Endoscope-assisted extracapsular dissection of benign parotid tumors through a single cephaloauricular furrow incision versus a conventional approach

doi:10.3877/cma.j.issn.1674-1366.2016.06.008

Abstract

Abstract:

Objective

To evaluate the feasibility of performing endoscope-assisted extracapsular dissections of benign parotid tumors using a single cephaloauricular furrow incision.

Methods

Sixty patients with benign parotid superficial lobe tumors were randomly divided into two groups: an endoscope-assisted (27 patients) group and conventional (33 patients) surgery group. Perioperative and post-operative outcomes of the patients were evaluated, including the maximum diameter of the tumors, length of the incision, operating time, estimated blood loss during the operation, amount and duration of drainage, satisfaction scores based on the cosmetic results, perioperative complications, and follow-up information.

Results

The diameters of the tumors were comparable between the groups (t= 0.253, P= 0.234) , and all operations were successfully performed as planned. The mean length of the incision in the endoscope-assisted group (3.5 ± 0.4) cm was significantly shorter than the conventional group (9.0 ± 1.7) cm (t= 16.645, P<0.001) . Meanwhile, the intraoperative blood loss (t= 16.028, P<0.001) , amount of drainage (t= 6.499, P= 0.003) , perioperative complications (χ²= 4.423, P= 0.035) and cosmetic outcomes (t= 16.285, P<0.001) were all improved in the endoscope-assisted group (P<0.05) . No tumor recurrence was found during 10-40 months of follow-up. Student′s t tests and chi-squared tests were used for the comparisons between the two groups. Statistical analyses were performed using the SPSS 18.0 package, and a P-value of <0.05 was considered to indicate statistical significance.

Conclusions

Cephaloauricular furrow incisions were totally and naturally hidden in this procedure. Endoscope-assisted extracapsular dissections of benign parotid tumors via a small cephaloauricular furrow incision was found to be feasible and reliable, providing a minimally invasive approach and a satisfactory appearance.

Key words: Parotid neoplasms, Endoscopy, Cephaloauricular furrow incision, Extracapsular dissection

Qunxing Li, Song Fan, Hanqing Zhang, Shule Xie, Weixiong Chen, Guokai Pan, Jinsong Li. Endoscope-assisted extracapsular dissection of benign parotid tumors through a single cephaloauricular furrow incision versus a conventional approach[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2016, 10(06): 408-413.

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References 21

[1]	Eveson JW, Cawson RA. Salivary gland tumours. A review of 2410 cases with particular reference to histological types，site，age and sex distribution[J]. J Pathol，1985，146(1):51-58.
[2]	Spiro RH. Salivary neoplasms：overview of a 35-year experience with 2，807 patients[J]. Head Neck Surg，1986，8(3):177-184.
[3]	Yan Y, Chen X. Endoscopic resection for benign parotid tumor through a cosmetic retroauricular incision with water sac establishing operative space：a new approach[J]. J Laparoendosc Adv Surg Tech A，2015，25(6):508-513.
[4]	Ketchum LD, Cohen IK, Masters FW. Hypertrophic scars and keloids. A collective review[J]. Plast Reconstr Surg，1974，53(2):140-154.
[5]	Fan S, Liang FY, Chen WL，et al. Minimally invasive selective neck dissection：a prospective study of endoscopically assisted dissection via a small submandibular approach in cT_1-2N₀ oral squamous cell carcinoma[J]. Ann Surg Oncol，2014，21(12):3876-3881.
[6]	Woo SH, Kim JP, Baek CH. Endoscope-assisted extracapsular dissection of benign parotid tumors using hairline incision[J]. Head Neck，2016，38(3):375-379.
[7]	Huang X, Sun W, Liu X，et al. Endoscope-assisted partial-superficial parotidectomy through a concealed postauricular skin incision[J]. Surg Endosc，2009，23(7):1614-1619.
[8]	Chen MK, Chang CC. Minimally invasive endoscope-assisted parotidectomy：a new approach[J]. Laryngoscope，2007，117(11):1934-1937.
[9]	Donatini G, Materazzi G, Miccoli P. The endoscopic approach to the neck：a review of the literature and an overview of the various techniques[J]. Surg Endosc，2012，26(1):287.
[10]	Guerrissi JO. Minimal invasive surgery in head and neck：video-assisted technique[J]. J Craniofac Surg，2010，21(3):882-886.
[11]	Gagner M, Inabnet WR 3rd. Endoscopic thyroidectomy for solitary thyroid nodules[J]. Thyroid，2001，11(2):161-163.
[12]	Miccoli P, Bendinelli C, Berti P，et al. Video-assisted versus conventional parathyroidectomy in primary hyperparathyroidism：a prospective randomized study[J]. Surgery，1999，126(6):1117-1121.
[13]	Shimizu K, Akira S, Tanaka S. Video-assisted neck surgery：endoscopic resection of benign thyroid tumor aiming at scarless surgery on the neck[J]. J Surg Oncol，1998，69(3):178-180.
[14]	Yeung HC, Ng WT, Kong CK. Endoscopic thyroid and parathyroid surgery[J]. Surg Endosc，1997，11(11):1135.
[15]	Lin SD, Tsai CC, Lai CS，et al. Endoscope-assisted parotidectomy for benign parotid tumors[J]. Ann Plast Surg，2000，45(3):269-273.
[16]	Chen J, Chen W, Zhang J，et al. Modified endoscope-assisted partial-superficial parotidectomy through a retroauricular incision[J]. ORL J Otorhinolaryngol Relat Spec，2014，76(3):121-126.
[17]	O′Brien CJ. Current management of benign parotid tumors--the role of limited superficial parotidectomy[J]. Head Neck，2003，25(11):946-952.
[18]	Xie L, Zhang D, Lu MM，et al. Minimally invasive endoscopic-assisted resection of benign tumors in the accessory parotid gland：5 case studies[J]. Head Neck，2012，34(8):1194-1197.
[19]	Roh JL. Extracapsular dissection of benign parotid tumors using a retroauricular hairline incision approach[J]. Am J Surg，2009，197(5):e53-e56.
[20]	McGurk M, Thomas BL, Renehan AG. Extracapsular dissection for clinically benign parotid lumps：reduced morbidity without oncological compromise[J]. Br J Cancer，2003，89(9):1610-1613.
[21]	Liang F, Fan S, Han P，et al. Endoscopic-assisted selective neck dissection via small lateral neck incision for early-stage（T1-2N0M0）head and neck squamous cell carcinoma：3-year follow-up results[J/OL]. Surg Endosc，2016[2016-11-10]. published online ahead of print July 1，2016]. URL

