脫細胞真皮基質預防Frey綜合征的系統評價_《中國循證醫學雜志》

作者：

曾憲濤 ¹ , 郭毅 ² , 夏凌云 ¹ , 黃偉 ¹ ,  冷衛東 ¹ , 劉東艷 ¹

1. 湖北醫藥學院附屬太和醫院口腔醫學中心（湖北十堰?442000）；2. 武漢大學公共衛生學院流行病學教研室（武漢?430071）;

關鍵詞：

脫細胞真皮基質預防 Frey綜合征系統評價 Meta分析

DOI：

10.7507/1672-2531.20110014

視頻：

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摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的　系統評價脫細胞真皮基質（AMD）預防Frey綜合征的有效性和安全性。
方法　計算機檢索Cochrane圖書館（2010年第1期）、MEDLINE、EMbase、SIGLE、GreyNet、NTIS、CBMdisc、VIP、CNKI和萬方數據庫，查找有關應用脫細胞真皮基質預防Frey綜合征的研究。檢索時限均為1995～2010年。由4名評價者獨立選擇試驗、提取資料和評估方法學質量，然后采用RevMan 5.0.0軟件對資料進行Meta分析。
結果　共納入15個研究，共計472例受試患者。Meta分析結果顯示，植入ADM能有效降低Frey綜合征發生，其主觀和客觀差異均有統計學意義［RR=0.11，95%CI（0.06，0.18），P lt;0.01；RR=0.14，95%CI（0.10，0.19），P lt;0.01］；暫時性面神經麻痹的發生率低于對照組，其差異無統計學意義［OR=0.78，95%CI（0.37，1.66），P=0.53］；血清腫及粘液囊腫的發生率高于對照組，其差異也無統計學意義［OR=2.63，95%CI（0.09，79.25），P=0.58］，并可以通過放置引流和局部加壓包扎解決；涎漏的發生率低于對照組，其差異有統計學意義［OR=0.24，95%CI（0.08，0.69），P=0.009］。
結論　本系統評價結果顯示，應用ADM能有效降低Frey綜合征的發生率，安全性較好。建議術前行碘酒/碘伏過敏檢查，術中行快速冰凍切片明確腫瘤性質，盡量固定牢固，術后放置負壓引流及行局部加壓包扎。

引用本文： 曾憲濤,郭毅,夏凌云,黃偉,冷衛東,劉東艷. 脫細胞真皮基質預防Frey綜合征的系統評價. 中國循證醫學雜志, 2011, 11(1): 76-83. doi: 10.7507/1672-2531.20110014 復制

