Skip to main content
Top
Published in: Journal of Maxillofacial and Oral Surgery 4/2022

25-06-2021 | Parotidectomy | Original article

Is This Novel Incision for Benign Parotid Tumors the Answer for Improved Esthetics and Access?

Authors: Ilker Burgaz, Haiping Miao, Yuan Chang, Rong Yang, Diancan Wang

Published in: Journal of Maxillofacial and Oral Surgery | Issue 4/2022

Login to get access

Abstract

Background

Incision scars and postoperative cosmesis are critical in the management of benign parotid tumors. Traditional incisions have a typical visible scar in the retromandibular area or require wide skin flaps.

Purpose

In this study, we introduced a new surgical approach called the tri-split flap approach and evaluated its technical feasibility and surgical outcomes.

Materials and Methods

Eleven patients with clinically benign parotid gland tumors underwent the tri-split flap approach and were followed for six to ten months postoperatively. Facial weakness, salivary fistula formation, first bite syndrome, earlobe numbness, and the subjective cosmetic results were evaluated.

Results

All tumors were completely excised, and the patients were highly satisfied with the esthetic outcome of the surgery. No patients developed wound dehiscence, facial nerve injury, or first bite syndrome during the follow-up period. One patient developed a minor salivary fistula that resolved after three weeks.

