A shift in the classic management of parotidectomy - the facelift approach

Ciofu, Mihai-Liviu; Cobzeanu, Mihail Dan; Boisteanu, Otilia; Sulea, Daniela; Giuvara, Razvan; Carp, Alexandra; Popescu, Eugenia; Costan, Victor-Vlad

doi:10.2478/rjr-2020-0011

Abstract

BACKGROUND. Improving the aesthetic and functional outcomes of parotidectomy is a constant concern of recent studies. We describe our experience on this topic by employing techniques inspired from rhytidectomy.

MATERIAL AND METHODS. We performed a retrospective study including patients that underwent parotidectomy through a facelift approach and we documented the details of the technique and the postoperative care and outcomes.

RESULTS. A total of 247 patients with parotid gland tumors were operated using the facelift approach. A superficial or quasi-total parotidectomy was performed, followed by a superficial musculoaponeurotic system-plasty. The postoperative outcomes were favourable regarding both the appearance and function, with minimal complications. The advantages of the employed technique are discussed.

CONCLUSION. It is possible to decrease the sequelae, simplify the postoperative care and improve the aesthetic outcome of parotidectomy cases by employing the facelift approach and the superficial musculoaponeurotic system (SMAS) reconstruction of the post-parotidectomy defect.

References

1. Irvine LE, Larian B, Azizzadeh B. Locoregional parotid reconstruction. Otolaryngol Clin North Am. 2016;49(2):435–46. DOI: 10.1016/j.otc.2015.10.012. Epub 2016 Feb 16.10.1016/j.otc.2015.10.01226897603
Search in Google Scholar Back to article
2. de Vicente JC, González-García M, de Villalaín L, Fernández-Valle Á. Modified facelift approach combined with a superficial musculoaponeurotic system flap in the treatment of benign parotid tumors. J Craniomaxillofac Surg. 2015;43(8):1655–61. DOI: 10.1016/j.jcms.2015.06.049. Epub 2015 Jul 10.10.1016/j.jcms.2015.06.04926293190
Search in Google Scholar Back to article
3. Bianchi B, Ferri A, Ferrari S, Copelli C, Sesenna E. Improving esthetic results in benign parotid surgery: statistical evaluation of facelift approach, sternocleidomastoid flap, and superficial musculoaponeurotic system flap application. J Oral Maxillofac Surg. 2011;69(4):1235–41. DOI: 10.1016/j.jons.2010.03.005. Epub 2010 Aug 12.10.1016/j.joms.2010.03.005
Search in Google Scholar Back to article
4. Zhang J, Jiang Q, Na S, Pan S, Cao Z, Qiu J. Minimal scar dissection for partial parotidectomy via a modified cosmetic incision and an advanced wound closure method. J Oral Maxillofac Surg. 2019;77(6):1317.e1–1317.e9. DOI: 10.1016/j.joms.2019.02.036. Epub 2019 Mar 2.10.1016/j.joms.2019.02.03630922883
Search in Google Scholar Back to article
5. Movassaghi K, Lewis M, Shahzad F, May JW Jr. Optimizing the aesthetic result of parotidectomy with a facelift incision and temporoparietal fascia flap. Plast Reconstr Surg Glob Open. 2019;7(2):e2067. DOI: 10.1097/GOX.0000000000002067. eCollection 2019 Feb.10.1097/GOX.0000000000002067641610930881826
Search in Google Scholar Back to article
6. Upile T, Jerjes WK, Nouraei SA, Grant W, Singh S, Sudhoff H, et al. Further anatomical approaches to parotid surgery. Eur Arch Otorhinolaryngol. 2010;267(5):793–800. DOI: 10.1007/s00405-009-1148-8. Epub 2009 Dec 1.10.1007/s00405-009-1148-819949957
Search in Google Scholar Back to article
7. Grover N, D’Souza A. Facelift approach for parotidectomy: an evolving aesthetic technique. Otolaryngol Head Neck Surg. 2013;148(4):548–56. DOI: 10.1177/0194599812475221. Epub 2013 Feb 4.10.1177/019459981247522123380762
Search in Google Scholar Back to article
8. Griffin JE, Jo C. Complications after superficial plane cervicofacial rhytidectomy: a retrospective analysis of 178 consecutive facelifts and review of the literature. J Oral Maxillofac Surg. 2007;65(11):2227–34.10.1016/j.joms.2006.10.07517954318
Search in Google Scholar Back to article
9. Nouraei SA, Al-Yaghchi C, Ahmed J, Kirkpatrick N, Mansuri S, Singh A, et al. An anatomical comparison of Blair and facelift incisions for parotid surgery. Clin Otolaryngol. 2006;31(6):531–4.10.1111/j.1365-2273.2006.01334.x17184460
Search in Google Scholar Back to article
10. Giotakis EI, Giotakis AI. Modified facelift incision and superficial musculoaponeurotic system flap in parotid malignancy: a retrospective study and review of the literature. World J Surg Oncol. 2020;18(1):8. DOI: 10.1186/s12957-020-1785-3.10.1186/s12957-020-1785-3695314431918725
Search in Google Scholar Back to article
11. Honig JF. Facelift approach with a hybrid SMAS rotation flap advancement flap in parotidectomy for prevention of scars and contour deficiency affecting the neck and sweat secretion of the cheek. J Craniofac Surg. 2004;15(5):797–803.10.1097/00001665-200409000-0001915346021
Search in Google Scholar Back to article
12. Foustanos A, Zavrides H. Face-lift approach combined with a superficial musculoaponeurotic system advancement flap in parotidectomy. Br J Oral Maxillofac Surg. 2007;45(8):652–5.10.1016/j.bjoms.2007.05.00817618020
Search in Google Scholar Back to article
13. Kim IK, Cho HW, Cho HY, Seo JH, Lee DH, Park SH. Facelift incision and superficial musculoaponeurotic system advancement in parotidectomy: case reports. Maxillofac Plast Reconstr Surg. 2015;37(1):40. DOI: 10.1186/s40902-015-0040-2.10.1186/s40902-015-0040-2463024926550560
Search in Google Scholar Back to article
14. Dell’Aversana Orabona G, Salzano G, Abbate V, Piombino P, Astarita F, Iaconetta G, et al. Use of the SMAS flap for reconstruction of the parotid lodge. Acta Otorhinolaryngol Ital. 2015;35(6):406–11. DOI: 10.14639/0392-100X-395.10.14639/0392-100X-395475505226900246
Search in Google Scholar Back to article
15. Meningaud JP, Bertolus C, Bertrand JC. Parotidectomy: assessment of a surgical technique including facelift incision and SMAS advancement. J Craniomaxillofac Surg. 2006;34(1):34–7.10.1016/j.jcms.2005.08.00716343918
Search in Google Scholar Back to article
16. Kyrgidis A, Triaridis S. Facelift approach in benign parotid surgery, Frey syndrome, and total superficial parotidectomy. J Oral Maxillofac Surg. 2011;69(10):2486–7. DOI: 10.1016/j.joms.2011.06.003.10.1016/j.joms.2011.06.00321824706
Search in Google Scholar Back to article

A shift in the classic management of parotidectomy - the facelift approach

Abstract

Paradigm

My account