51 病人接受耳前切線進行顳顎關節手術後,產生Frey\'s syndrome ,下列那一項是最不宜進行的治療方式?
(A)腮腺切除
(B)局部使用副交感神經拮抗劑
(C)皮下置入筋膜
(D)繼續觀察
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統計: A(781), B(40), C(94), D(123), E(0) #2405157
統計: A(781), B(40), C(94), D(123), E(0) #2405157
詳解 (共 4 筆)
#6152322
D)腮腺切除是可能造成frey's syndrome的原因(切到交感、副交感神經,復原時副交感神經錯接到交感支配的汗腺上)
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補充原文書frey syndrome治療方式與GPT翻譯:
Most cases are mild enough that treatment is not required. Moreover, approximately 5% of adult patients and almost all affected infants experience spontaneous resolution of the syndrome. If treatment is desired, intracutaneous injections of botu- linum toxin A can provide long-term relief, although injec- tions may need to be repeated. Topically applied anticholinergic medications, such as scopolamine and gly- copyrrolate, also have been used for short-term control. Surgical management, such as insertion of various tissue barriers or tympanic neurectomy, rarely is indicated or required. The initial risk for developing Frey syndrome is greatly diminished by positioning a musculofascial flap or allograft between the gland and the overlying skin of the cheek at the time of parotidectomy.
大多數病例輕微到不需要治療。此外,約有5%的成年患者和幾乎所有受影響的嬰兒都會自發痊癒。如果需要治療,皮內注射A型肉毒毒素可以提供長期緩解,但可能需要重複注射。外用抗膽鹼藥物,如東莨菪鹼和格隆溴銨,也可用於短期控制。外科治療,如插入各種組織屏障或進行鼓膜神經切除術,極少被指示或需要。在進行腮腺切除術時,在腺體和覆蓋面頰的皮膚之間放置肌筋膜瓣或同種異體移植物,能大大減少Frey綜合徵的初始風險。
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