耳后沟入路茎突截短术治疗茎突综合征

Retroauricular auricular sulcus approach to styloid process surgery for the treatment of Eagle's syndrome

摘要

目的 探讨耳后沟入路茎突截短术治疗茎突综合征的可行性。方法 选择2018年1月1日至2024年5月15日就诊于临沂市人民医院耳鼻咽喉头颈外科的茎突综合征患者60例，随机分为试验组(A组)与对照组(B组)，每组30例。A组行耳后沟入路茎突截短术，B组行经口入路扁桃体切除术联合茎突截短术。比较两组患者的手术时间、茎突截短长度、疼痛视觉模拟评分(visual analogue scale，VAS)、吞咽功能评分、临床疗效及术后并发症发生情况。结果 与B组相比，A组手术时间更短，茎突截短长度更长，GEE分析显示VAS疼痛评分与吞咽功能评分的时间主效应及组别×时间交互效应均有统计学意义(P均<0.001)，术后3 d与7 d A组评分低于B组(P均<0.001)；两组临床疗效及术后并发症发生情况的差异无统计学意义(P>0.05)。结论 耳后沟入路茎突截短术治疗茎突综合征具有手术时间短、创伤小、术后疼痛轻、对吞咽功能影响小等优势，且不影响临床疗效和安全性，值得进一步临床推广及应用。

Abstract

Objective This study aims to assess the feasibility of the styloid process via retroauricular sulcus approach in patients diagnosed with Eagle’s syndrome. Methods Sixty patients diagnosed with Eagle’s syndrome at the Department of Otorhinolaryngology Head and Neck Surgery, Linyi People’s Hospital, between January 1, 2018, and May 15, 2024, were enrolled and randomly assigned to either the experimental group (Group A, n=30) or the control group (Group B, n=30). Group A underwent styloid process resection via a retroauricular sulcus approach, while Group B received transoral tonsillectomy combined with styloid process resection. Outcome measures included operative time, length of styloid resection, Visual Analogue Scale (VAS) pain scores, swallowing function scores, clinical efficacy, and postoperative complications. Results Compared with Group B, Group A exhibited significantly shorter operative time, greater resection length, GEE showed significant time effects and group-by-time interactions for VAS pain and swallowing function scores (all P<0.001); scores in Group A were lower than those in Group B at postoperative days 3 and 7 (all P<0.001). No statistically significant differences were observed in clinical efficacy or postoperative complications between the two groups (P>0.05). Conclusion The retroauricular sulcus approach for styloid process resection offers advantages including reduced operative time, minimal invasiveness, decreased postoperative pain, and less impact on swallowing function, without compromising clinical efficacy or safety. This technique warrants broader clinical application.

关键词

茎突截短术 / 茎突综合征 / 耳后沟入路

Key words

Resection of the styloid process / Eagle’s syndrome / Retroauricular sulcus approach

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