Conclusion

The tri-split flap approach not only provides adequate exposure of the surgical site to achieve complete resection of benign parotid gland neoplasms but also results in a very short and highly concealed post-operative scar. This technique is a potential surgical approach in parotidectomy.
Appendix
Available only for authorised users
Literature
1.
go back to reference Gao M, Hao Y, Huang MX, Ma DQ, Chen Y, Luo HY, Gao Y, Cao ZQ, Peng X, Yu GY (2017) Salivary gland tumours in a northern Chinese population: a 50-year retrospective study of 7190 cases. Int J Oral Maxillofac Surg 46:343–349CrossRef Gao M, Hao Y, Huang MX, Ma DQ, Chen Y, Luo HY, Gao Y, Cao ZQ, Peng X, Yu GY (2017) Salivary gland tumours in a northern Chinese population: a 50-year retrospective study of 7190 cases. Int J Oral Maxillofac Surg 46:343–349CrossRef
2.
go back to reference Bonavolonta P, Dell’Aversana Orabona G, Maglitto F, Abbate V, Committeri U, Salzano G, Improta G, Iaconetta G, Califano L (2019) Postoperative complications after removal of pleomorphic adenoma from the parotid gland: a long-term follow up of 297 patients from 2002 to 2016 and a review of publications. Br J Oral Maxillofac Surg 57:998–1002CrossRef Bonavolonta P, Dell’Aversana Orabona G, Maglitto F, Abbate V, Committeri U, Salzano G, Improta G, Iaconetta G, Califano L (2019) Postoperative complications after removal of pleomorphic adenoma from the parotid gland: a long-term follow up of 297 patients from 2002 to 2016 and a review of publications. Br J Oral Maxillofac Surg 57:998–1002CrossRef
3.
go back to reference Jin H, Kim BY, Kim H, Lee E, Park W, Choi S, Chung MK, Son YI, Baek CH, Jeong HS (2019) Incidence of postoperative facial weakness in parotid tumor surgery: a tumor subsite analysis of 794 parotidectomies. BMC Surg 19:199CrossRef Jin H, Kim BY, Kim H, Lee E, Park W, Choi S, Chung MK, Son YI, Baek CH, Jeong HS (2019) Incidence of postoperative facial weakness in parotid tumor surgery: a tumor subsite analysis of 794 parotidectomies. BMC Surg 19:199CrossRef
4.
go back to reference Henneman R, Berger DMS, Karakullukcu MB, Smeele LE, Lohuis PF, Jozwiak K, van der Hage JA, Balm AJ (2020) Surgical site complications after parotid gland surgery for benign tumors in a centralized setting: a Clavien-Dindo class cohort analysis. Eur J Surg Oncol 46:258–262CrossRef Henneman R, Berger DMS, Karakullukcu MB, Smeele LE, Lohuis PF, Jozwiak K, van der Hage JA, Balm AJ (2020) Surgical site complications after parotid gland surgery for benign tumors in a centralized setting: a Clavien-Dindo class cohort analysis. Eur J Surg Oncol 46:258–262CrossRef
5.
go back to reference Bovenzi CD, Ciolek P, Crippen M, Curry JM, Krein H, Heffelfinger R (2019) Reconstructive trends and complications following parotidectomy: incidence and predictors in 11,057 cases. J Otolaryngol Head Neck Surg 48:64CrossRef Bovenzi CD, Ciolek P, Crippen M, Curry JM, Krein H, Heffelfinger R (2019) Reconstructive trends and complications following parotidectomy: incidence and predictors in 11,057 cases. J Otolaryngol Head Neck Surg 48:64CrossRef
6.
go back to reference Appiani E (1967) Handling of a parotidectomy and muscular graft. Prensa Med Argent 54:1242–1243 Appiani E (1967) Handling of a parotidectomy and muscular graft. Prensa Med Argent 54:1242–1243
7.
go back to reference Appiani E, Delfino MC (1984) Plastic incisions for facial and neck tumors. Ann Plast Surg 13:335–352CrossRef Appiani E, Delfino MC (1984) Plastic incisions for facial and neck tumors. Ann Plast Surg 13:335–352CrossRef
8.
go back to reference Yu GY, Peng X (2019) Conservative and functional surgery in the treatment of salivary gland tumours. Int J Oral Sci 11:22CrossRef Yu GY, Peng X (2019) Conservative and functional surgery in the treatment of salivary gland tumours. Int J Oral Sci 11:22CrossRef
9.
go back to reference Myssiorek D (2018) Extracapsular dissection and limited parotidectomy. Oper Tech Otolaryngol 29:139–143CrossRef Myssiorek D (2018) Extracapsular dissection and limited parotidectomy. Oper Tech Otolaryngol 29:139–143CrossRef
10.