1.	Donati M, Gandolfo L, Privitera A, et al. Superficial parotidectomy as first choice for parotid tumours. Chir Ital, 2007, 59(1): 91-97.
2.	Marchese-Ragona R, De Filippis C, Marioni G, et al. Treatment of complications of parotid gland surgery. Acta Otorhinolaryngol Ital, 2005, 25(3): 174-178.
3.	Koch M, Zenk J, Iro H. Long-term results of morbidity after parotid gland surgery in benign disease. Laryngoscope, 2010, 120(4): 724-730.
4.	Frey L. Le syndrome du nerf auriculotemporal. Rev Neuro, 1923, 2: 92-104.
5.	Harrison K, Donaldson I. Frey’s syndrome. J R Soc Med, 1979, 72: 503-508.
6.	de Bree R, van der Waal I, Leemans CR. Management of frey syndrome. Head & Neck, 2007, 29(8): 773-778 .
7.	Rustemeyer J, Eufinger H, Bremerich A. The incidence of Frey’s syndrome. J Cranio-Maxillofac Surg, 2008, 36(1): 34-37.
8.	Malatskey S, Rabinovich I, Fradis M, et al. Frey syndrome-delayed clinical onset: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2002, 94(3): 338-340.
9.	Wenzel GI, Draf W. Unusually long latency before the appearance of Frey’s syndrome after parotidectomy. HNO, 2004, 52(6): 554-556.
10.	Baek CH, Chung MK, Jeong HS, et al. Questionnaire evaluation of sequelae over 5 years after parotidectomy for benign diseases. J of Plast Reconstr and Aesthet Surg, 2009, 62: 633-638.
11.	Clayman MA, Clayman SM, Seagle MB. A review of the surgical and medical treatment of Frey syndrome. Ann Plast Surg, 2006, 57(5): 581-584.
12.	Martos Díaz P, Bances del Castillo R, Mancha de la Plata M, et al. Clinical results in the management of Frey’s Syndrome with injections of Botulinum Toxin. Med Oral Patol Oral Cir Bucal, 2008, 13(4): E248-252.
13.	Curry JM, Fisher KW, Heffelfinger RN, et al. Superficial Musculoaponeurotic System Elevation and Fat Graft Reconstruction After Superficial Parotidectomy. Laryngoscope, 2008, 118(2): 210-215.
14.	Rubinstein RY, Rosen A, Leeman D. Frey syndrome: treatment with temporoparietal fascia flap interposition. Arch Otolaryngol Head Neck Surg, 1999, 125(7): 808-811.
15.	Oa A, Ps K. Prevention of Frey’s syndrome and volume deficit after parotidectomy using the superficial temporal artery fascial flap. Br J Plast Surg, 1999, 52(4): 256-260.
16.	Terzis JK, Olivares FS. Uses of the superficial temporal fascial flap in facial paralysis. Plast Reconstr Surg, 2008, 122(6): 176e-185e.
17.	Filho WQ, Dedivitis RA, Rapoport A, et al. Sternocleidomastoid Muscle Flap Preventing Frey Syndrome following Parotidectomy. World J Surg, 2004, 28, 361-364.
18.	Guntinas-Lichius O, Gabriel B, Klussmann JP. Risk of facial palsy and severe Frey’s syndrome after conservative parotidectomy for benign disease: analysis of 610 operations. Acta Otolaryngol, 2006, 126(10): 1104-1109.
