ENT Unit, San Luigi Gonzaga Hospital, Orbassano (TO), Italy.
Department of Oncology, University of Turin, Orbassano (TO), Italy.
Acta Otorhinolaryngol Ital. 2022 Dec;42(6):516-524. doi: 10.14639/0392-100X-N2231.
Parotidectomy is the main treatment for parotid tumours, but its functional and aesthetic sequelae can be very disturbing for patients.
15 patients underwent total conservative parotidectomy, harvesting of a superficial musculoaponeurotic system (SMAS) flap and lipofilling between May 2014 and June 2020 for a benign parotid tumour. Aesthetic, functional sequelae and cosmetic results were assessed with the House-Brackmann scale, Luna-Ortiz's classification and a semiquantitative questionnaire. Lipofilling resorption was analysed by maxillofacial and neck MRI imaging at 2 years after surgery. The results were compared to a group of 21 patients who underwent total parotidectomy without harvesting a SMAS flap and lipofilling.
No complications were observed. No facial defects were seen during follow-up. Post-operative MRI showed fat resorption was less than 20% in 12 patients and from 20 to 30% in 3 patients. Cosmetic satisfaction was 100% in all cases. Only 1 patient (6%) complained of Frey's syndrome.
Lipofilling is an excellent solution considering its efficacy, safety, simplicity, duration over time and economic costs. Donor site invasiveness is minimal, and reintervention is always possible. Face-lift incision and SMAS flap can improve aesthetic results and minimise the disfiguring impact of the surgical scar.
腮腺切除术是腮腺肿瘤的主要治疗方法，但它会给患者带来功能和美观方面的严重后遗症。
2014 年 5 月至 2020 年 6 月期间，15 例良性腮腺肿瘤患者接受了全腮腺保守切除术、浅层肌肉筋膜系统（SMAS）皮瓣游离和脂肪填充术。采用 House-Brackmann 量表、Luna-Ortiz 分类和半定量问卷评估美容、功能后遗症和美容效果。术后 2 年通过颌面颈部 MRI 成像分析脂肪填充吸收率。结果与 21 例未行 SMAS 皮瓣游离和脂肪填充的全腮腺切除术患者进行比较。
未观察到任何并发症。随访期间未出现面部缺陷。术后 MRI 显示 12 例患者的脂肪吸收率小于 20%，3 例患者的脂肪吸收率为 20%至 30%。所有病例的美容满意度均为 100%。仅有 1 例（6%）患者抱怨 Frey 综合征。
考虑到其疗效、安全性、简单性、随时间的持续效果和经济成本，脂肪填充是一种极好的解决方案。供区侵袭性极小，可随时进行再次干预。面部提升切口和 SMAS 皮瓣可改善美容效果，并最大程度减少手术疤痕的毁容影响。