go back to reference Martin H, Jayasinghe J, Lowe T (2020) Superficial parotidectomy versus extracapsular dissection: literature review and search for a gold standard technique. Int J Oral Maxillofac Surg 49:192–199CrossRef Martin H, Jayasinghe J, Lowe T (2020) Superficial parotidectomy versus extracapsular dissection: literature review and search for a gold standard technique. Int J Oral Maxillofac Surg 49:192–199CrossRef
11.
go back to reference Cheung SH, Kwan WYW, Tsui KP, Chow TL (2018) Partial parotidectomy under local anesthesia for benign parotid tumors-an experience of 50 cases. Am J Otolaryngol 39:286–289CrossRef Cheung SH, Kwan WYW, Tsui KP, Chow TL (2018) Partial parotidectomy under local anesthesia for benign parotid tumors-an experience of 50 cases. Am J Otolaryngol 39:286–289CrossRef
12.
go back to reference Quer M, Guntinas-Lichius O, Marchal F, Vander Poorten V, Chevalier D, León X, Dulguerov P (2016) Classification of parotidectomies: a proposal of the European Salivary Gland Society. Eur Arch Otorhinolaryngol 273:3307–3312CrossRef Quer M, Guntinas-Lichius O, Marchal F, Vander Poorten V, Chevalier D, León X, Dulguerov P (2016) Classification of parotidectomies: a proposal of the European Salivary Gland Society. Eur Arch Otorhinolaryngol 273:3307–3312CrossRef
13.
go back to reference Zhang Q, Yang Y, Yang P, Tan Y, Liu X, Xiong B, Qiu J (2019) Cosmetic approach selection in parotidectomy for benign parotid gland tumour according to its location. J Plast Reconstr Aesthet Surg 73:921–926CrossRef Zhang Q, Yang Y, Yang P, Tan Y, Liu X, Xiong B, Qiu J (2019) Cosmetic approach selection in parotidectomy for benign parotid gland tumour according to its location. J Plast Reconstr Aesthet Surg 73:921–926CrossRef
14.
go back to reference Zhang J, Jiang Q, Na S, Pan S, Cao Z, Qiu J (2019) Minimal scar dissection for partial parotidectomy via a modified cosmetic incision and an advanced wound closure method. J Oral Maxillofac Surg 77:13171CrossRef Zhang J, Jiang Q, Na S, Pan S, Cao Z, Qiu J (2019) Minimal scar dissection for partial parotidectomy via a modified cosmetic incision and an advanced wound closure method. J Oral Maxillofac Surg 77:13171CrossRef
15.
go back to reference Petroianu A (2012) Parotidectomy by periauricular incision. Otolaryngol Head Neck Surg 146:247–249CrossRef Petroianu A (2012) Parotidectomy by periauricular incision. Otolaryngol Head Neck Surg 146:247–249CrossRef
16.
go back to reference Jo MG, Lee DJ, Cha W (2019) A modified V-shaped incision combined with superficial musculo-aponeurotic system flap for parotidectomy. Acta Otolaryngol 139:178–183CrossRef Jo MG, Lee DJ, Cha W (2019) A modified V-shaped incision combined with superficial musculo-aponeurotic system flap for parotidectomy. Acta Otolaryngol 139:178–183CrossRef
17.
go back to reference Ahn D, Sohn JH, Lee GJ (2018) Feasibility of a new V-shaped incision for parotidectomy: a preliminary report. Br J Oral Maxillofac Surg 56:406–410CrossRef Ahn D, Sohn JH, Lee GJ (2018) Feasibility of a new V-shaped incision for parotidectomy: a preliminary report. Br J Oral Maxillofac Surg 56:406–410CrossRef
18.
go back to reference Furuta Y, Tsubuku T, Matsumura M (2015) Parotidectomy by U-shaped Skin Incision for small Benign Tumors. J Otol Rhinol 4:2 Furuta Y, Tsubuku T, Matsumura M (2015) Parotidectomy by U-shaped Skin Incision for small Benign Tumors. J Otol Rhinol 4:2
19.
go back to reference Shemen L, Wolf J, Turner J (2006) Modified rhytidectomy incision for parotidectomy. Oper Tech Otolaryngol 17:210–213CrossRef Shemen L, Wolf J, Turner J (2006) Modified rhytidectomy incision for parotidectomy. Oper Tech Otolaryngol 17:210–213CrossRef
20.
go back to reference Ahmedli N, Myssiorek D (2018) Parotidectomy incisions. Oper Tech Otolaryngol 29:135–138CrossRef Ahmedli N, Myssiorek D (2018) Parotidectomy incisions. Oper Tech Otolaryngol 29:135–138CrossRef
21.
go back to reference Wise DM (2000) Periauricular face lift incisions and the auricular anchor. Plast Reconstr Surg 105:2620–2623CrossRef Wise DM (2000) Periauricular face lift incisions and the auricular anchor. Plast Reconstr Surg 105:2620–2623CrossRef
22.
go back to reference Barberá R, Castillo F, D’Oleo C, Benítez S, Cobeta I (2014) Superficial musculoaponeurotic system flap in partial parotidectomy and clinical and subclinical Frey’s syndrome. Cosmesis and quality of life. Head Neck 36:130–136CrossRef Barberá R, Castillo F, D’Oleo C, Benítez S, Cobeta I (2014) Superficial musculoaponeurotic system flap in partial parotidectomy and clinical and subclinical Frey’s syndrome. Cosmesis and quality of life. Head Neck 36:130–136CrossRef
