不同类型经口入路茎突手术的疗效分析

Efficacy analysis of styloid process operation with different types of transoral approach surgery

摘要:

目的 采取新的经口入路茎突手术分类方法，探讨其相关影响因素和临床疗效。方法 回顾性分析2017年11月—2020年6月湘雅常德医院收治的茎突综合征患者32例（41侧），全部经口入路手术，分析其手术类型、茎突长度、前倾角、内倾角以及术后6个月随访的治疗效果和VAS评分。结果 32例（41侧）经口入路茎突手术患者，按新方法分类，其中茎突切除术7侧、茎突缩短术23侧、茎突折断术6侧、茎突梳理术5侧。术后6个月复查，患者视觉模拟评价量表（VAS）评分明显低于术前（P<0.05）；3例患者认为术后咽部症状无缓解，其余患者均认为有效，总体有效率为90.2%。结论 根据茎突长度、前倾角、内倾角和患者意愿，选择合理的手术方法。不同类型经口入路手术治疗茎突综合征，具有较好的临床效果，值得推广应用。

Abstract:

Objective To investigate the affect factors and curative effect of different surgical treatment with a new method for classification of transoral resection of the styloid process.Methods Retrospective analysis was performed on 32 patients (41 sides) with styloid process syndrome admitted to the Xiangya Changde Hospital from November 2017 to June 2020, all cases were treated with transoral approach surgery to styloid process. It was analyzed for the type of operation, the length, introversion angle, and anteversion angle of styloid process, the therapeutic effect of 6 months follow-up and VAS score.Results According to the new method, 32 patients (41 sides) underwent styloid process surgery via oral approach, including 7 sides of styloidectomy, 23 sides of styloid-shortenning, 6 sides of styloid-fracturing and 5 sides of styloid-combing.The VAS score was lower in post-operative patients than in pre-operative ones (P<0.01). Only 3 patients thought that the pharyngeal symptoms were not relieved after surgery, and the other patients thought it was effective. The overall effective rate was 90.2%.Conclusions The reasonable surgical method was selected according to the length, introversion angle and anteversion angle of styloid process, and patients’ wishes. It is worthy of popularization and application for different types of transoral approach surgery to styloid process with favorable efficacy.