Clinical Analysis And Prevention Guidance Of The Complications After Parotidectomy

Objective:To study and discuss the incidence,occurrence time,treatment plan,and influencing factors of complications such as facial nerve injury,salivary leakage/effusion,Frey's syndrome,periauricular paresthesia,maxillofacial depression,xerostomia,recurrence after parotidectomy.Finally,the above research results are combined to provide guidance for clinical observation,clinical treatment and prevention of complications.Methods:After collecting the cases of parotidectomy in the First Affiliated Hospital of Kunming Medical University(from October 2016 to September 2019),clinical analysis was carried out on the postoperative complications such as facial nerve injury,salivary leakage/effusion,Frey's syndrome,periauricular paresthesia,maxillofacial depression,xerostomia,recurrence...etc.The influencing factors of facial nerve injury salivary fistula/effusion and Frey's syndrome were analyzed by statistical methods.Results:Among the collected 416 patients,the incidence of postoperative complications was 92.79%.The complications occurred in order from high to bottom:324 cases of periauricular paresthesia(77.88%),250 cases of maxillofacial depression(60.10%),156 cases of Frey's syndrome(37.50%),106 cases of facial nerve injury(25.48%),50 cases of salivary leakage/effusion(12.20%),11 cases of xerostomia(2.64%),5 cases of recurrence(1.20%).In terms of recovery of complications,the recovery time of temporary facial nerve injury under the nutritional nerve treatment was 21.25±13.2 weeks,while the recovery time under the nutritional nerve+acupuncture treatment was 7.64±2.94 weeks,the difference is statistically significant.And the total recovery rate was 96.08%;The recovery time of salivary leakage/effusion under pressure dressing was 22.29±16.92 days,while under the treatment of pressure dressing+atropine,the recovery time was 16.89±8.94 days,the total recovery rate was 100%;The recovery time of periauricular paresthesia was 35.12±21.87 weeks,with a recovery rate of 93.41%.The recovery time of maxillofacial depression was 49.20±29.24 weeks,with a recovery rate of 55.89%.In the analysis of influencing factors of complications:the facial nerve injury is related to the years of operation for the surgeon,whether the facial nerve is free,the type of tumor,etc;the occurrence of salivary leakage/effusion is related to the surgical procedure.There was no statistical difference between partial superfacial parotidectomy and superfacial parotidectomy.But there was statistical difference between the total parotidectomy and partial superfacial parotidectomy or superfacial parotidectomy.The occurrence of Frey's syndrome is related to the surgical procedure,and has nothing to do with gender,age,whether to preserve the great auricular nerve.Conclusion:Parotidectomy has more complications,and the recovery time for complications is relatively long,and even some complications will accompany the whole life.But the recovery rate is high.In order to optimize the surgical effect,it is recommended that surgeons with extensive experience complete parotidectomy.At the same time,factors such as salivary leakage,Frey's syndrome and recurrence should be considered in the selection of the surgical procedure.Patients who have had postoperative complications should be actively treated,such as facial nerve injury,except nutritional nerves,traditional chinese medicine treatment can be considered.After the occurrence of salivary leakage,it is recommended that the atropine be required in addition to conventional compression bandaging.In addition,patients who have experienced complications should be explained,comforted and psychologically guided in a timely manner.