19.	曲延剛, 孫樂剛, 王玉良, 等. 腮腺手術置入滌綸薄片預防Frey綜合癥. 實用口腔醫學雜志, 2002, 18(2): 175-176.
20.	李德志, 吳躍煌, 王曉雷, 等. 腮腺腫瘤術后Frey綜合征預防的初步研究.中華外科雜志, 2006, 44(15): 1033-1035.
21.	郭錫久, 阮興朝, 冉紅兵, 等. 膨體聚四氟乙烯植入整復腮腺術后凹陷畸形. 中國美容醫學, 2005, 14(6): 697-698.
22.	Clayman MA, Clayman LZ. Use of AlloDerm as a barrier to treat chronic Frey’s syndrome. Otolaryngol Head Neck Surg, 2001, 124(6): 687.
23.	Papadogeorgakis N, Petsinis V, Christopoulos P, et al. Use of a porcine dermal collagen graft (Permacol) in parotid surgery. Br J Oral Maxillofac Surg, 2009, 47(5):378-381.
24.	邱蔚六, 主編. 口腔頜面外科學. 第6版. 北京: 人民衛生出版社, 2008: 371-372.
25.	Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.2 [updated September 2009]. The Cochrane Collaboration, 2009. Available from www.cochrane-handbook.org.
26.	田剛, 江中明, 朱強. 口腔組織補片預防味覺出汗綜合癥的臨床觀察. 中國現代實用醫學雜志, 2006, 5(8): 70-71.
27.	俞凱, 楊鈞, 李滿敬, 等. 脫細胞異體真皮基質預防味覺出汗綜合癥的臨床觀察. 中華口腔醫學雜志, 2007, 42(9): 570-571.
28.	孫海鵬, 馮力, 翁汝漣, 等. 脫細胞異體真皮基質預防腮腺切除術后味覺出汗綜合癥和面部凹陷的臨床研究. 廣東牙病防治, 2008, 16(4): 161-163.
29.	張瑞鑫. 脫細胞真皮基質（ADM）在預防Frey’s綜合癥中的應用. 山東: 山東大學口腔臨床醫學, 2008.
30.	廖湘凌, 吳斌, 張艷, 等. 脫細胞真皮基質用于預防腮腺切除術后Frey綜合癥. 河北醫科大學學報, 2008, 29(2): 223-235.
31.	董作青, 張凡, 魏奉才, 等. 應用脫細胞真皮基質預防腮腺切除術后Frey綜合癥. 山東大學學報（醫學版）, 2008, 46(8): 801-803.
32.	勞軍平, 陳巨峰, 歐陽可雄, 等. 組織瓣修復和異體脫細胞真皮基質植入預防腮腺切術后Frey綜合癥. 中山大學學報（醫學科學版）, 2008, 39(3S): 158-1560.
33.	曾憲濤, 解龍川, 冷衛東, 等. 異種脫細胞真皮基質在預防Frey’s綜合癥中的應用. 臨床口腔醫學雜志, 2009, 25(6): 364-366.
34.	陳勇, 徐明耀.預防腮腺切除術后味覺出汗綜合癥的臨床研究. 口腔醫學研究, 2009, 25(1): 64-66.
35.	曾昭旋. 腮腺咬肌筋膜和脫細胞異體真皮基質在預防腮腺手術后Frey’s綜合癥中的應用. 臨床口腔醫學雜志, 2009, 26(1): 41-42.
36.	王時光, 張紅杰, 王志興. 脫細胞異體真皮基質預防味覺出汗綜合癥中的臨床研究. 口腔頜面外科雜志, 2010, 20(1): 37-39.
37.	Ye WM, Zhu HG, Zheng JW, et al. Use of allogenic acellular dermal matrix in prevention of Frey’s syndrome after parotidectomy. Br J Oral Maxillofac Surg, 2008, 46(8): 649-652.
38.	Govindaraj S, Cohen M, Genden EM, et al. The Use of Acellular Dermis in the Prevention of Frey’s Syndrome. Laryngoscope, 2001, 111: 1993-1998.
39.	Sinha UK, Saadat D, Doherty CM, et al. Use of AlloDerm implant to prevent frey syndrome after parotidectomy. Arch Facial Plast Surg, 2003, 5(1): 109-112.
40.	CHEN WL, YANG ZH, HUANG ZQ, et al. SMAS fold flap and allograft dermal matrix repair parotid bed following parodectomy to prevent facial deformity and Frey’s syndrome. China J of Oral and Maxilloficial Sur, 2007, 5(4): 265-269.
41.	Harper JR. Tissue regeneration using a human acellular tissue matrix: A histological perspective. LifeCell Clinical Monograph Series, 2005.
42.	姜篤銀, 付小兵, 盛志勇, 等. 無細胞異種真皮基質降解因素的研究. 中華實驗外科雜志, 2003, 20(4): 360-361.
43.	姜篤銀, 陳璧. 無細胞異種真皮基質研究進展. 中華燒傷雜志, 2003, 19: 66-68.

