Cummins Andi J, Surek Christopher C, Charafeddine Ali H, Scomacao Isis, Duraes Eliana, Zins James E
Case Western Reserve University School of Medicine, Cleveland, OH, USA.
U.S. Dermatology Partners, Kansas City, KS, USA.
Aesthetic Plast Surg. 2020 Apr;44(2):354-358. doi: 10.1007/s00266-019-01608-x. Epub 2020 Jan 24.
Patients who have previously undergone superficial parotidectomy may also seek facelift surgery for facial aging and rejuvenation. These patients present unique challenges compared to a standard facelift patient. Most concerning is the location of facial nerve branches, which may be superficial and displaced. In addition, significant contour deformities and abnormal scar patterns may be present. The purpose of the study is to review our series of patients and assess potential morbidity and safety of facelift surgery in superficial parotidectomy patients.
A retrospective case series was performed reviewing all patients who underwent facelift surgery following superficial parotidectomy from 2000 to 2017. Data were collected for: postoperative facial nerve deficit, soft tissue contour and scar deformities, facelift technique, ancillary soft tissue augmentation procedures and pre- and postoperative photographs. An evidence-based treatment algorithm to address specific problems in this patient population was developed.
A total of seven patients were identified who underwent facelift surgery following parotidectomy. Patients underwent one of the standard SMAS procedure on the non-parotidectomy side, and surgical modifications were made to address the parotidectomy side; soft tissue augmentation was performed in two patients. Precautions to identify the facial nerve and prevent injury, including nerve monitoring and stimulation, were utilized in all seven patients. No permanent postoperative facial nerve injury was noted.
Facelift following superficial parotidectomy was safely performed in all cases. Special consideration should be given to contour deformities, facial nerve location and scar placement. However, if approached properly, these patients can still be considered as suitable candidates for facelift surgery.
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既往接受过腮腺浅叶切除术的患者也可能因面部老化和年轻化而寻求面部提升手术。与标准的面部提升手术患者相比，这些患者存在独特的挑战。最令人担忧的是面神经分支的位置，其可能表浅且移位。此外，可能存在明显的轮廓畸形和异常瘢痕模式。本研究的目的是回顾我们的一系列患者，并评估腮腺浅叶切除术后患者面部提升手术的潜在发病率和安全性。
进行一项回顾性病例系列研究，回顾2000年至2017年间所有在腮腺浅叶切除术后接受面部提升手术的患者。收集以下数据：术后面神经缺损、软组织轮廓和瘢痕畸形、面部提升技术、辅助软组织增强手术以及术前和术后照片。制定了一种基于证据的治疗算法，以解决该患者群体中的特定问题。
共确定7例在腮腺切除术后接受面部提升手术的患者。患者在未行腮腺切除术的一侧接受了标准的SMAS手术之一，并对行腮腺切除术的一侧进行了手术改良；2例患者进行了软组织增强。所有7例患者均采用了识别面神经并防止损伤的预防措施，包括神经监测和刺激。未发现永久性术后面神经损伤。
所有病例中腮腺浅叶切除术后的面部提升手术均安全进行。应特别考虑轮廓畸形、面神经位置和瘢痕位置。然而，如果处理得当，这些患者仍可被视为面部提升手术的合适候选人。
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