手术联合抗抑郁药物治疗Eagle综合征的疗效评价
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摘要
目的评价经口外入路切除茎突联合使用抗抑郁药物治疗Eagle综合征的疗效。方法 32例Eagle综合征患者,术前以抑郁自评量表行抑郁程度自我评估,均超过49分,诊断为抑郁患者。患者均在全麻下经口外入路切除过长茎突,其中试验组患者16例,术后予以氟西汀20 mg/d;对照组未服用抗抑郁药物,其他术后护理同试验组。术后随访12~36个月,比较两组疗效。结果所有患者均未出现手术并发症。试验组中15例(93.8%)症状完全消失,1例(6.2%)症状部分缓解,试验组Eagle综合征治愈率为93.8%(15/16)。对照组患者中5例术后疼痛症状未完全缓解,对照组Eagle综合征治愈率为68.8%(11/16)。所有患者行药物干预后均未见并发症,均达满意的术后外观,无其他不适。结论经口外入路行茎突切除术简单可靠,由于Eagle综合征常伴有抑郁症状,手术联合抗抑郁药物氟西汀为Eagle综合征理想的治疗方法。
Objective To evaluate the effect of Eagle syndrome treatment by styloid resection from extraoral approach combined with antidepressants therapy. Methods 32 patients with Eagle syndrome got a score over 49 in a self-rating depression scale preoperatively,and they were all diagnosed as depression. All patients underwent resection of the elongated styloid processes under general anesthesia via an extra-oral approach,furthermore 16 patients in the experiment group were treated with fluoxetine 20 mg / day for 3 weeks postoperatively,which was not used in the control group. Beside this,other treatment were all the same. They were all followed for 12- 36 months for the comparation of their treatment effect. Results No surgical complications were observed. The cure rate in the experiment group is 93. 8% whichin the control group is 68. 8%. No complications occurred in any patient with depression medicine intervention. All patients had satisfactory cosmetic results and no paresthesias. Conclusion Dissection of styloid process via an extra-oral approach is operationable and reliable,as depression is one of the main problems in patients with Eagle syndrome,dissection of styloid process combined with antidepressants( fluoxetine) is preferred for treating Eagle syndrome.
Objective To evaluate the effect of Eagle syndrome treatment by styloid resection from extraoral approach combined with antidepressants therapy. Methods 32 patients with Eagle syndrome got a score over 49 in a self-rating depression scale preoperatively,and they were all diagnosed as depression. All patients underwent resection of the elongated styloid processes under general anesthesia via an extra-oral approach,furthermore 16 patients in the experiment group were treated with fluoxetine 20 mg / day for 3 weeks postoperatively,which was not used in the control group. Beside this,other treatment were all the same. They were all followed for 12- 36 months for the comparation of their treatment effect. Results No surgical complications were observed. The cure rate in the experiment group is 93. 8% whichin the control group is 68. 8%. No complications occurred in any patient with depression medicine intervention. All patients had satisfactory cosmetic results and no paresthesias. Conclusion Dissection of styloid process via an extra-oral approach is operationable and reliable,as depression is one of the main problems in patients with Eagle syndrome,dissection of styloid process combined with antidepressants( fluoxetine) is preferred for treating Eagle syndrome.
引文
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[5]Cullu N,Deveer M,Sahan M,et al.Radiological evaluation of the styloid process length in the normal population[J].Folia Morphol,2013,72(4):318-321.
[6]Santini L,Achache M,Gomert,R,et al.Transoral surgical treatment of Eagle’s syndrome:case report and review of literature[J].Rev Laryngol Otol Rhinol,2012,133(3):141-144.
[7]Kapoor V,Jindal G,Garg S,et al.Eagle’s Syndrome:a new surgical technique for styloidectomy[J].J Maxillofac Oral Surg,2015,14(11):360-365.
[8]Palesy P,Murray GM,De Boever J,et al.The involvement of the styloid process in head and neck pain--a preliminary study[J].J Oral Rehabil,2000,27(4):275-287.
[9]Diamond LH,Cottrell DA,Hunter MJ,et al.Eagle’s syndrome:a report of 4 patients treated using a modified extraoral approach[J].J Oral Maxillofac Surg,2001,59(12):1420-1426.
