Application analysis of a modified retroauricular hairline incision in the resection of a benign parotid gland tumor

doi:10.7518/hxkq.2021.03.008

Abstract

Abstract: Objective

This study aimed to evaluate the application value of a modified retroauricular hairline incision and a sternocleidomastoid flap with an inferior pedicle in the resection of benign parotid gland tumors.

Methods

Forty-eight patients with benign parotid gland tumors were retrospectively analyzed: 19 cases were included in the experimental group with an improved retroauricular hairline incision and a sternocleidomastoid flap with an inferior pedicle, and 29 cases were assigned in the control group with a modified facelift incision. Operation time, postoperative drainage, postoperative esthetic degree, and incidence of facial nerve paralysis, salivary fistula, and Frey's syndrome were compared.

Results

After the esthetic procedure, the average score of the experimental group was higher than that of the control group, and the esthetic effect of the former was better than that of the latter (P<0.05). The incidence of the operation time, facial nerve paralysis, salivary fistula, and Frey's syndrome of both groups had no statistically significant differences (P>0.05).

Conclusion

The modified retroauricular hairline incision and sternocleidomastoid flap with an inferior pedicle can be applied to resect benign parotid gland tumors safely. It shows a better cosmetic effect and does not cause obvious postoperative complications. Therefore, it should be promoted for tumor treatments.

Key words: parotid tumor, retroauricular hairline incision, sternocleidomastoid flap, surgery, cosmetic

CLC Number:

R 782.05

Chen Fen, Li Yu, Ke Xing, Wu Pingfan, Guo Lingyan, Lei Zhenge, Tan Weibin, Chen Linlin. Application analysis of a modified retroauricular hairline incision in the resection of a benign parotid gland tumor[J]. West China Journal of Stomatology, 2021, 39(3): 293-299.

