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10.1186_s40463-020-00472-z.pdf 1,02MB
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1000 Titel
  • Prospective outcomes following drainless superficial parotidectomy with sternocleidomastoid flap reconstruction
1000 Autor/in
  1. Melong, Jonathan C. |
  2. Rigby, Matthew H. |
  3. Corsten, Martin |
  4. Trites, Jonathan R. B. |
  5. Bulter, Angela |
  6. Taylor, S. Mark |
1000 Verlag
  • SAGE Publications
1000 Erscheinungsjahr 2020
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2020-01-01
1000 Erschienen in
1000 Quellenangabe
  • 49(1)
1000 Copyrightjahr
  • 2020
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1186/s40463-020-00472-z |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7541257/ |
1000 Publikationsstatus
1000 Begutachtungsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • <jats:sec><jats:title>Background</jats:title><jats:p> Patients undergoing superficial parotidectomy for benign parotid lesions are at risk of postoperative complications, most notably cosmetic complications such as facial paralysis and contour defects, and functional complications including Frey's syndrome. Traditionally, surgical drains have been placed at the end of surgery to prevent hematoma and sialocele formation. However, this can increase the risk of postoperative complications and contribute to a prolonged course in hospital. To try and prevent these risks and complications, we introduced a novel technique of a drainless parotidectomy by reconstructing the resulting parotid bed defect with a superiorly based sternocleidomastoid (SCM) rotational flap and by placement of gelfoam into the wound bed and a facelift dressing postoperatively to provide additional hemostasis and avoid drain placement. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> All patients with benign parotid disease undergoing a drainless superficial parotidectomy and reconstruction with a superiorly based SCM rotational flap at our center were identified within a prospective cohort database between July 2010–2018. Primary outcomes included postoperative cosmetic and functional outcomes, complications and length of hospital stay. A secondary cost analysis was done to compare this novel technique to traditional superficial parotidectomy with surgical drain placement. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> Fifty patients were identified within the database and were included in the final analysis. The average length of hospital stay was 1.02 days. All patients were satisfied with their aesthetic outcome at 1 year. During long term follow-up, 63% of patients reported normal appearance of the operated side. Seven patient's (14%) developed temporary facial paresis following surgery. All patients had resultant normal facial function at follow-up in 1 year. No patients developed subjective Frey's Syndrome. Two patients (4%) developed a postoperative sialocele requiring drainage and one patient (2%) developed a hematoma on extubation requiring evacuation and drain placement. Cost analysis demonstrated a cost savings of approximately $975 per person following surgery. </jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p> In the current study, we introduced a novel approach of a drainless superficial parotidectomy using a superiorly based SCM flap, gelfoam and placement of a post-operative facelift dressing. This drainless approach was associated with good long-term cosmetic and functional outcomes with few postoperative complications. This new technique may also offer the potential for long-term savings to the health care system. </jats:p></jats:sec>
1000 Sacherschließung
lokal Aged [MeSH]
lokal Superficial parotidectomy
lokal Postoperative Complications/epidemiology [MeSH]
lokal Drainless parotidectomy
lokal Reconstructive Surgical Procedures/economics [MeSH]
lokal Male [MeSH]
lokal Postoperative Complications/prevention
lokal Parotid Gland/surgery [MeSH]
lokal Original Research Article
lokal Sweating, Gustatory/prevention
lokal Female [MeSH]
lokal Adult [MeSH]
lokal Humans [MeSH]
lokal Sternocleidomastoid flap
lokal Prospective Studies [MeSH]
lokal Treatment Outcome [MeSH]
lokal Costs and Cost Analysis [MeSH]
lokal Drainage [MeSH]
lokal Middle Aged [MeSH]
lokal Facial paralysis
lokal Frey's syndrome
lokal Parotid Diseases/surgery [MeSH]
lokal Reconstructive Surgical Procedures/methods [MeSH]
lokal Contour defect
lokal Surgical Flaps [MeSH]
1000 Liste der Beteiligten
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