23.
go back to reference Mantsopoulos K, Mueller SK, Goncalves M, Schapher M, Koch M, Iro H (2019) Does increasing the incidence of extracapsular dissection for benign tumors of the parotid correlate with an increased need for revision surgery? Oral Oncol 94:111–114CrossRef Mantsopoulos K, Mueller SK, Goncalves M, Schapher M, Koch M, Iro H (2019) Does increasing the incidence of extracapsular dissection for benign tumors of the parotid correlate with an increased need for revision surgery? Oral Oncol 94:111–114CrossRef
24.
go back to reference Fang KM, Wen MH, Hsu WL, Chang CM, Hou PY, Liao LJ (2019) Ultrasonographic and elastographic biometry in adult major salivary glands: a preliminary case-control report. Sci Rep 9:1–7CrossRef Fang KM, Wen MH, Hsu WL, Chang CM, Hou PY, Liao LJ (2019) Ultrasonographic and elastographic biometry in adult major salivary glands: a preliminary case-control report. Sci Rep 9:1–7CrossRef
25.
26.
go back to reference Jost G, Guenon P, Gentil S (1999) Parotidectomy: a plastic approach. Aesthetic Plast Surg 23:1–4CrossRef Jost G, Guenon P, Gentil S (1999) Parotidectomy: a plastic approach. Aesthetic Plast Surg 23:1–4CrossRef
27.
go back to reference Cummins AJ, Surek CC, Charafeddine AH, Scomacao I, Duraes E, Zins JE (2020) Facelift surgery following superficial parotidectomy: Is it safe? Aesthet Plast Surg 44:1–5CrossRef Cummins AJ, Surek CC, Charafeddine AH, Scomacao I, Duraes E, Zins JE (2020) Facelift surgery following superficial parotidectomy: Is it safe? Aesthet Plast Surg 44:1–5CrossRef
28.
go back to reference Paskhover B, Paul BC, Rosenberg DB (2017) Rhytidectomy After Parotidectomy. Am J Cosme Surg 35:92–98CrossRef Paskhover B, Paul BC, Rosenberg DB (2017) Rhytidectomy After Parotidectomy. Am J Cosme Surg 35:92–98CrossRef
29.
go back to reference Boynton JF, Cohen BE, Barrera A (2006) Rhytidectomy and parotidectomy combined in the same patient. Aesthetic Plast Surg 30:125–131CrossRef Boynton JF, Cohen BE, Barrera A (2006) Rhytidectomy and parotidectomy combined in the same patient. Aesthetic Plast Surg 30:125–131CrossRef
30.
go back to reference Bulut OC, Hohenberger R, Oladokun D, Odenwald K, Plinkert PK, Federspil PA (2019) Long-term quality of life and sensory impact of great auricular nerve preservation in parotid surgery as measured with the Parotidectomy Outcome Inventory-8. Clin Otolaryngol. 44:743–748CrossRef Bulut OC, Hohenberger R, Oladokun D, Odenwald K, Plinkert PK, Federspil PA (2019) Long-term quality of life and sensory impact of great auricular nerve preservation in parotid surgery as measured with the Parotidectomy Outcome Inventory-8. Clin Otolaryngol. 44:743–748CrossRef
31.
go back to reference Moretti A, Citraro L, Petrucci AG, Di Giovanni P, Di Mauro R, Giacomini PG (2015) Great auricular nerve preservation in parotid surgery: rationale and long-term results insights. Eur Arch Otorhinolaryngol 272:3515–3520CrossRef Moretti A, Citraro L, Petrucci AG, Di Giovanni P, Di Mauro R, Giacomini PG (2015) Great auricular nerve preservation in parotid surgery: rationale and long-term results insights. Eur Arch Otorhinolaryngol 272:3515–3520CrossRef
32.
go back to reference Hu J, Ye W, Zheng J, Zhu H, Zhang Z (2010) The feasibility and significance of preservation of the lobular branch of the great auricular nerve in parotidectomy. Int J Oral Maxillofac Surg 39:684–689CrossRef Hu J, Ye W, Zheng J, Zhu H, Zhang Z (2010) The feasibility and significance of preservation of the lobular branch of the great auricular nerve in parotidectomy. Int J Oral Maxillofac Surg 39:684–689CrossRef
Metadata
Title
Is This Novel Incision for Benign Parotid Tumors the Answer for Improved Esthetics and Access?
Authors
Ilker Burgaz
Haiping Miao
Yuan Chang
Rong Yang
Diancan Wang
Publication date
25-06-2021
Publisher
Springer India
Published in
Journal of Maxillofacial and Oral Surgery / Issue 4/2022
Print ISSN: 0972-8279
Electronic ISSN: 0974-942X
DOI
https://doi.org/10.1007/s12663-021-01605-1

Other articles of this Issue 4/2022

Journal of Maxillofacial and Oral Surgery 4/2022 Go to the issue