Figures/Tables 6

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Tab 1

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References 24

1	张志愿. 口腔颌面外科学[M]. 北京: 人民卫生出版社, 2018: 363.
	Zhang ZY. Oral and maxillofacial surgery[M]. Beijing: People's Medical Publishing House, 2018: 363.
2	Ahn D, Sohn JH, Lee GJ. Feasibility of a new V-shaped incision for parotidectomy: a preliminary report[J]. Br J Oral Maxillofac Surg, 2018, 56(5): 406-410.
3	俞光岩, 马大权. 北京大学口腔医院唾液腺肿瘤研究50年回顾[J]. 北京大学学报(医学版), 2015, 47(1): 1-7.
	Yu GY, Ma DQ. Fifty years' retrospection of systemic study on salivary gland tumors[J]. J Peking Univ (Health Sci), 2015, 47(1): 1-7.
4	Kim DY, Park GC, Cho YW, et al. Partial superficial parotidectomy via retroauricular hairline incision[J]. Clin Exp Otorhinolaryngol, 2014, 7(2): 119-122.
5	Ahmedli N, Myssiorek D. Parotidectomy incisions[J]. O-per Tech Otolayngol Head Neck Surg, 2018, 29(3): 135-138.
6	Dai XM, Liu H, He J, et al. Treatment of postparotidectomy Frey syndrome with the interposition of temporalis fascia and sternocleidomastoid flaps[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2015, 119(5): 514-521.
7	吴平安, 陆钊群, 关亚峰, 等. 改良耳后发际切口在腮腺浅叶肿瘤切除术中的应用[J]. 中华耳鼻咽喉头颈外科杂志, 2017, 52(12): 905-908.
	Wu PA, Lu ZQ, Guan YF, et al. Application of functional parotidectomy via retroauricular hairline incision in the excising superficial parotid tumor[J]. Chin J Otorhinolaryngol Head Neck surg, 2017, 52(12): 905-908.
8	徐志坚, 陈良嗣, 罗小宁, 等. 改良面部除皱切口在腮腺浅叶肿瘤切除术中的应用[J]. 临床耳鼻咽喉头颈外科杂志, 2014, 28(10): 738-740.
	Xu ZJ, Chen LS, Luo XN, et al. The clinical application of modified rhytidectomy incision in superficial parotid tumor surgery[J]. J Clin Otorhinolaryngol Head Neck Surg, 2014, 28(10): 738-740.
9	Lohuis PJ, Tan ML, Bonte K, et al. Superficial parotidectomy via facelift incision[J]. Ann Otol Rhinol Laryngol, 2009, 118(4): 276-280.
10	吴平安, 梁伟英, 陆钊群, 等. 改良耳周切口在功能性腮腺切除术中的应用[J]. 临床耳鼻咽喉头颈外科杂志, 2017, 31(13): 995-997.
	Wu PA, Liang WY, Lu ZQ, et al. Functional modified periauricular incision in parotidectomya[J]. J Clin Otorhinolaryngol Head Neck Surg, 2017, 31(13): 995-997.
11	唐正琪. 不同切口下腮腺浅叶肿瘤切除术对患者围术期临床指标、美观性及术后并发症的影响[J]. 中国眼耳鼻喉科杂志, 2019, 19(1): 35-38.
	Tang ZQ. Influence of different kinds of surgical incisions on the clinical indicators in peri-operative period,aesthetics and postoperative complications in patients with parotid superficial lobe tumor[J]. Chin J Ophthalmol Otorhinolaryngol, 2019, 19(1): 35-38.
12	王俊林, 宋勇, 刘彦杰, 等. 耳周定点法设计腮腺除皱美容切口的临床研究[J]. 口腔医学研究, 2016, 32(12): 1312-1315.
	Wang JL, Song Y, Liu YJ, et al. Application of peri-auricle positioning method in aesthetic incision of parotidectomy: a clinical study[J]. J Oral Sci Res, 2016, 32(12): 1312-1315.
13	Ahmedli N, Myssiorek D. Parotidectomy incisions[J]. O-per Tech Otolayngol Head Neck Surg, 2018, 29(3): 135-138.
14	舒仪经, 阚秀. 癌症早期诊断现代技术: 细针吸取细胞病理学[M]. 北京: 人民卫生出版社, 2000: 11-12.
	Shu YJ, Kan X. Modern technology for early diagnosis of cancer: pathology of fine needle aspiration cells[M]. Beijing: People's Medical Publishing House, 2000: 11-12.
15	李天潢, 黄受方. 实用细针吸取细胞学[M]. 北京: 科学出版社, 2000: 9.
	Li TH, Huang SF. Practical fine needle aspiration cytology[M]. Beijing: Science Publishing House, 2000: 9.
16	黄志权, 张大明. 微创外科技术在口腔颌面外科中的应用[J]. 口腔疾病防治, 2018, 26(2): 75-82.
	Huang ZQ, Zhang DM. The application of minimally invasive surgery in oral and maxillofacial surgery[J]. J Prevent Treat Stomatol Dis, 2018, 26(2): 75-82.
17	Mantsopoulos K, Goncalves M, Iro H. Transdermal scopolamine for the prevention of a salivary fistula after parotidectomy[J]. Br J Oral Maxillofac Surg, 2018, 56(3): 212-215.
18	俞光岩, 马大权. 腮腺肿瘤切除术的改进和发展[J]. 中华口腔医学杂志, 2007, 42(1): 6-9.
	Yu GY, Ma DQ. Improvement and development of parotid gland tumor resection[J]. Chin J Stomatol, 2007, 42(1): 6-9.
19	Ghassemi A, Modabber A, Brzoska PO, et al. Vascularised fatty tissue: its role in prevention of the symptoms of Frey syndrome after parotidectomy[J]. Br J Oral Maxillofac Surg, 2018, 56(9): 877-880.
20	Pellitteri PK. Prevention of Frey syndrome[J]. Oper Tech Otolayngol Head Neck Surg, 2018, 29(3): 177-184.
21	Balasundaram I, Nasser NA. Paraumbilical fat graft for the correction of contour deformity following parotidectomy and prevention of Frey syndrome[J]. Int J Oral Ma-xillofac Surg, 2016, 45(3): 380-382.
22	Wang C, Wu D, Mao C, et al. The preventive effect of decellularized pericardial patch against Frey's syndrome following the superficial parotidectomy[J]. J Craniomaxillofac Surg, 2019, 47(5): 832-836.
23	Yuen AP. Aesthetic consideration of parotidectomy-post-aural approach and extended sternomastoid flap: how we do it[J]. Clin Otolaryngol, 2010, 35(3): 231-234.
24	Rai A, Jain A, Khan M. Posterior belly of digastric muscle flap for contour deformity correction after superficial parotidectomy[J]. J Stomatol Oral Maxillofac Surg, 2018, 119(4): 304-306.

项目		试验组	对照组	P值
年龄/岁		39±14.49	56±11.86	0.000*
肿瘤大小/cm		2.43±0.90	2.77±0.99	0.238
肿瘤位置/例	腮腺下极	17	21	0.132
	耳后区	2	8
肿瘤病理性质/例	多形性腺瘤	14	13
	肌上皮瘤	1	3
	基底细胞腺瘤	4	2
	腺淋巴瘤	0	11
平均手术时间/h		1.77±0.34	1.83±0.32	0.548
术后引流量/mL		65.39±34.32	60.59±31.30	0.619
切口满意度/分		7.95±0.91	6.62±0.78	0.000*
术后并发症/例	面神经麻痹	1	2	0.332
	面颈部凹陷	0	10	0.000*
	涎瘘	2	1	0.332
	Frey综合征	0	0	-

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