Carta F, Mariani C, Marrosu V, Gerosa C, Puxeddu R
Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Italy.
Unit of Pathology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Italy.
Br J Oral Maxillofac Surg. 2020 Nov;58(9):1128-1132. doi: 10.1016/j.bjoms.2020.06.015. Epub 2020 Jul 7.
The authors report their experience regarding parotidectomy performed under a three-dimensional-high-definition (3D-HD) exoscope, with the aim of evaluating its effectiveness in parotid surgery. This is a prospective study on nine patients treated by the same surgeon. All patients underwent parotidectomy for extrafacial primary tumours without preoperative involvement of the skin or of the facial nerve from March 2019 to June 2019 with the use of a 3D-HD exoscope. Magnification was variable from 8x to 30x with direct vision supplied by a 3D monitor. Six men and three women, mean (range) age 47.8 (19-74) years underwent parotidectomy. No patient experienced postoperative complications or definitive facial palsy. The mean (range) time of surgery was 149.4 (115 - 210) minutes. The 3D exoscope represents a valid alternative to the operative microscope or surgical loupe for parotid surgery. It is a light instrument allowing for precise surgical dissection of the parotid region by reducing the risks for iatrogenic lesions of the facial nerve using a real 3D magnification of the anatomical structures in HD. Furthermore, its use does not prolong the operative time and shows high potential for training and educational purposes since the operating room staff can better perceive the procedure and the surgeon's fine gestures. Although the preliminary applications show promising results, there is still a need for wider scientific validation.
作者报告了他们在三维高清（3D-HD）外视镜下进行腮腺切除术的经验，旨在评估其在腮腺手术中的有效性。这是一项针对由同一位外科医生治疗的9名患者的前瞻性研究。从2019年3月至2019年6月，所有患者均使用3D-HD外视镜进行腮腺切除术，以治疗面部外原发性肿瘤，术前皮肤或面神经未受累。放大倍数在8倍至30倍之间变化，通过3D监视器提供直视。6名男性和3名女性，平均（范围）年龄47.8（19-74）岁，接受了腮腺切除术。没有患者出现术后并发症或永久性面瘫。平均（范围）手术时间为149.4（115 - 210）分钟。3D外视镜是腮腺手术中手术显微镜或手术放大镜的有效替代工具。它是一种轻便的仪器，通过高清真实3D放大解剖结构，降低面神经医源性损伤风险，从而实现腮腺区域的精确手术解剖。此外，它的使用不会延长手术时间，并且由于手术室工作人员可以更好地了解手术过程和外科医生的精细操作，因此在培训和教育方面具有很高的潜力。尽管初步应用显示出了有前景的结果，但仍需要更广泛的科学验证。