[10]Mortellaro C,Biancucci P,Picciolo G,et al.Eagle’s syndrome:importance of a corrected diagnosis and adequate surgical treatment[J].J Craniofac Surg,2002,13(6):755-758.
[11]Kettani N,Benchaaboun H.Eagle’s syndrome.Presse Med,2015,44(5):560-561.
[12]Fini G,Gasparini G,Filippini F,et al.The long styloid process syndrome or Eagle’s syndrome[J].J Craniomaxillofac Surg,2000,28(2):123-127.
[13]Cipriani A,Brambilla P,Furukawa T,et al.Fluoxetine versus other types of pharmacotherapy for depression[J/OL].Cochrane Database Syst Rev,2005[2015-03-15].http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004185.pub2/abstract;jsessionid=E30650BBE6A8C8D48BDA2B489C8B14B7.f01t01.
[14]Kosar MI,Atalar MH,Sabanciogullari,et al.Evaluation of the length and angulation of the styloid process in the patient with prediagnosis of Eagle syndrome[J].Folia Morphol,2011,70(4):295-299.
[15]Tsapakis EM,Soldani F,Tondo L,et al.Efficacy of antidepressants in juvenile depression:meta-analysis[J].Br J Psychiatry,2008,193(1):10-17.
[2]Kamal A,Nazir R,Usman M,et al.Eagle syndrome;radiological evaluation and management[J].J Pak Med Assoc,2014,64(11):1315-1317.
[3]Beder E,Ozgursoy OB,Karatayli OS,et al.Three-dimensional computed tomography and surgical treatment for Eagle’s syndrome[J].Ear Nose Throat J,2006,85(7):443-445.
[4]Guimaraes AS,Pozza DH,de Castro IC,et al.Complete ossification of the stylohyoid chain as cause of Eagle’s syndrome:a very rare case report[J].J Contemp Dent Pract,2014,15(4):500-505.
[5]Cullu N,Deveer M,Sahan M,et al.Radiological evaluation of the styloid process length in the normal population[J].Folia Morphol,2013,72(4):318-321.
[6]Santini L,Achache M,Gomert,R,et al.Transoral surgical treatment of Eagle’s syndrome:case report and review of literature[J].Rev Laryngol Otol Rhinol,2012,133(3):141-144.
[7]Kapoor V,Jindal G,Garg S,et al.Eagle’s Syndrome:a new surgical technique for styloidectomy[J].J Maxillofac Oral Surg,2015,14(11):360-365.
[8]Palesy P,Murray GM,De Boever J,et al.The involvement of the styloid process in head and neck pain--a preliminary study[J].J Oral Rehabil,2000,27(4):275-287.
[9]Diamond LH,Cottrell DA,Hunter MJ,et al.Eagle’s syndrome:a report of 4 patients treated using a modified extraoral approach[J].J Oral Maxillofac Surg,2001,59(12):1420-1426.
[10]Mortellaro C,Biancucci P,Picciolo G,et al.Eagle’s syndrome:importance of a corrected diagnosis and adequate surgical treatment[J].J Craniofac Surg,2002,13(6):755-758.
[11]Kettani N,Benchaaboun H.Eagle’s syndrome.Presse Med,2015,44(5):560-561.
[12]Fini G,Gasparini G,Filippini F,et al.The long styloid process syndrome or Eagle’s syndrome[J].J Craniomaxillofac Surg,2000,28(2):123-127.
[13]Cipriani A,Brambilla P,Furukawa T,et al.Fluoxetine versus other types of pharmacotherapy for depression[J/OL].Cochrane Database Syst Rev,2005[2015-03-15].http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004185.pub2/abstract;jsessionid=E30650BBE6A8C8D48BDA2B489C8B14B7.f01t01.
[14]Kosar MI,Atalar MH,Sabanciogullari,et al.Evaluation of the length and angulation of the styloid process in the patient with prediagnosis of Eagle syndrome[J].Folia Morphol,2011,70(4):295-299.
[15]Tsapakis EM,Soldani F,Tondo L,et al.Efficacy of antidepressants in juvenile depression:meta-analysis[J].Br J Psychiatry,2008,193(1):10-17.