Sullivan C A, Masin J, Maniglia A J, Stepnick D W
Department of Otolaryngology--Head and Neck Surgery, Case Western Reserve University, Cleveland, Ohio, USA.
Laryngoscope. 1999 Feb;109(2 Pt 1):198-203. doi: 10.1097/00005537-199902000-00005.
OBJECTIVES/HYPOTHESIS: Complications of rhytidectomy have been widely reported in the literature. This study examines the incidence of complications after rhytidectomy in the hands of chief residents under appropriate attending supervision in an otolaryngology-head and neck surgery training program.
The charts of 96 consecutive SMAS rhytidectomy patients were retrospectively reviewed. Patients were selected for surgery from a clinic designed exclusively for cosmetic facial surgery patients. This clinic was run by the otolaryngology chief resident and was supervised by an attending staff surgeon. Most patients elected local anesthesia and sedation administered by the surgical team. Submental liposuction was performed followed by SMAS plication rhytidectomy.
Follow-up ranged from 1 to 60 months. Complications included expanding hematoma (1%), temporary facial nerve weakness (3%), pretragal/mastoid skin slough (4.2%), permanent ear numbness (1%), hypertrophic scar (3.1%), wound infection (1%), and dissatisfaction with result (4%). There were no cases of permanent facial nerve injury.
These complication rates compare favorably with reported rates of larger studies over the past 30 years. These data support the conclusion that rhytidectomy can be performed safely by otolaryngology residents with little morbidity and good patient satisfaction.
目的/假设：文献中已广泛报道了除皱术的并发症。本研究调查了在耳鼻喉头颈外科培训项目中，在适当的主治医生监督下，住院总医师实施除皱术后并发症的发生率。
回顾性分析了96例连续接受SMAS除皱术患者的病历。患者均选自专门为面部美容手术患者设立的诊所。该诊所由耳鼻喉科住院总医师负责运营，并由主治外科医生监督。大多数患者选择了由手术团队实施的局部麻醉和镇静。先进行颏下吸脂术，然后行SMAS折叠除皱术。
随访时间为1至60个月。并发症包括血肿扩大（1%）、暂时性面神经麻痹（3%）、耳前/乳突皮肤脱落（4.2%）、永久性耳部麻木（1%）、增生性瘢痕（3.1%）、伤口感染（1%）以及对手术效果不满意（4%）。无永久性面神经损伤病例。
这些并发症发生率与过去30年大型研究报道的发生率相比更有利。这些数据支持以下结论：耳鼻喉科住院医师可以安全地实施除皱术，发病率低，患者满意度高。
