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腮腺切除术后基于胸锁乳突肌前份的部分厚度肌瓣

Anteriorly Based Partial Thickness Sternocleidomastoid Muscle Flap Following Parotidectomy.

作者信息

Dalmia Deepak, Behera Sanjaya Kumar, Bhatia Jas Simran Singh

机构信息

Department of ENT, Dr. BAM Hospital, Byculla (E), Mumbai, India ; Department of ENT and HNS, Dr. BAM Central Railway Hospital, Byculla (E), Mumbai, 400027 India.

Department of ENT, Dr. BAM Hospital, Byculla (E), Mumbai, India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2016 Mar;68(1):60-4. doi: 10.1007/s12070-015-0906-8. Epub 2016 Mar 14.

Abstract

The anteriorly based partial thickness sternocleidomastoid (SCM) muscle flap is among the various methods described to correct parotidectomy defects, but its indications and limitations are not clearly demonstrated in several reports. This study was done to test the aesthetic outcome of this method, its indications and limitations. At Dr. Babasaheb Ambedkar Memorial hospital, Mumbai, 20 patients presenting with benign parotid tumors underwent parotidectomy. 16 underwent superficial parotidectomy and 3 underwent adequate parotidectomy, 1 had total parotidectomy. The anteriorly based partial thickness SCM muscle flap was used to correct the contour deformity and to prevent Frey syndrome. The aesthetic result was evaluated by assessing and scoring the overall appearance of the scar, the degree of symmetry of the reconstructed parotid region and the site of the donor muscle in comparison to their contralateral normal sides. The overall aesthetic appearance was good in 17 patients, and moderate in 3 patients. 17/20 patients had an overall deep satisfaction with the result. The residual hollowness following total parotidectomy defect and the poor quality of scars were the main reasons affecting the aesthetic outcome. Superficial parotidectomy through modified Blair's incision with immediate reconstruction with anteriorly based partial thickness SCM flap allows a satisfactory aesthetic outcome and minimal donor site morbidity. Scores of the above two parameters were accessed. Patients' satisfaction was assessed by patients questionnaire.

摘要

以胸锁乳突肌(SCM)肌瓣前侧为基底的部分厚度肌瓣是用于纠正腮腺切除术后缺损的多种方法之一,但在几份报告中其适应证和局限性并未得到明确阐述。本研究旨在测试该方法的美学效果、适应证和局限性。在孟买的巴巴萨赫布·安贝德卡尔纪念医院,20例患有腮腺良性肿瘤的患者接受了腮腺切除术。16例行浅叶腮腺切除术,3例行全腮腺切除术,1例行腮腺全切术。采用以胸锁乳突肌肌瓣前侧为基底的部分厚度肌瓣来纠正外形畸形并预防味觉出汗综合征。通过评估和评分瘢痕的整体外观、重建腮腺区域的对称程度以及供肌部位与其对侧正常部位相比的情况来评价美学效果。17例患者的整体美学外观良好,3例为中等。20例患者中有17例对结果总体深感满意。全腮腺切除术后缺损后的残余凹陷和瘢痕质量差是影响美学效果的主要原因。通过改良布莱尔切口行浅叶腮腺切除术并立即用以胸锁乳突肌肌瓣前侧为基底的部分厚度肌瓣进行重建可获得满意的美学效果且供区并发症最少。对上述两个参数进行了评分。通过患者问卷评估患者的满意度。

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本文引用的文献

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Parotidectomy for benign parotid tumors: an aesthetic approach.腮腺良性肿瘤的腮腺切除术:一种美学方法。
J Egypt Natl Canc Inst. 2011 Jun;23(2):67-72. doi: 10.1016/j.jnci.2011.09.005. Epub 2011 Oct 8.
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Reconstruction after total parotidectomy using a de-epithelialized free flap.
J Craniomaxillofac Surg. 2007 Dec;35(8):364-8. doi: 10.1016/j.jcms.2007.07.005. Epub 2007 Oct 22.
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Parotidectomy: assessment of a surgical technique including facelift incision and SMAS advancement.
J Craniomaxillofac Surg. 2006 Jan;34(1):34-7. doi: 10.1016/j.jcms.2005.08.007. Epub 2005 Dec 15.
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Functional outcome after total parotidectomy reconstruction.
Laryngoscope. 2004 Feb;114(2):223-6. doi: 10.1097/00005537-200402000-00009.

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