Nofal Ahmad Abdel-Fattah, Mohamed Morsi
Department of Otorhinolaryngology-Head and Neck Surgery, Zagazig University, Zagazig, Egypt.
Department of General Surgery, Zagazig University, Zagazig, Egypt.
Int Arch Otorhinolaryngol. 2015 Oct;19(4):319-24. doi: 10.1055/s-0035-1549155. Epub 2015 Mar 27.
Introduction Most patients after either superficial or total parotidectomy develop facial deformity and Frey syndrome, which leads to a significant degree of patient dissatisfaction. Objective Assess the functional outcome and esthetic results of the superiorly based sternocleidomastoid muscle (SCM) flap after superficial or total parotidectomy. Methods A prospective cohort study for 11 patients subjected to parotidectomy using a partial-thickness superiorly based SCM flap. The functional outcome (Frey syndrome, facial nerve involvement, and ear lobule sensation) and the esthetic results were evaluated subjectively and objectively. Results Facial nerve palsy occurred in 5 cases (45%), and all of them recovered completely within 6 months. The Minor starch iodine test was positive in 3 patients (27%), although only 1 (9%) subjectively complained of gustatory sweating. The designed visual analog score completed by the patients themselves ranged from 0 to 3 with a mean of 1.55 ± 0.93; the scores from the blinded evaluators ranged from 1 to 3 with a mean 1.64 ± 0.67. Conclusion The partial-thickness superiorly based SCM flap offers a reasonable cosmetic option for reconstruction following either superficial or total parotidectomy by improving the facial deformity. The flap also lowers the incidence of Frey syndrome objectively and subjectively with no reported hazard of the spinal accessory nerve.
大多数接受浅叶或全腮腺切除术后的患者会出现面部畸形和味觉出汗综合征,这会导致患者出现明显的不满情绪。目的:评估在浅叶或全腮腺切除术后使用以胸锁乳突肌(SCM)肌瓣为蒂的改良型SCM肌瓣的功能结果和美学效果。方法:对11例接受腮腺切除术并使用部分厚度的以SCM肌瓣为蒂的改良型SCM肌瓣的患者进行前瞻性队列研究。主观和客观地评估功能结果(味觉出汗综合征、面神经受累情况和耳垂感觉)和美学效果。结果:5例(45%)患者出现面神经麻痹,所有患者均在6个月内完全恢复。3例患者(27%)的Minor淀粉碘试验呈阳性,尽管只有1例(9%)患者主观上抱怨有味觉性出汗。患者自行完成的视觉模拟评分范围为0至3分,平均为1.55±0.93分;盲法评估者的评分范围为1至3分,平均为1.64±0.67分。结论:部分厚度的以SCM肌瓣为蒂的改良型SCM肌瓣通过改善面部畸形,为浅叶或全腮腺切除术后的重建提供了一种合理的美容选择。该肌瓣还能客观和主观地降低味觉出汗综合征的发生率,且未报告有副神经损伤的风险。