Nair Satish, Aishwarya J G, Jain Aditya, Pavithra V, Mohan Sneha
Department of ENT-HNS, Apollo Hospitals, Bannerghatta Road, Bangalore, Karnataka 560076 India.
Indian J Otolaryngol Head Neck Surg. 2022 Dec;74(Suppl 3):6174-6179. doi: 10.1007/s12070-021-02882-5. Epub 2021 Sep 30.
Traditional parotidectomy incision was devised by Blair (1912) which was modified by Bailey (1941). Over the years various approaches and techniques have evolved to improve the aesthetic outcome and at the same time for complete disease clearance with reduced complications. In this study, we evaluated the feasibility of our mini-incision parotidectomy technique along with the surgical and quality of life (QOL) outcomes. This prospective case series was conducted at Apollo Hospitals, Bangalore over a period of 2 years (June 2018-August 2020) and includes 20 patients. The surgical outcomes were assessed in terms of feasibility of mini-incision technique with respect to levels of parotid involved and functional outcomes in terms of presence or absence of complications like facial palsy (temporary or permanent), seroma and Frey's syndrome. Patient related quality of life (QOL) outcomes were assessed in terms of post-operative pain score, patient comfort score and cosmetic score by using numerical rating scale-11 (NRS-11). The mini-incision parotidectomy technique is feasible for lesions in all the parotid levels and conversion or lengthening of incision was not needed in any of the cases. 2(10%) patients had temporary facial palsy (House-Brackman grade III) which was recovered within 3 weeks after surgery. One patient (5%) with adenoid cystic carcinoma had permanent facial palsy. Out of 20 patients 2(10%) had seroma and 1(5%) patient presented with Frey's syndrome. Mean post-operative pain score at 0, 6 and 24 h were 4.8, 3.4 and 1.8 out of 10 respectively. Mean comfort score was 9 out of 10 and mean cosmetic score was 9.5 out of 10. Mini-incision parotidectomy technique can render improved functional as well as aesthetic outcomes after parotidectomy without compromising the surgical clearance of the disease process.
传统腮腺切除术切口由布莱尔（1912年）设计，后经贝利（1941年）改良。多年来，各种手术方法和技术不断发展，以改善美学效果，同时实现疾病的彻底清除并减少并发症。在本研究中，我们评估了小型切口腮腺切除术技术的可行性以及手术效果和生活质量（QOL）结果。本前瞻性病例系列研究在班加罗尔的阿波罗医院进行，为期2年（2018年6月至2020年8月），共纳入20例患者。根据小型切口技术在腮腺受累程度方面的可行性以及面神经麻痹（暂时性或永久性）、血清肿和弗雷综合征等并发症的有无来评估手术效果。通过使用数字评分量表-11（NRS-11），从术后疼痛评分、患者舒适度评分和美容评分方面评估患者相关的生活质量（QOL）结果。小型切口腮腺切除术技术对于所有腮腺水平的病变都是可行的，所有病例均无需延长或转换切口。2例（10%）患者出现暂时性面神经麻痹（House-Brackman III级），术后3周内恢复。1例（5%）腺样囊性癌患者出现永久性面神经麻痹。20例患者中有2例（10%）出现血清肿，1例（5%）患者出现弗雷综合征。术后0、6和24小时的平均疼痛评分分别为4.8分、3.4分和1.8分（满分10分）。平均舒适度评分为9分（满分10分），平均美容评分为9.5分（满分10分）。小型切口腮腺切除术技术在腮腺切除术后可在不影响疾病手术清除的情况下改善功能和美学效果。
