Park Jun-Ook
Department of Otolaryngology Head and Neck Surgery, Inje University College of Medicine, Haeundae Paik Hospital, Busan, South Korea.
World J Surg. 2017 Jun;41(6):1488-1493. doi: 10.1007/s00268-017-3873-2.
This study evaluated the feasibility of non-magnified resection of various benign lesions of the upper neck using the facelift incision without endoscopic equipment to establish indications for the procedure.
This retrospective analysis examined 86 patients who underwent surgery for upper neck masses using the facelift incision or conventional transcervical incision at our institute between January 2012 and December 2015.
We performed 41 operations using facelift incisions (facelift group) and 45 using conventional horizontal incisions (conventional group). All 86 operations were successful. In the facelift group, no patient needed conversion to conventional open resection and no patient required the use of an endoscopic device due to a limited surgical view for safe resection. There were no major surgical complications in either group. Transient sensory changes in the auricle occurred in 26% of the patients in the facelift group, but all patients recovered within 2 months. In all patients in the facelift group, the scars were invisible as they were covered by the auricle and hair, while the surgical scars were noticeable in 91% (41/45) of the patients in the conventional group when they were wearing standard shirts (p < 0.001) at 3-4 weeks after surgery.
The facelift approach provides a short direct route to upper neck masses, and it enables an adequate workspace not only for endoscopic or robotic surgery, but also for open surgery with the naked eye. The surgical indications for the facelift incision include the removal of most benign tumors occurring in the upper neck at levels II and III.
本研究评估了在不使用内镜设备的情况下,通过面部提升切口对颈部上段各种良性病变进行非放大切除的可行性,以确定该手术的适应症。
本回顾性分析研究了2012年1月至2015年12月间在我院接受颈部上段肿块手术的86例患者,这些患者采用了面部提升切口或传统的经颈切口。
我们采用面部提升切口进行了41例手术(面部提升组),采用传统水平切口进行了45例手术(传统组)。所有86例手术均成功。在面部提升组中,没有患者需要转为传统的开放切除,也没有患者因手术视野受限而需要使用内镜设备以进行安全切除。两组均未出现重大手术并发症。面部提升组26%的患者出现耳廓短暂感觉改变,但所有患者均在2个月内恢复。在面部提升组的所有患者中,瘢痕被耳廓和头发覆盖而不可见,而在传统组中,91%(41/45)患者术后3 - 4周穿着标准衬衫时手术瘢痕明显可见(p < 0.001)。
面部提升入路为颈部上段肿块提供了一条短而直接的路径,它不仅能为内镜或机器人手术提供足够的操作空间,也能为肉眼直视下的开放手术提供足够空间。面部提升切口的手术适应症包括切除发生在颈部上段II级和III级的大多数良性肿瘤。