De Rinaldis Danilo, Scozzaro Calogero, Calvo Alessandro, Basilicata Michele, De Ponte Francesco Saverio, Catalfamo Luciano
Department of Biomedical and Dental Sciences and of Morphological and Functional Images, University of Messina, Messina, Italy.
UOSD Special Care Dentistry, Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, 00100 Rome, Italy.
Indian J Otolaryngol Head Neck Surg. 2024 Oct;76(5):4506-4515. doi: 10.1007/s12070-024-04898-z. Epub 2024 Jul 20.
New technologies are increasingly widespread in medical practice. Particularly, the 3D view is considered among the most useful innovations for surgery. It allows the operator to reconstruct the patient's anatomy in his own mind, going beyond his personal imagination. In the last few years, a new facility has been experienced, it's the Exoscopy. Exoscopy is a magnified vision system, similar to Microscopy, but which also allows a tridimensional vision of the surgical anatomy. Despite Exoscopy having been used for years in Neurosurgery, it has been just rarely described in parotid surgery. We intend to report our experience with Exoscope Aesculap AEOS used to remove benign tumors of the parotid gland. We treated 14 patients with benign tumors of the parotid gland, since September 2023 to November 2023. Each surgery was conducted by the same expert surgeon which also reported his experience about intra-operative complications (as bleeding) in comparison to the traditional procedure without Exoscope. We evaluated the learning curve of Exoscope-Assisted Parotid Surgery comparing, among them, the operative times of the same procedures performed in chronological order. Each patient underwent the same follow-up which included three checks at one month, three months and six months. The follow-up was especially about the evaluation of palsy of the VII C.N. which was assessed through House-Brackmann score (H-B score). The results of our experience reports that the Exoscope is a useful tool for parotid gland surgery. It allows an excellent visualization of the facial nerve main trunk and its branches. Although the first procedures presented longer times in comparison to traditional surgery, the progressive reduction of the operative times demonstrates that the learning curve of Exoscopy is very fast. Certainly, more experience is required for the full introduction of Exoscopy in surgery practice of parotid gland but, now, its potentialities are highly exciting.
新技术在医学实践中越来越普遍。特别是，三维视图被认为是手术中最有用的创新之一。它使手术医生能够在脑海中重建患者的解剖结构，超越其个人想象。在过去几年中，一种新设备得到了应用，即外视镜。外视镜是一种放大视觉系统，类似于显微镜，但也能提供手术解剖结构的三维视觉。尽管外视镜在神经外科已经使用多年，但在腮腺手术中却很少被描述。我们打算报告我们使用蛇牌AEOS外视镜切除腮腺良性肿瘤的经验。自2023年9月至2023年11月，我们治疗了14例腮腺良性肿瘤患者。每次手术均由同一位专家外科医生进行，他还报告了与无外视镜的传统手术相比术中并发症（如出血）的经验。我们通过按时间顺序比较相同手术的手术时间，评估了外视镜辅助腮腺手术的学习曲线。每位患者都接受了相同的随访，包括在1个月、3个月和6个月时进行三次检查。随访尤其关注通过House-Brackmann评分（H-B评分）评估的面神经麻痹情况。我们的经验结果表明，外视镜是腮腺手术的一种有用工具。它能很好地显示面神经主干及其分支。尽管最初的手术与传统手术相比时间更长，但手术时间的逐渐缩短表明外视镜的学习曲线非常快。当然，要在腮腺手术实践中全面引入外视镜还需要更多经验，但目前，其潜力非常令人兴奋。
