Wasson Joseph, Karim Haider, Yeo Justin, Panesar Jaan
Department of Otolaryngology, Luton and Dunstable Hospital, Luton, UK.
Ann R Coll Surg Engl. 2010 Jan;92(1):40-3. doi: 10.1308/003588410X12518836440009.
Traditionally, the cervicomastoidfacial (CMF) incision is used to excise benign tumours of the parotid gland. The rhytidectomy or modified facelift (MF) incision allows an alternative approach which leaves no visible neck scar. The objective of this study was to establish the frequency of each surgical approach used and identify any difference in complication and patient satisfaction between the two incisions for benign conditions of the parotid gland.
A retrospective analysis of 101 case notes for patients who underwent parotidectomy by both ENT and maxillofacial departments between January 2006 and February 2008 was undertaken. All histologically confirmed cases of malignancy were excluded. For each incision, immediate postoperative complications were obtained from the notes. A postal patient outcome evaluation questionnaire sought information regarding persistent and late complications as well as a visual analogue scar satisfaction score for both incisions.
Overall, 79 parotidectomies were included (59 CMF incisions, 20 MF incisions). Of CMF incisions, 34% suffered facial weakness immediately postoperatively versus 20% of MF incisions. Of CMF incisions, 4% suffered postoperative haematomas versus none following MF incisions. In the study cohort, 47 (60%) responded to the postal feedback questionnaire (33 CMF versus 14 MF respondents). Information regarding immediate and late postoperative ipsilateral facial paraesthesia and gustatory sweating was obtained. Mean visual analogue scar satisfaction scores were 9.4 for CMF incisions and 8.9 for MF incisions.
Immediate and late complications for CMF and MF approaches for benign disease parotidectomy were comparable, but scar satisfaction following MF incision was not greater than CMF incisions.
传统上，颈乳突面部（CMF）切口用于切除腮腺良性肿瘤。除皱术或改良面部提升（MF）切口提供了另一种方法，不会留下可见的颈部瘢痕。本研究的目的是确定每种手术方法的使用频率，并确定在腮腺良性疾病中两种切口在并发症和患者满意度方面是否存在差异。
对2006年1月至2008年2月期间由耳鼻喉科和颌面外科进行腮腺切除术的101例患者的病例记录进行回顾性分析。所有组织学确诊的恶性病例均被排除。对于每个切口，从记录中获取术后即刻并发症。通过邮寄患者结局评估问卷来获取有关持续性和晚期并发症的信息，以及两种切口的视觉模拟瘢痕满意度评分。
总体而言，纳入了79例腮腺切除术（59例采用CMF切口，20例采用MF切口）。CMF切口组中，34%的患者术后即刻出现面部无力，而MF切口组为20%。CMF切口组中，4%的患者出现术后血肿，而MF切口组无此情况。在研究队列中，47例（60%）回复了邮寄反馈问卷（33例CMF切口患者和14例MF切口患者）。获取了有关术后即刻和晚期同侧面部感觉异常及味觉出汗的信息。CMF切口的平均视觉模拟瘢痕满意度评分为9.4分，MF切口为8.9分。
CMF和MF两种方法用于腮腺良性疾病切除术的即刻和晚期并发症相当，但MF切口后的瘢痕满意度并不高于CMF切口。
