ABSTRACT
Objective:Facial nerves can be dissected using anterograde and retrograde approaches. The optimal technique for the facial nerve dissection of a patient with benign parotid tumor has not yet been determined. This study focused on facial nerve dysfunc-tion and recovery rate after anterograde and retrograde facial-nerve dissections. Methods:The data of 110 patients with benign carotid adenoma from the Head and Neck Department of this hospital who were hospitalized between January 2011 and January 2013 were col-lected. These patients were divided into groups A (n=52) and B (n=58). Anterograde and retrograde dissections of the facial nerve were performed on group A and group B patients, respectively. Based on the preferential order of dissection, group B was divided into groups B1, B2, and B3 representing the zygomatic, buccal, and marginal mandibular branches, respectively. The patients were postoperatively observed to check for potential symptoms, such as facial paralysis along with its severity and recovery. The House-Brackmann grading system was used to assess all patients. Results:The operation could be successful, with better nerve exposure, using these approaches. Statistical differences were observed in the nerve injury and recovery rates between the groups, with group A better than group B, and group B2 better than the other two groups (P<0.05). Conclusion:Anterograde facial nerve dissection should be routinely used in be-nign parotid tumor, and the buccal branch of facial nerve dissection should be preferentially considered when no other option apart from retrograde dissection is available.
ABSTRACT
Pleomorphic adenoma ranks first among parotid gland tumors. Surgical procedure, which includes enucleation, ex-tra-capsular resection, partial superficial parotidectomy (PSP), superficial parotidectomy (SP), and total parotidectomy (TP), remains to be the treatment of choice for pleomorphic adenoma. In the last century, physicians lacked understanding on the pathological character-istics of pleomorphic adenoma and facial neurotomia. Thus, simple enucleation of tumors has always been the major therapy for pa-tients to reduce the rate of facial nerve injury. However, postoperative recurrence was frequently observed in patients that have under-gone simple enucleation. In this study, the surgeons attempted to control the relapse rate by enlarging the scope of excision when remov-ing a pleomorphic adenoma, and by performing an extra-capsular resection procedure that was developed in the clinic. Although the tu-mor peplos was excised, the surgeons failed to control the relapse rate. SP and TP apparently decreased the relapse rate of the pleomor-phic adenomas. However, these therapies seem to be overcorrected by the aggravation of facial nerve injuries. PSP is a relatively ad-vanced technique that is currently used in parotid surgery. PSP reduces the rate of relapse and facial nerve injury, as verified by basic pa-thology research. Nevertheless, the controversy between advanced PSP and classic SP still exists. Plastic surgery, pathology research, and gene testing were used to evaluate the advantages of advanced PSP and classic SP. However, the research failed to derive a con-firmed result that can determine which treatment method is fit and unfit to treat pleomorphic adenoma. Our study reviews the trend of parotid surgery from a historic point of view.
ABSTRACT
<p><b>OBJECTIVE</b>To compare the differences in recurrence rates and surgical complications between thyroidectomy alone and thyroidectomy combined with central neck dissection as initial treatments to differentiated thyroid cancer and evaluate the clinic significance of central neck dissection for these patients.</p><p><b>METHODS</b>The literatures published in 1998-2013 were searched in Wanfang database, Chongqing VIP database, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Pubmed, Medline and Beijing Kangjian foreign medical journal full text service. According to the inclusion and deletion criteria, 30 articles were included. Of them 26 articles involved in complications, hypocalcemia and recurrent laryngeal nerve palsy as two major complications were involved in 26 articles and 24 articles respectively, and 26 articles involved in recurrence rate. RevMan5.0 software package was used to perform meta-analysis.</p><p><b>RESULTS</b>Total complication rate in experimental group (plus central neck dissection) was 13.08% higher than that in control group (thyroidectomy only), the odds ratio (OR) [95% confidence interval (95%CI)] was 2.32[2.02, 2.67], Z value was 11.80, P < 0.01. Hypocalcemia in the experimental group was 11.80% higher than that in control group, OR value [95%CI] was 2.58[2.21, 3.02], Z was 11.98, P < 0.01. The rates of recurrent laryngeal nerve paralysis were low in both experimental group (5.26%) and control group(3.95%), and OR value [95%CI] was 1.22 [0.94, 1.58], Z was 1.48, P = 0.14. Recurrence rate in experimental group was 2.23% lower than that in control group, OR value [95%CI] was 0.78 [0.63,0.97], Z was 2.35, P = 0.03.</p><p><b>CONCLUSION</b>Central compartment dissection as initial treatment to differentiated thyroid cancer may reduce the risk of recurrence, but increases the incidence of total complications and hypocalcemia, and has no significant effect on the rate of the recurrent laryngeal nerve paralysis.</p>
Subject(s)
Humans , Neck Dissection , Neoplasm Recurrence, Local , Thyroid Neoplasms , Pathology , General SurgeryABSTRACT
Objective To investigate the quality of life for clinical patients with malignant tumors and the influencing factors so as to provide health departments with basis for improvement. Methods(Using) methods of interviews and questionnaires,investigations were made on the quality of life for 639 patients with malignant tumors diagnosed between January 2001 and July 2002 in the various cities and regions of Sichuan and the influencing factors by means of filling out quality of life assessment scales.(Results) The quality of life for patients with malignant tumors was in general pretty low,scoring 54.40?10.95.Careers in management were positively related to psychological status(P