1. Donati M, Gandolfo L, Privitera A, et al. Superficial parotidectomy as first choice for parotid tumours. Chir Ital, 2007, 59(1): 91-97.
2. Marchese-Ragona R, De Filippis C, Marioni G, et al. Treatment of complications of parotid gland surgery. Acta Otorhinolaryngol Ital, 2005, 25(3): 174-178.
3. Koch M, Zenk J, Iro H. Long-term results of morbidity after parotid gland surgery in benign disease. Laryngoscope, 2010, 120(4): 724-730.
4. Frey L. Le syndrome du nerf auriculotemporal. Rev Neuro, 1923, 2: 92-104.
5. Harrison K, Donaldson I. Frey’s syndrome. J R Soc Med, 1979, 72: 503-508.
6. de Bree R, van der Waal I, Leemans CR. Management of frey syndrome. Head & Neck, 2007, 29(8): 773-778 .
7. Rustemeyer J, Eufinger H, Bremerich A. The incidence of Frey’s syndrome. J Cranio-Maxillofac Surg, 2008, 36(1): 34-37.
8. Malatskey S, Rabinovich I, Fradis M, et al. Frey syndrome-delayed clinical onset: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2002, 94(3): 338-340.
9. Wenzel GI, Draf W. Unusually long latency before the appearance of Frey’s syndrome after parotidectomy. HNO, 2004, 52(6): 554-556.
10. Baek CH, Chung MK, Jeong HS, et al. Questionnaire evaluation of sequelae over 5 years after parotidectomy for benign diseases. J of Plast Reconstr and Aesthet Surg, 2009, 62: 633-638.
11. Clayman MA, Clayman SM, Seagle MB. A review of the surgical and medical treatment of Frey syndrome. Ann Plast Surg, 2006, 57(5): 581-584.
12. Martos Díaz P, Bances del Castillo R, Mancha de la Plata M, et al. Clinical results in the management of Frey’s Syndrome with injections of Botulinum Toxin. Med Oral Patol Oral Cir Bucal, 2008, 13(4): E248-252.
13. Curry JM, Fisher KW, Heffelfinger RN, et al. Superficial Musculoaponeurotic System Elevation and Fat Graft Reconstruction After Superficial Parotidectomy. Laryngoscope, 2008, 118(2): 210-215.
14. Rubinstein RY, Rosen A, Leeman D. Frey syndrome: treatment with temporoparietal fascia flap interposition. Arch Otolaryngol Head Neck Surg, 1999, 125(7): 808-811.
15. Oa A, Ps K. Prevention of Frey’s syndrome and volume deficit after parotidectomy using the superficial temporal artery fascial flap. Br J Plast Surg, 1999, 52(4): 256-260.
16. Terzis JK, Olivares FS. Uses of the superficial temporal fascial flap in facial paralysis. Plast Reconstr Surg, 2008, 122(6): 176e-185e.
17. Filho WQ, Dedivitis RA, Rapoport A, et al. Sternocleidomastoid Muscle Flap Preventing Frey Syndrome following Parotidectomy. World J Surg, 2004, 28, 361-364.
18. Guntinas-Lichius O, Gabriel B, Klussmann JP. Risk of facial palsy and severe Frey’s syndrome after conservative parotidectomy for benign disease: analysis of 610 operations. Acta Otolaryngol, 2006, 126(10): 1104-1109.
19. 曲延剛, 孫樂剛, 王玉良, 等. 腮腺手術置入滌綸薄片預防Frey綜合癥. 實用口腔醫學雜志, 2002, 18(2): 175-176.
