腮腺手术中保留或牺牲耳大神经(GAN)的临床意义长期以来一直是争议的话题。这项研究旨在比较接受浅表腮腺切除术并保留或处死GAN的患者的感觉恢复率和生活质量(QoL)。对50名患者进行了前瞻性分析,28保存了GAN,22牺牲了它。主要结果是触觉敏感性和QoL。次要结果是手术时间和其他并发症。两组的触觉敏感度都有逐渐改善,在术后1、3、6和9个月时显示出有利于保留组的统计学差异(p<0.05)。两组术后12个月的触感差异无统计学意义。GAN保存和处死组1、3、6、9和12个月为42.8%,42.8%,57.1%,57.1%,78.5%,0%,0%,13.6%,27.3%,和59.1%,分别。根据QoL评估,感觉评分的平均(SD)损失有显著差异(处死组0.86(0.94)和保留组0.39(0.62),p=0.039)。然而,就问卷的其他类别而言,组间无统计学差异.两组之间在手术时间和其他并发症方面没有显着差异。这项研究得出的结论是,当客观评估时,感觉障碍最终在术后第一年的下半年减轻了严重程度。GAN保存将长期结果中的感觉干扰降至最低,但GAN保存或牺牲后,总体QoL似乎不受影响。
The clinical implications of great auricular nerve (GAN) preservation or sacrifice during parotid surgery have long been a topic of controversy. This study aimed to compare sensory recovery rates and quality of life (QoL) in patients who had undergone superficial parotidectomy and had their GAN preserved or sacrificed. Fifty patients were prospectively analysed, 28 with the GAN preserved, and 22 with it sacrificed. The primary outcomes were tactile sensitivity and QoL. The secondary outcomes were operating times and other complications. There was a gradual improvement in tactile sensitivity in both groups, which showed a statistically significant difference favouring the preserved group at 1, 3, 6, and 9 months postoperatively (p<0.05). There was no statistically significant difference in tactile sensation for both groups at 12 months postoperatively. The overall sensory recovery rates in the GAN preserved and sacrificed groups after 1, 3 ,6, 9 and 12 months were 42.8%, 42.8%, 57.1%, 57.1%, and 78.5%, and 0%, 0%, 13.6%, 27.3%, and 59.1%, respectively. According to the QoL assessment, there was a significant difference in mean (SD) loss of sensation scores (sacrificed group 0.86 (0.94) and preserved group 0.39 (0.62), p= 0.039). However, there were no statistical differences between the groups regarding other categories of the questionnaire. No significant difference was seen between groups regarding operating time and other complications. This study concluded that when evaluated objectively, sensory impairment ultimately lessened in severity in the second half of the first postoperative year. GAN preservation minimised sensation disturbance in long-term results, but overall QoL seemed to be unaffected following GAN preservation or sacrifice.