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全腮腺切除术后美学与功能并发症的管理。首次使用 Surgimend® 真皮基质治疗腮腺恶性肿瘤患者的长期经验。

Management of Aesthetical and Functional Complications after Total Parotidectomy. First Long-Term Experiences with Dermal Matrix Surgimend ® in Patient Affected by Malignant Parotid Tumors.

作者信息

Bonavolonta Paola, Iaconetta Giorgio, Improda Giovanni, Germano Cristiana, Borriello Gerardo, Goglia Federica, Abbate Vincenzo, Piombino Pasquale, Califano Luigi, Dell'Aversana Orabona Giovanni

机构信息

Maxillofacial Surgery UnitDepartmentof Medicine and SurgeryDepartment of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Sergio Pansini 5, 80131 Naples, Italy.

Department of Neurosurgery, University of Salerno, Salerno, Italy.

出版信息

J Maxillofac Oral Surg. 2024 Dec;23(6):1535-1541. doi: 10.1007/s12663-022-01761-y. Epub 2022 Jul 23.

DOI:10.1007/s12663-022-01761-y
PMID:39618453
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11607226/
Abstract

BACKGROUND

This is an observational cohort study on patients affected by malignant parotid tumors treated with total parotidectomy. The aim of our work is to analyze and compare the effects and complications after parotidectomy, using or not SurgiMend ®.

METHODS

40 patients were retrospectively enrolled between September 2014 and June 2020. Basing on the placement of SurgiMend ® for parotid lodge reconstruction, the samples were divided into two groups. Thus, the incidence rate of complications after the surgical procedure was analyzed between the two groups.

RESULTS

Patients in whom SurgiMend ® was used reported a lower rate of complications The ANOVA test ( = 0.05) revealed a significant difference of Vancouver Scar Scale (VSS) between the two groups, representation as vascularity and pigmentation improvement, changing scar color, scar height reduction, and increased pliability.

CONCLUSION

Although many techniques are available to fill the parotidectomy defect, improve facial contour and prevent Frey's syndrome, the use of SurgiMend ® matrix is one of most effective and reliable method to address these complications, with the advantage of decreased operative time due to not require an additional surgical donor site.

摘要

背景

这是一项关于接受全腮腺切除术治疗的腮腺恶性肿瘤患者的观察性队列研究。我们研究的目的是分析和比较使用或不使用SurgiMend®进行腮腺切除术后的效果和并发症。

方法

回顾性纳入2014年9月至2020年6月期间的40例患者。根据是否使用SurgiMend®进行腮腺窝重建将样本分为两组。因此,分析了两组手术并发症的发生率。

结果

使用SurgiMend®的患者并发症发生率较低。方差分析(P = 0.05)显示两组之间温哥华瘢痕量表(VSS)存在显著差异,表现为血管化和色素沉着改善、瘢痕颜色改变、瘢痕高度降低和柔韧性增加。

结论

尽管有许多技术可用于填补腮腺切除术后的缺损、改善面部轮廓和预防Frey综合征,但使用SurgiMend®基质是解决这些并发症最有效和可靠的方法之一,其优点是无需额外的手术供区,从而缩短了手术时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e71/11607226/6310e71ad29a/12663_2022_1761_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e71/11607226/4b9a306427d7/12663_2022_1761_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e71/11607226/6310e71ad29a/12663_2022_1761_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e71/11607226/4b9a306427d7/12663_2022_1761_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e71/11607226/6310e71ad29a/12663_2022_1761_Fig2_HTML.jpg

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本文引用的文献

1
Prognostic factors in parotid cancers: Clinicopathological and treatment factors influencing outcomes.腮腺癌的预后因素:影响预后的临床病理及治疗因素
Indian J Cancer. 2018 Jan-Mar;55(1):98-104. doi: 10.4103/ijc.IJC_503_17.
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Complications after parotid gland surgery Our experience.腮腺手术后的并发症 我们的经验
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Use of the SMAS flap for reconstruction of the parotid lodge.使用SMAS瓣重建腮腺区。
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Effects of free fat grafting on the prevention of Frey's syndrome and facial depression after parotidectomy: A prospective randomized trial.游离脂肪移植对腮腺切除术后预防味觉出汗综合征和面部凹陷的效果:一项前瞻性随机试验。
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Paraumbilical fat graft for the correction of contour deformity following parotidectomy and prevention of Frey syndrome.脐旁脂肪移植用于腮腺切除术后轮廓畸形的矫正及预防味觉出汗综合征。
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What score on the Vancouver Scar Scale constitutes a hypertrophic scar? Results from a survey of North American burn-care providers.温哥华瘢痕量表的多少分算作增生性瘢痕?北美烧伤护理提供者调查的结果。
Burns. 2015 Nov;41(7):1442-8. doi: 10.1016/j.burns.2015.04.018. Epub 2015 Jul 2.
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Bovine versus Porcine Acellular Dermal Matrix: A Comparison of Mechanical Properties.牛脱细胞真皮基质与猪脱细胞真皮基质:力学性能比较
Plast Reconstr Surg Glob Open. 2014 Jun 6;2(5):e155. doi: 10.1097/GOX.0000000000000072. eCollection 2014 May.
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Reconstructive techniques of the parotid region.腮腺区的重建技术。
J Craniofac Surg. 2014 May;25(3):998-1002. doi: 10.1097/SCS.0000000000000664.
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A modified Vancouver Scar Scale linked with TBSA (mVSS-TBSA): Inter-rater reliability of an innovative burn scar assessment method.改良温哥华瘢痕量表结合体表面积(mVSS-TBSA):一种创新烧伤瘢痕评估方法的组内信度。
Burns. 2013 Sep;39(6):1142-9. doi: 10.1016/j.burns.2013.01.014. Epub 2013 Feb 22.