The clinical application of modified rhytidectomy incision in superficial parotid tumor surgery / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the modified rhytidectomy incision in superficial parotidectomy.@*METHOD@#Thirty-five patients with superficial parotid tumor were included in this study. A modified rhytidectomy incision often used in facial plastic surgery was used for superficial parotidectomy and subtotal superficial parotidectomy with preservation of facial nerve and great auricular nerve. The follow-up study included the exposed region, the cosmetic effect of this approach and the rate of complication.@*RESULT@#All patients healed without salivary fistula, and were satisfied with this modified approach. Temporary paralysis of the marginal mandibular branch of facial nerve were found in five patients, and six patients felt insensible around earlobe after operation. They all recovered in 1 to 3 months after surgery, no recurrence was happened during follow-up in 36 to 60 months (median follow-up period was 48 months).@*CONCLUSION@#The modified rhytidectomy incision provided good exposure, had less complication and better cosmetic outcome.

A comparison between endoscopic-assisted second branchial cleft cyst resection via retroauricular hairline approach and conventional second branchial cleft cyst resection / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To assess the feasibility, risks and advantages of endoscope-assisted second branchial cleft cyst (SBCC) resection via the retroauricular hairline approach (RHA) by comparing with conventional trans cervical approach.@*METHOD@#Using prospective clinical controlled study, in twenty five patients with SBCC, 13 cases underwent endoscope-assisted resection via the RHA, 12 cases underwent conventional transcervical approach resection. Preoperatively, the sizes, locations and adjacency of all lesions were evaluated by ultrasonography, CT or MRI. Pathologic diagnoses of all cases were identified as SBCC using fine needle aspiration biopsy. Two groups were compared at length of incision, operation time, bleeding, incision cosmetic result, complication etc.@*RESULT@#All 25 operations were successfully performed. Length of incision and operation time in endoscopic group were significantly longer than that of the transcervical group (P < 0.05). After three months, the mean subjective satisfaction score of incision scar in the endoscopic group was significantly higher than that of transcervical group (P < 0.01). In endoscopic group, 1 cases (7.7%) with temporary numbness of earlobe and 1 case (7.7%) with a darkened color change of the flap margin at the incision angle were found postoperatively. However, they were recovered within 1 month. All the 25 patients were disease free with a follow-up from 18 to 36 months (median follow-up: 26 months).@*CONCLUSION@#Endoscope-assisted SBCC resection via RHA is feasible and safe for the treatment of SBCC. In comparison with the transcervical approach, this method can provide an invisible incision and better cosmetic re suits without significant complications.

Meta-analysis on the risk factors for stomal recurrence after total laryngectomy / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the risk factors of stomal recurrence in patients after total laryngectomy.@*METHOD@#A thorough literature search was performed among Wanfang database, Chinese Scientific Journals Database of VIP and pubmed database. Meta analysis was performed on a total of 2725 patients in 2 Chinese papers and 6 English papers which met the inclusion criteria. Data was analyzed by RevMan 5.0 software.@*RESULT@#Subglottic and transglottic location (tumor location), the extent of the tumor of the primary site (T4), preoperative tracheotomy were important risk factors of recurrence after total laryngectomy.@*CONCLUSION@#Subglottic and transglottic location (tumor location), the extent of the tumor of the primary site (T4), preoperative tracheotomy were related to stomal recurrence after total laryngectomy.

Selective neck dissection for treating recurrent branchial anomalies / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the role of selective neck dissection in the treatment of recurrent branchial anomalies.@*METHOD@#The clinical data of 18 patients with recurrent branchial anomalies were retrospectively analyzed. In accordance with the embryologic and anatomic features of branchial anomalies, different types of selective neck dissection were applied. With dissection and protection of important vessels, nerves and other structures, enbloc resection principles were applied to extirpate branchial lesions, scarrings and inflammatory granuloma during the operation.@*RESULT@#Of all 18 patients, 16 cases were healed with primary healing, 2 cases with local incision infection were healed after dressing changes. A temporary facial nerve paralysis occurred in 1 case with recurrent first branchial cleft fistula postoperatively, and completely recovered 2 months after operation. A postoperative temporary vocal cord paralysis occurred in 1 case with recurrent fourth branchial cleft fistula, and totally recuperated 1 month after operation. No recurrences were found in all 18 cases with a follow-up period of 12-78 months (average 35 months).@*CONCLUSION@#Selective neck dissection is a safe and effective surgical procedure for the radical treatment of recurrent branchial anomalies.

Application of rhomboid flap for the repairment of postoperative defects in head and neck cutaneous tumor / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To summarize the clinical repairment experience of postoperative skin defects in head and neck cutaneous tumor.@*METHOD@#From July 2002 to September 2006, 24 patients with head and neck cutaneous tumor were treated in our department. Every specimen and resection margin of all cases were monitored by intraoperative frozen section. Extents of operative skin defects were from 1.0 cm x 1.5 cm to 3.0 cm x 3.5 cm, all of which were repaired by rhomboid flap.@*RESULT@#All the cases were primarily repaired, and followed up 6 month to 3 years. The repaired skins had the normal colour, without obviously scars or secondary deformations.@*CONCLUSION@#The rhomboid flap is reasonably designed, conveniently procured and manipulated. It is a better method to immediately repair the head and neck skin defects after radical excision of tumor.