关于腮腺肿瘤手术当前临床工作流程及三维模型未来应用的共识：一项德尔菲研究
Consensus on current clinical workflow and future use of 3D models in parotid gland tumor surgery: A Delphi study.
文献信息
| PMID | 42913203 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Manon C M Moll |
| 作者单位 | Department of Head and Neck Surgery and Oncology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek, Plesmanlaan 121, Amsterdam, 1066 CX, the Netherlands; Department of Head and Neck Surgery and Oncology, Verwelius 3D Lab, The Netherlands Cancer Institute, Antoni van Leeuwenhoek, Amsterdam, the Netherlands; Academic Centre of Dentistry Amsterdam, Vrije Universiteit, Gustav Mahlerlaan 3004, Amsterdam, 1081 LA, the Netherlands. Electronic address: man.moll@nki.nl. |
| 期刊 | Oral oncology |
| SCI 分区 | Q1 |
| IF | 4.6 |
| 研究类型 | 指南共识 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
目的： 基于MRI的三维模型可提供腮腺肿瘤与面神经关系的患者特异性空间信息。然而，其在临床实践中的潜在作用及实施支持程度仍不明确。本研究旨在评估外科医生对腮腺手术当前临床工作流程及三维模型未来作用的共识程度。
研究设计： 我们采用三轮德尔菲研究，探讨每年实施五例以上腮腺手术的外科医生之间的共识。第一轮包括关于腮腺手术、创新及三维模型使用的半结构化访谈。采用归纳分析制定第二轮陈述和问题。在第二和第三轮中，参与者采用7点形容词量表对问题和陈述进行评分。
结果： 由来自九家荷兰医院的15名外科医生（包括9名耳鼻咽喉科医生和6名口腔颌面外科医生）组成的小组完成了所有研究轮次。第三轮中10%的陈述达成部分共识。在涉及恶性肿瘤、面神经功能障碍、深叶肿瘤、固定肿瘤、不可触及肿瘤及乳突切除术指征的病例中，发现MRI扫描和三维模型使用的重要性均呈上升趋势。与术中应用相比，三维模型用于术前规划和患者咨询的重要性趋势更强。
结论： 尽管共识有限，本研究确定了MRI使用的指征，并强调了三维模型在腮腺肿瘤手术中的感知价值。
英文摘要
OBJECTIVE: MRI-based 3D models provide patient-specific spatial information on the relationship between parotid gland tumors and the facial nerve. However, their potential role in clinical practice and the level of support for their implementation remain unclear. This study aimed to assess the level of consensus among surgeons on the current clinical workflows in parotid gland surgery and the future role of 3D models.
STUDY DESIGN: We used a three-round Delphi study to explore consensus among surgeons performing more than five parotid surgeries annually. Round 1 consisted of semi-structured interviews about parotid surgery, innovations, and the use of 3D models. Inductive analysis was used to formulate statements and questions for round 2. In rounds 2 and 3, participants rated the questions and statements on a 7-point adjective scale.
RESULTS: A panel of 15 surgeons, including 9 otolaryngologists and 6 oral and maxillofacial surgeons from nine Dutch hospitals, completed all study rounds. Partial consensus was observed for 10% of statements in round 3. Trends toward greater importance of both MRI scanning and 3D model use were identified in cases involving malignancy, facial nerve dysfunction, deep lobe tumors, fixed tumors, non-palpable tumors, and indications for a mastoidectomy. Stronger trends toward importance were observed for using 3D models in preoperative planning and patient counseling than in their use during surgery.
CONCLUSION: Although consensus was limited, this study identified indications for MRI use and highlighted the perceived value of 3D models in parotid gland tumor surgery.