ナカミゾ　ムネナガ   Nakamizo Munenaga   中溝　宗永    所属   医学部 医学科（東京女子医科大学病院）    職種   特任教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Significance of preserving the posterior branch of the great auricular nerve in parotidectomy.
掲載誌名	正式名：Journal of Nippon Medical School = Nippon Ika Daigaku zasshi 略　 称：J Nippon Med Sch ISSNコード：13454676/13454676
掲載区分	国外
巻・号・頁	71(5),pp.323-327
著者・共著者	YOKOSHIMA Kazuhiko, NAKAMIZO Munenaga, OZU Chika, FUKUMOTO Akira, INAI Shunta, BABA Shunkichi, YAGI Toshiaki
担当区分	2nd著者
発行年月	2004/10
概要	OBJECTIVE:Sensory disturbance due to excision of the great auricular nerve in patients who have undergone parotidectomy sometimes causes discomfort to the patients. In order to reduce the postoperative discomfort of the pinna, we tried to preserve the posterior branch of the great auricular nerve.METHODS:Forty patients with parotid tumor were included in this study. Twenty-one of these patients had pleomorphic adenoma, 16 had adenolymphoma and 3 had a low grade malignant tumor. Sensations of the pinna and the quality of life (QOL) after parotidectomy were evaluated using a 0-100 Visual Analogue Scale (VAS) assessed at 2 weeks, 1 month, 2 months, 3 months and 6 months after parotidectomy.RESULTS:The posterior branch of the great auricular nerve was preserved in 26 out of 40 patients (65%). No difference was observed in the incidence of complications except sensory disturbance of the pinna with this surgical procedure as compared to the surgical technique where the great auricular nerve was excised. The VAS score for the sensation was significantly higher in the group of patients whose great auricular nerve was preserved at 2 months (35.0+/-20.8 vs. 18.5+/-9.2), 3 months (64.4+/-18.3 vs. 26.4+/-13.8) and 6 months (66.9+/-16.2 vs. 26.6+/-11.4) after parotidectomy. The VAS score for the QOL was also significantly higher in the group of patients whose great auricular nerve was preserved at 2 months (50.3+/-21.8 vs. 35.1+/-14.5), 3 months (69.5+/-27.5 vs. 45.9+/-22.6) as well as 6 months (71.9+/-24.1 vs. 45.7+/-19.1) after parotidectomy.CONCLUSION:Preservation of the posterior branch of the great auricular nerve during parotidectomy is valuable in order to reduce the postoperative sensory disturbance of the pinna that follows conventional surgery. It further helps to improve the QOL of these patients after parotidectomy.
DOI	10.1272/jnms.71.323
PMID	15514449