Guerrissi Jorge Orlando
Plastic Surgery Department, Argerich Hospital, Ciudad Autonoma de Buenos Aires, Buenos Aires, Argentina.
J Craniofac Surg. 2012 Jul;23(4):1202-4. doi: 10.1097/SCS.0b013e31824e26b6.
Tumors that developed into the soft tissues of the cheek rising from the anterior prolongation of the parotid gland, minor salivary glands, and the masseter muscle are the most profitable with the use of video-assisted surgery.In the Department of Plastic Surgery at Argerich Hospital in Buenos Aires, Argentina, from 1999 to 2010, video-assisted approaches were used in the treatment of 158 patients, 16 of them presented tumors that developed into the tissues of the cheek.Intraoral approach such as natural orifice surgery was performed in 13 cases; in the other 3 cases, a preauricular incision was performed. Minor complications such as hematoma and transitory paresis of the superior buccal nerve were detected.Video-assisted technique offers both good illumination and excellent magnification, permitting not only a safe anatomic dissection by means of surgical maneuvers in avascular planes but also contributed to avoid injuries of facial nerve branches and secondary obstruction of the Stensen duct. On the other hand, when intraoral incisions are used, visible scarring is avoided; the uses of transoral areas are the most feasible approaches of natural orifice surgery.The outcome achieved with endoscopic techniques in mediofacial lateral areas has permitted to consider it as the first election in the surgical treatment in tumors that developed into the soft tissues of the cheek, offering more advantages than the classic approaches.
起源于腮腺前延、小唾液腺和咬肌并发展至颊部软组织的肿瘤,采用视频辅助手术治疗效果最佳。1999年至2010年期间,阿根廷布宜诺斯艾利斯阿杰里奇医院整形科采用视频辅助方法治疗了158例患者,其中16例患者的肿瘤发展至颊部组织。13例患者采用了经口入路,如自然腔道手术;另外3例患者采用了耳前切口。发现了一些轻微并发症,如血肿和颊上神经短暂性麻痹。视频辅助技术提供了良好的照明和出色的放大效果,不仅能够通过在无血管平面进行手术操作实现安全的解剖分离,还有助于避免面神经分支损伤和斯滕森导管的继发性梗阻。另一方面,使用经口切口时可避免可见瘢痕;经口区域的应用是自然腔道手术最可行的入路。在内侧面部外侧区域采用内镜技术取得的结果,使其被视为颊部软组织肿瘤手术治疗的首选方法,比传统方法具有更多优势。