Quality of life after surgery for benign disease of the parotid gland.

OBJECTIVE: To evaluate quality of life after surgery for benign neoplastic disease of the parotid gland. PATIENTS AND METHODS: A quality of life questionnaire, which was created from the Hebrew version of the University of Washington Quality of Life prototype, was applied to 55 patients who underwent surgery for benign neoplastic parotid disease. All patients were examined in Baskent University Adana Teaching and Medical Research Center, where all except 10 subjects (who responded by phone) completed the quality of life questionnaire. RESULTS: The highest overall score was 96.3 indicating no salivary fistula. Only one patient complained of salivary secretion through the wound scar. The lowest overall score was 59.5 indicating loss of sensation. Although no post-surgical pain was reported by 32 (58 per cent) patients, 16 (29 per cent) patients reported a post-surgical change in their appearance. Scarring and surgical site depression were reported by 26 (47 per cent) and 17 patients (30 per cent), respectively. Facial nerve impairment was reported by seven patients (13 per cent) during the early post-operative period; these patients recovered from that impairment. The only significant statistical correlations were noted between general health and gender, and between post-surgical pain and gender. There was not any statistical correlation between all data and age, tumour type and education level. CONCLUSION: The general status of patients who have undergone surgery for a benign parotid neoplasm can be assessed with a quality of life questionnaire. Patients' post-surgical quality of life can be improved by the correct choice of surgical approach and reconstructive method.

Microvascular reconstruction of the mandible in irradiated patients.

This work focuses on the use of revascularized free flaps for the reconstruction of the major defects of the mandible after the removal of advanced-stage tumors in irradiated patients. It uses three representative cases to study the problems of complex patients and the possible reconstructive options. The cases, all three young patients (two females and one male), had undergone a mandibulectomy and adjuvant radiotherapy for malignant neoplasms. In each case, secondary reconstruction of the mandible and soft tissue was necessary and was performed using microvascular free flaps. An osteomyocutaneous iliac crest free flap was used in two cases, whereas a double flap (fibula free flap + rectus abdominis free flap) was used in the other case. In all three cases, after the microvascular reconstruction, an orthognathic procedure was performed to obtain the correct maxillomandibular relationship. The advantages and disadvantages of the various techniques used are discussed.

[Musculo-cutaneous flaps in the reconstruction of the organs after oncological operations in the head and neck areas]. / Platy skórno-miesniowe w rekonstrukcji narzadów po operacjach onkologicznych w obrebie glowy i szyi.

A method of skin-muscular flaps construction is being discussed together with their use for the reconstruction of the organs after oncological surgery of the head and neck. Own experience with the use of such flaps in 83 cases are also discussed.

Superficial musculoaponeurotic system amelioration of parotidectomy defects.

Resection of the parotid area for tumor results in several deformities. In addition to the neck scar, there is a retromandibular and cheek depression. By using a rhytidectomy incision and advancement of the superficial musculoaponeurotic fascia, we have obtained excellent exposure for all parotid operations, including those for accessory parotid lobe lesions, and have corrected the resultant deformities initially or secondarily. This procedure has been used for superficial and deep lobe tumors, partial masseter muscle resection, and recurrent tumors without compromising any of the principles of parotid tumor resection. The approach has resulted in greater acceptance of the tumor surgery by patients and less dissatisfaction postoperatively.