20. 李德志, 吳躍煌, 王曉雷, 等. 腮腺腫瘤術后Frey綜合征預防的初步研究.中華外科雜志, 2006, 44(15): 1033-1035.
21. 郭錫久, 阮興朝, 冉紅兵, 等. 膨體聚四氟乙烯植入整復腮腺術后凹陷畸形. 中國美容醫學, 2005, 14(6): 697-698.
22. Clayman MA, Clayman LZ. Use of AlloDerm as a barrier to treat chronic Frey’s syndrome. Otolaryngol Head Neck Surg, 2001, 124(6): 687.
23. Papadogeorgakis N, Petsinis V, Christopoulos P, et al. Use of a porcine dermal collagen graft (Permacol) in parotid surgery. Br J Oral Maxillofac Surg, 2009, 47(5):378-381.
24. 邱蔚六, 主編. 口腔頜面外科學. 第6版. 北京: 人民衛生出版社, 2008: 371-372.
25. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.2 [updated September 2009]. The Cochrane Collaboration, 2009. Available from www.cochrane-handbook.org.
26. 田剛, 江中明, 朱強. 口腔組織補片預防味覺出汗綜合癥的臨床觀察. 中國現代實用醫學雜志, 2006, 5(8): 70-71.
27. 俞凱, 楊鈞, 李滿敬, 等. 脫細胞異體真皮基質預防味覺出汗綜合癥的臨床觀察. 中華口腔醫學雜志, 2007, 42(9): 570-571.
28. 孫海鵬, 馮力, 翁汝漣, 等. 脫細胞異體真皮基質預防腮腺切除術后味覺出汗綜合癥和面部凹陷的臨床研究. 廣東牙病防治, 2008, 16(4): 161-163.
29. 張瑞鑫. 脫細胞真皮基質（ADM）在預防Frey’s綜合癥中的應用. 山東: 山東大學口腔臨床醫學, 2008.
30. 廖湘凌, 吳斌, 張艷, 等. 脫細胞真皮基質用于預防腮腺切除術后Frey綜合癥. 河北醫科大學學報, 2008, 29(2): 223-235.
31. 董作青, 張凡, 魏奉才, 等. 應用脫細胞真皮基質預防腮腺切除術后Frey綜合癥. 山東大學學報（醫學版）, 2008, 46(8): 801-803.
32. 勞軍平, 陳巨峰, 歐陽可雄, 等. 組織瓣修復和異體脫細胞真皮基質植入預防腮腺切術后Frey綜合癥. 中山大學學報（醫學科學版）, 2008, 39(3S): 158-1560.
33. 曾憲濤, 解龍川, 冷衛東, 等. 異種脫細胞真皮基質在預防Frey’s綜合癥中的應用. 臨床口腔醫學雜志, 2009, 25(6): 364-366.
34. 陳勇, 徐明耀.預防腮腺切除術后味覺出汗綜合癥的臨床研究. 口腔醫學研究, 2009, 25(1): 64-66.
35. 曾昭旋. 腮腺咬肌筋膜和脫細胞異體真皮基質在預防腮腺手術后Frey’s綜合癥中的應用. 臨床口腔醫學雜志, 2009, 26(1): 41-42.
36. 王時光, 張紅杰, 王志興. 脫細胞異體真皮基質預防味覺出汗綜合癥中的臨床研究. 口腔頜面外科雜志, 2010, 20(1): 37-39.
37. Ye WM, Zhu HG, Zheng JW, et al. Use of allogenic acellular dermal matrix in prevention of Frey’s syndrome after parotidectomy. Br J Oral Maxillofac Surg, 2008, 46(8): 649-652.
38. Govindaraj S, Cohen M, Genden EM, et al. The Use of Acellular Dermis in the Prevention of Frey’s Syndrome. Laryngoscope, 2001, 111: 1993-1998.
39. Sinha UK, Saadat D, Doherty CM, et al. Use of AlloDerm implant to prevent frey syndrome after parotidectomy. Arch Facial Plast Surg, 2003, 5(1): 109-112.
40. CHEN WL, YANG ZH, HUANG ZQ, et al. SMAS fold flap and allograft dermal matrix repair parotid bed following parodectomy to prevent facial deformity and Frey’s syndrome. China J of Oral and Maxilloficial Sur, 2007, 5(4): 265-269.
41. Harper JR. Tissue regeneration using a human acellular tissue matrix: A histological perspective. LifeCell Clinical Monograph Series, 2005.
42. 姜篤銀, 付小兵, 盛志勇, 等. 無細胞異種真皮基質降解因素的研究. 中華實驗外科雜志, 2003, 20(4): 360-361.
43. 姜篤銀, 陳璧. 無細胞異種真皮基質研究進展. 中華燒傷雜志, 2003, 19: 66-68.

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脫細胞真皮基質預防Frey綜合征的系統評價

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《中國循證醫學雜志》

脫細胞真皮基質預防Frey綜合征的系統評價

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