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超声刀与电灼法行部分下颌下腺切除术的比较

Partial Submandibular Gland Resection With Ultrasonic Dissector vs Electrocautery.

作者信息

Buckner Hallie, Shah Anil R

出版信息

Aesthet Surg J Open Forum. 2025 Feb 11;7:ojaf011. doi: 10.1093/asjof/ojaf011. eCollection 2025.

DOI:10.1093/asjof/ojaf011
PMID:40236889
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11997774/
Abstract

BACKGROUND

The superficial aspect of the submandibular gland can be removed to improve the aesthetic appearance of the face and neck. This study describes a novel surgical technique to resect part of the submandibular gland during a deep neck or facelift.

OBJECTIVES

Describe the technique to remove the superficial lobe of the submandibular gland using an ultrasonic dissector. Analyze the association between the uses of ultrasonic technology and reduced postoperative complications. Compare rates of postoperative complications between standard electrocautery and ultrasonic dissection.

METHODS

Experimental and control groups were established. A Sonicision ultrasonic dissector (Covidien, Dublin, Ireland) was used for resection in the experimental group, whereas electrocautery was used for resection in the control group. Postoperative outcomes of neuropraxia, hematoma, seroma, and sialocele formation were collected. Statistical analysis was performed using a Fisher's exact test in RStudio.

RESULTS

Control patients ( = 32) experienced 1 hematoma, 3 seromas, 3 sialoceles, and 3 neuropraxias. Experimental patients ( = 48) experienced 2 seromas with no hematomas, sialoceles, or neuropraxia. No association of statistical significance between reduced risk of complications and use of ultrasonic dissection was found.

CONCLUSIONS

This novel technique has the potential to improve the safety and efficacy of partial submandibular gland resection. However, a follow-up study with a greater sample size and without confounding variables, such as intraoperative injection of Botulinum toxin, is necessary.

LEVEL OF EVIDENCE 3: (Therapeutic).

摘要

背景

可切除下颌下腺的浅部以改善面部和颈部的美观。本研究描述了一种在颈部深层手术或面部提升术中切除部分下颌下腺的新型手术技术。

目的

描述使用超声刀切除下颌下腺浅叶的技术。分析超声技术的使用与术后并发症减少之间的关联。比较标准电灼术和超声刀切除术的术后并发症发生率。

方法

设立实验组和对照组。实验组使用Sonicision超声刀(柯惠医疗,爱尔兰都柏林)进行切除,而对照组使用电灼术进行切除。收集术后神经失用、血肿、血清肿和涎瘘形成的结果。在RStudio中使用Fisher精确检验进行统计分析。

结果

对照组患者(n = 32)出现1例血肿、3例血清肿、3例涎瘘和3例神经失用。实验组患者(n = 48)出现2例血清肿,无血肿、涎瘘或神经失用。未发现并发症风险降低与超声刀切除术的使用之间存在统计学意义上的关联。

结论

这种新技术有可能提高部分下颌下腺切除术的安全性和有效性。然而,有必要进行一项样本量更大且无混杂变量(如术中注射肉毒杆菌毒素)的随访研究。

证据水平3:(治疗性)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc0f/11997774/fb266fbaffa9/ojaf011f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc0f/11997774/615808222033/ojaf011f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc0f/11997774/fb266fbaffa9/ojaf011f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc0f/11997774/615808222033/ojaf011f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc0f/11997774/fb266fbaffa9/ojaf011f2.jpg

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Plast Reconstr Surg. 2025 Jan 1;155(1):35-45. doi: 10.1097/PRS.0000000000011419. Epub 2024 Mar 25.
2
Clinical Anatomy of Feeding Artery of the Submandibular Gland.下颌下腺供血动脉的临床解剖学
J Craniofac Surg. 2022 Oct 1;33(7):2256-2257. doi: 10.1097/SCS.0000000000008613. Epub 2022 Mar 3.
3
Haemostatic devices in parotid surgery: a systematic review.腮腺手术中的止血器械:系统评价。
J Laryngol Otol. 2021 Oct;135(10):848-854. doi: 10.1017/S0022215121001973. Epub 2021 Aug 23.
4
[Injection of incobotulinum toxin A for the prevention of postoperative salivary fistula and sialocele].注射英妥昔单抗A预防术后涎瘘和涎囊肿
Stomatologiia (Mosk). 2021;100(2):55-59. doi: 10.17116/stomat202110002155.
5
Intraoperative botulinum toxin injection for superficial partial parotidectomy: A prospective pilot study.术中肉毒毒素注射用于腮腺浅叶部分切除术:一项前瞻性初步研究。
Clin Otolaryngol. 2021 Sep;46(5):998-1004. doi: 10.1111/coa.13767. Epub 2021 Apr 27.
6
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7
Vascular clinical anatomy of the submandibular gland.颌下腺的血管临床解剖。
J Craniomaxillofac Surg. 2020 Jun;48(6):582-589. doi: 10.1016/j.jcms.2020.04.004. Epub 2020 Apr 22.
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Botulinum toxin A is an effective therapeutic tool for the management of parotid sialocele and fistula: A systematic review.A型肉毒杆菌毒素是治疗腮腺唾液囊肿和瘘管的有效工具:一项系统评价。
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