Clinical application of midpiece facial nerve dissection in regional parotidectomy / 华西口腔医学杂志

OBJECTIVE@#To propose and evaluate the clinical effect of midpiece facial nerve dissection through transparotid approach in regional parotidectomy.@*METHODS@#A total of 136 patients with benign parotid tumors were categorized into three groups according to the way of facial nerve dissection: anterograde dissection from main trunk (anterograde, n=70), retrograde dissection from distal branches (retrograde, n=34), and midpiece dissection through transparotid approach (middle dissection, n=32). Surgery duration, facial nerve injury, salivary fistula, earlobe sensation, Frey's syndrome, and aesthetic evaluation were compared.@*RESULTS@#The surgery duration in the middle dissection group was significantly shorter than that in the other two groups. The proportion of salivary fistula was higher in the anterograde group (9 cases, 12.9%; P<0.05) compared with that in the other groups. Postoperative facial nerve injury was similar between the middle dissection (1 case, 3.1%) and anterograde groups (3 cases, 4.3%) with lower injury rate compared with the retrograde group (7 cases, 20.6%). The anterograde group had more cases of hypoesthesia of the earlobe (12 cases, 17.1%; P<0.05) than the other two groups. Aesthetic score was higher in the anterograde and middle dissection groups compared with that in the retrograde group (P<0.05).@*CONCLUSIONS@#Midpiece facial nerve dissection is technically feasible and clinically viable in regional parotidectomy.

Extracapsular dissection of the upper part of parotid gland benign tumor using a tragus edge combined retroauticular hairline incision approach / 口腔疾病防治

Objective@#To investigate the clinical effect of dissection in the upper part of parotid gland benign tumor using a tragus edge combined retroauticular hairline incision approach.@*Methods@#20 cases of upper part of parotid gland benign tumor were resected using the tragus edge combined retroauticular hairline incision approach, the surgery and cosmetic effect were analyzed. @*Results@#Parotid gland tumors were checked by CT before the operation and diagnosed by frozen section analysis during the operation. The tumors were successfully complete resected in all cases. There were no complications of Frey’s syndrome, postoperative bleeding, and flap necrosis, 2 cases showed a temporary earlobe numbness, 1 case of temporary facial nerve paralysis and 1 case of salivary fistula. There were no tumor recurrence after 24 ~ 48 months followed up. Surgical incision cosmetic effect is satisfactory. @*Conclusion@#The tragus edge combined retroauticular hairline incision is safe and feasible, with less complications for the upper part of parotid gland benign tumor resecetion.