may increase as the tumor grows. It is important to provide an accurate explanation on the risks of postoperative complications to all patients to obtain appropriate informed consent for surgery.Level of Evidence 4 Laryngoscope, 2021