Department of Otorhinolaryngology (120-752), Yonsei University College of Medicine, 250 Sungsan-ro Seodaemun-gu, Seoul, Korea.
World J Surg. 2011 Oct;35(10):2228-37. doi: 10.1007/s00268-011-1209-1.
Recently, the modified facelift incision (FLI) has gained increasing popularity for its cosmetic benefits in parotidectomy. However, many surgeons remain concerned with the adequacy of the exposure and are unwilling to use the FLI for anterior or superior tumors of the parotid gland because these tumors are closer to the superficially positioned facial nerve branch. To evaluate the changing trends in parotidectomy incisions for benign lesions at a single institute, and to compare the surgical outcomes between the modified Blair incision (BI) and FLI, and determine the adequacy and possible indications or limitations of the FLI, especially for tumors located in the anterior or superior parotid gland.
Retrospective study analyzed 357 patients who had various benign parotid diseases and underwent parotidectomy at Severance Hospital between January 2005 and December 2009. Revisions or recurrences and histologically confirmed malignancies were excluded. Tumor location was divided into superficial and deep lobes. The superficial lobe was subdivided into anterior, superior, inferior, and middle portions. Patients' profiles, surgical outcomes, and cosmetic satisfaction score on a scale of 0 (extremely dissatisfied) to 10 (extremely satisfied) were compared.
In all, 344 patients underwent BI or FLI. The FLI was performed increasingly each year. For anterior (n = 58) or superior tumors (n = 32), there was no significant difference between the type of incision and tumor size or complications. No facial nerve palsy occurred in either group. For deep-lobe tumors (n = 67), the mean tumor size was significantly larger in the BI group (p = 0.025). There was a significant difference between facial nerve palsy and tumor size (p < 0.001) but no significant difference between facial nerve palsy and tumor location (p = 0.145) or the type of incision (p = 0.530). The mean scar satisfaction score was significantly higher in the FLI group (p <0.001). There was a positive correlation between the scar and deep hollow satisfaction score (Pearson coefficient of correlation = 0.547; p < 0.001)
The modified facelift incision is feasible for most benign parotid lesions regardless of tumor location, even for anterior or superior tumors. Using the modified facelift incision may be extended with a surgeon's accumulated experience, but for a large deep-lobe tumor, the modified Blair incision is still considered useful.
最近，改良的面部提升切口（FLI）因其在腮腺切除术方面的美容优势而越来越受到关注。然而，许多外科医生仍然担心暴露的充分性，并且不愿意使用 FLI 来切除腮腺的前或上侧肿瘤，因为这些肿瘤更接近位置表浅的面神经分支。为了评估一家机构中良性病变的腮腺切除术切口的变化趋势，并比较改良 Blair 切口（BI）和 FLI 的手术结果，确定 FLI 的充分性以及其可能的适应证或局限性，特别是对于位于腮腺前或上侧的肿瘤。
回顾性研究分析了 2005 年 1 月至 2009 年 12 月在 Severance 医院接受各种良性腮腺疾病切除术的 357 例患者。排除了复发或组织学证实的恶性肿瘤患者。根据肿瘤位置将肿瘤分为浅叶和深叶。浅叶进一步分为前、上、下和中部分。比较患者的一般情况、手术结果和 0（非常不满意）至 10（非常满意）的美容满意度评分。
共有 344 例患者接受 BI 或 FLI 治疗。FLI 的应用逐年增加。对于前（n = 58）或上侧肿瘤（n = 32），切口类型与肿瘤大小或并发症之间无显著差异。两组均未发生面神经瘫痪。对于深叶肿瘤（n = 67），BI 组的平均肿瘤大小明显更大（p = 0.025）。面神经瘫痪与肿瘤大小之间存在显著差异（p < 0.001），但与肿瘤位置（p = 0.145）或切口类型（p = 0.530）无关。FLI 组的瘢痕满意度评分显著更高（p < 0.001）。瘢痕与深凹满意度评分之间呈正相关（皮尔逊相关系数 = 0.547；p < 0.001）。
改良的面部提升切口对于大多数良性腮腺病变都是可行的，无论肿瘤位置如何，甚至对于前或上侧肿瘤也是如此。随着外科医生经验的积累，改良的面部提升切口的应用范围可能会扩大，但对于大型深叶肿瘤，改良的 Blair 切口仍被认为是有用的。
