皮瓣脂肪移植重建腮腺切除术缺损可使面部注意正常化。
Dermal Fat Grafting to Reconstruct the Parotidectomy Defect Normalizes Facial Attention.
机构信息
Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA.
出版信息
Laryngoscope. 2021 Jan;131(1):E124-E131. doi: 10.1002/lary.28890. Epub 2020 Jul 13.
OBJECTIVES/HYPOTHESIS: Use validated eye-tracking technology to objectively measure 1) the attentional distraction of facial contour defects after superficial and total parotidectomy and 2) changes in attentional distraction with abdominal dermal fat graft reconstruction.
METHODS
Standardized frontal and oblique facial images of 16 patients who had undergone superficial or total parotidectomy with or without fat graft reconstruction; four normal controls were obtained. One hundred casual observers were recruited to view these images, and gaze data were collected using a Tobii Pro eye-tracking system. Gaze durations for predefined facial areas of interest were analyzed using mixed-effects linear regression to test study hypotheses.
RESULTS
For frontal images, total parotidectomy increased gaze to the operated parotid area compared to the contralateral nonoperated parotid area (92 milliseconds, 95% confidence interval [CI]: 48-138 milliseconds, P < .001). Fat grafting normalized the attentional distraction, with no difference in gaze time on the operated parotid region compared to normal control faces (P = .414). For oblique images, total parotidectomy increased gaze to the operated parotid area compared to the contralateral nonoperated parotid area (658 milliseconds, 95% CI: 463-854 milliseconds, P < .001). Fat grafting normalized this attentional distraction, with no difference in gaze time on the operated parotid region compared to normal control faces (P = .504). In both views, superficial parotidectomy demonstrated no significant attentional distractions, with or without fat grafting.
CONCLUSIONS
This eye-tracking study objectively demonstrates that total parotidectomy results in a facial contour deformity that is distracting to observers, whereas superficial parotidectomy does not. For total parotidectomy, this attentional distraction can be normalized with dermal fat graft reconstruction.
LEVEL OF EVIDENCE
3b Laryngoscope, 131:E124-E131, 2021.
目的/假设：使用经过验证的眼动追踪技术客观测量 1）腮腺浅叶和全切除术后面部轮廓缺陷的注意力分散，2）腹部真皮脂肪移植重建后面部轮廓缺陷的注意力分散的变化。
方法
获得 16 例接受腮腺浅叶或全切除术及或脂肪移植重建的患者的标准正面和斜面部图像；获得 4 例正常对照。招募了 100 名随机观察者来观察这些图像，并使用 Tobii Pro 眼动追踪系统收集注视数据。使用混合效应线性回归分析来分析预定的面部感兴趣区域的注视时间，以检验研究假设。
结果
对于正面图像，与对侧未手术的腮腺区相比，全腮腺切除术增加了对手术侧腮腺区的注视时间（92 毫秒，95%置信区间[CI]：48-138 毫秒，P<.001）。脂肪移植使注意力分散正常化，与正常对照面部相比，手术侧腮腺区的注视时间无差异（P=.414）。对于斜位图像，与对侧未手术的腮腺区相比，全腮腺切除术增加了对手术侧腮腺区的注视时间（658 毫秒，95% CI：463-854 毫秒，P<.001）。脂肪移植使这种注意力分散正常化，与正常对照面部相比，手术侧腮腺区的注视时间无差异（P=.504）。在两种视图中，腮腺浅叶切除术均无明显的注意力分散，无论是否进行脂肪移植。
结论
这项眼动追踪研究客观地表明，全腮腺切除术导致观察者注意力分散的面部轮廓畸形，而腮腺浅叶切除术则没有。对于全腮腺切除术，真皮脂肪移植重建可使这种注意力分散正常化。
证据水平
3b Laryngoscope, 131:E124-E131, 2021.
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