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目的 :研究术后放疗对面神经损伤恢复的影响。方法 :将 1995— 1997年间腮腺肿瘤术后出现面瘫的2 0名患者分成单纯手术组 (operationgroup ,以下简称O组 ) 6例和术后放疗组 (operationandradiationgroup ,以下简称OR组 ) 14例。OR组于术后 4周内放疗 ,以手术日至面瘫完全消失所需时间比较两组面神经功能恢复的差异。结果 :经术后 4周 48— 6 1Gy常规放疗 ,腮腺肿瘤术后面神经损伤的恢复基本不受影响。OR组肿瘤量平均 5 5 91±3 6 4Gy。面神经平均恢复时间O组为 6 4月 ,OR组为 9月 ;经t检验 ,两组结果无显著性差异 ,P =0 10 5。肿瘤累及的面神经 ,经术中保留术后放疗 ,其功能可完全恢复 ,面瘫消失时间平均 8 4月。除 1例腮腺恶性淋巴瘤出现远处转移外 ,其余均未出现局部复发和远处转移。结论 :包括 5 0岁以上的腮腺恶性肿瘤患者 ,面神经解剖术造成的面瘫 ,经术后常规放疗 ,术后 9个月左右恢复正常 ,不致产生永久性面瘫。与肿瘤粘连的面神经经解剖术后辅以适量放疗可达到既根治肿瘤又保留面神经及其功能的疗效
Objective: To study the effect of postoperative radiotherapy on the recovery of facial nerve injury. Methods: Twenty patients with facial paralysis after parotid tumor from 1995 to 1997 were divided into 6 patients in operation group (O group) and 14 patients in operation and radiation group (OR). The OR group received radiotherapy within 4 weeks after operation, and the difference of facial nerve function recovery was compared between the time of operation and the complete disappearance of facial paralysis. Results: After 48-61 Gy of conventional radiotherapy 4 weeks after surgery, the recovery of facial nerve injury of parotid gland tumor was basically unaffected. The average tumor size of OR group was 5 5 91 ± 36 4Gy. The average recovery time of facial nerve in group O was 6 months and that in OR group was 9 months. There was no significant difference between the two groups (P = 0 105) by t-test. Tumors involving the facial nerve, after surgery to retain postoperative radiotherapy, its function can be fully restored, the disappearance of facial paralysis an average of 8.4 months. In addition to a case of parotid malignant lymphoma distant metastasis, the rest were no local recurrence and distant metastasis. CONCLUSION: Facial paralysis caused by facial nerve anatomy, including patients with parotid gland cancer over 50 years old, after conventional radiotherapy, returns to normal after about 9 months of operation and will not cause permanent facial paralysis. With the adhesion of the facial nerve after anatomy supplemented with appropriate amount of radiotherapy can achieve both radical treatment of the tumor and retain the efficacy of the facial nerve and its efficacy