대이개 신경 뒷가지 희생군과 보존군에서 감각 차이의 비교
Comparative Study of Sensation with or without Preservation of Great Auricular Nerve during Parotidectomy
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Background and Objectives Whether to sacrifice the posterior branch of great auricular nerve (GAN) during parotidectomy is disputatious. This study was to provide a guideline for de-cision-making. Subjects and Method Thirty-two patients who underwent parotidectomy due to parotid mass were randomized into two groups. Three patients who underwent further treatment were ex-cluded. Fourteen patients underwent classic parotidectomy by sacrificing GAN whereas 15 patients underwent surgery that preserved the nerve. A two-point discrimination test, sensation of light touch, sharp instrument, blunt instrument and temperature were evaluated preoperatively, and at 7 days, 1, 3, 6, 12 months and 45 months, postoperatively. Patients’ preference for the ope-ration time to preserve the nerve was also evaluated. Results The mean preservation time was 156 seconds. There was no difference in touch sensa-tion, preoperatively, between the two groups. The two-point discrimination test of the infra-auricular area showed significant differences at 1 week postoperatively (p＜0.05). The two-point discrimination test of lobule showed significant differences at 1 month (p＜0.05), but these dif-ferences disappeared at 1 and 3 months. All measured data had no statistically sig-nificant differences at 3 and 6 months. At one year, light touch sensation of lobule and temperature sensa-tion of infra-auricular area showed significant differences (p＜0.05). Differences in tempera-ture were found at 45 months of follow-up. Of the patients, 95% wanted to preserve the nerve. Conclusion The authors suggest that the posterior branch of GAN was preserved according to patients’ preference for the sensation of temperature in the infra-auricular area.
Abstract
Background and Objectives Whether to sacrifice the posterior branch of great auricular nerve (GAN) during parotidectomy is disputatious. This study was to provide a guideline for de-cision-making. Subjects and Method Thirty-two patients who underwent parotidectomy due to parotid mass were randomized into two groups. Three patients who underwent further treatment were ex-cluded. Fourteen patients underwent classic parotidectomy by sacrificing GAN whereas 15 patients underwent surgery that preserved the nerve. A two-point discrimination test, sensation of light touch, sharp instrument, blunt instrument and temperature were evaluated preoperatively, and at 7 days, 1, 3, 6, 12 months and 45 months, postoperatively. Patients’ preference for the ope-ration time to preserve the nerve was also evaluated. Results The mean preservation time was 156 seconds. There was no difference in touch sensa-tion, preoperatively, between the two groups. The two-point discrimination test of the infra-auricular area showed significant differences at 1 week postoperatively (p＜0.05). The two-point discrimination test of lobule showed significant differences at 1 month (p＜0.05), but these dif-ferences disappeared at 1 and 3 months. All measured data had no statistically sig-nificant differences at 3 and 6 months. At one year, light touch sensation of lobule and temperature sensa-tion of infra-auricular area showed significant differences (p＜0.05). Differences in tempera-ture were found at 45 months of follow-up. Of the patients, 95% wanted to preserve the nerve. Conclusion The authors suggest that the posterior branch of GAN was preserved according to patients’ preference for the sensation of temperature in the infra-auricular area.
참고문헌 (15)
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