Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China.
Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China.
J Craniomaxillofac Surg. 2022 May;50(5):449-455. doi: 10.1016/j.jcms.2021.09.012. Epub 2021 Sep 30.
The aim of the study was to evaluate the efficacy and preliminary outcomes of using a postauricular-groove approach without endoscopic assistance for the excision of parotid tumors. Patients who underwent parotidectomy using a postauricular-groove incision were selected for this study. For patients in which parotidectomy was difficult, namely, for tumors located in the deep lobe area, the parotid gland sternocleidomastoid space was fully utilized, and the tumor was resected from the posterior plane. A total of fifty-eight patients with parotid tumor were enrolled and divided into superior lobe group (n = 46) and deep lobe group (n = 12). The difference in operation time (94 vs 119 min) and postoperative drainage (20.18 vs 45.33 mL) was statistically significant between the tumors in the superficial and deep lobes. However, postoperative cosmetic VAS score was 10 (extremely satisfied) for all patients. The incidence of transient facial nerve paralysis was comparable (8.7% vs 16.7%), and all of them resolved spontaneously within 3 months. No recurrence of tumors was found in either group in the median follow-up interval of 26.45 months (range 22.2-35.3 months), which was comparable to the result using the conventional "S" approach. After making full use of the parotid gland sternocleidomastoid space, the postauricular-groove approach demonstrated satisfactory facial nerve protection, as well as easy maneuverability without the risk of surgical complications for tumors located in the deep lobe area. Importantly, the postauricular-groove approach showed excellent cosmetic outcomes for all patients and should be considered an alternative approach for parotidectomy of selected cases.
本研究旨在评估不借助内镜经耳后沟入路切除腮腺肿瘤的疗效和初步结果。选择经耳后沟切口行腮腺切除术的患者进行本研究。对于腮腺深叶区肿瘤等切除困难的患者，充分利用腮腺颌后区，从后平面切除肿瘤。共纳入 58 例腮腺肿瘤患者，分为上叶组（n=46）和深叶组（n=12）。浅叶与深叶肿瘤在手术时间（94 分钟比 119 分钟）和术后引流（20.18 毫升比 45.33 毫升）方面的差异有统计学意义。但所有患者术后美容视觉模拟评分（VAS）均为 10（非常满意）。暂时性面瘫的发生率相似（8.7%比 16.7%），所有患者均在 3 个月内自发缓解。在中位数为 26.45 个月（22.2-35.3 个月）的随访期间，两组均未发现肿瘤复发，与传统“S”形入路结果相当。充分利用腮腺颌后区，耳后沟入路可对面神经提供满意的保护，且对于深叶区肿瘤操作简便，无手术并发症风险。重要的是，耳后沟入路对所有患者均取得了良好的美容效果，应考虑作为某些病例腮腺切除术的替代方法。