项目		内镜组(n = 27)	传统组(n = 33)	P值
性别（男∶女）		17∶10	20∶13	0.852
年龄（岁）		40.1(25.1 ~ 58.6)	41.7(24.9 ~ 59.9)	0.585
肿瘤直径（cm，±s）		2.6 ± 0.8(1.6 ~ 3.8)	2.7 ± 0.9(1.4 ~ 4.3)	0.234
切口长度（cm，±s）		3.5 ± 0.4(2.5 ~ 4.5)	9.0 ± 1.7(6.3 ~ 11.8)	<0.001
术中出血量（ml，±s）		21.6 ± 7.9	91.3 ± 21.6	<0.001
转为开放手术（例）		0	-	?
手术时间（min，±s）		82.9 ± 20.3	78.4 ± 15.5	0.054
引流量（ml，±s）		31.2 ± 7.9	52.8 ± 11.7	0.003
引流时间（d，±s）		2.5 ± 0.2	3.0 ± 0.3	0.369
并发症		?	?	0.035
?	耳大神经麻木	4	9	0.244
?	暂时性面瘫	3	7	0.486
?	唾液腺瘘	1	2	?
?	血肿	1	1	?
?	味觉出汗综合征	0	1	?
?	皮肤坏死	0	0	?
?	切口感染	0	0	?
病理		?	?	0.829
?	多形性腺瘤	15	19	?
?	Warthin瘤	10	13	?
?	基底细胞腺瘤	2	0	?
?	良性淋巴上皮病变	0	1	?
外观满意度(±s)		9.1 ± 0.4	7.9 ± 2.4	<0.001
随访时间（月）		24(10 ~ 40)	26(13 ~ 40)	0.175
肿瘤复发		0	0	?

项目		内镜组(n = 27)	传统组(n = 33)	P值
性别（男∶女）		17∶10	20∶13	0.852
年龄（岁）		40.1(25.1 ~ 58.6)	41.7(24.9 ~ 59.9)	0.585
肿瘤直径（cm，±s）		2.6 ± 0.8(1.6 ~ 3.8)	2.7 ± 0.9(1.4 ~ 4.3)	0.234
切口长度（cm，±s）		3.5 ± 0.4(2.5 ~ 4.5)	9.0 ± 1.7(6.3 ~ 11.8)	<0.001
术中出血量（ml，±s）		21.6 ± 7.9	91.3 ± 21.6	<0.001
转为开放手术（例）		0	-	?
手术时间（min，±s）		82.9 ± 20.3	78.4 ± 15.5	0.054
引流量（ml，±s）		31.2 ± 7.9	52.8 ± 11.7	0.003
引流时间（d，±s）		2.5 ± 0.2	3.0 ± 0.3	0.369
并发症		?	?	0.035
?	耳大神经麻木	4	9	0.244
?	暂时性面瘫	3	7	0.486
?	唾液腺瘘	1	2	?
?	血肿	1	1	?
?	味觉出汗综合征	0	1	?
?	皮肤坏死	0	0	?
?	切口感染	0	0	?
病理		?	?	0.829
?	多形性腺瘤	15	19	?
?	Warthin瘤	10	13	?
?	基底细胞腺瘤	2	0	?
?	良性淋巴上皮病变	0	1	?
外观满意度(±s)		9.1 ± 0.4	7.9 ± 2.4	<0.001
随访时间（月）		24(10 ~ 40)	26(13 ~ 40)	0.175
肿瘤复发		0	0	?

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