Superficial parotidectomy: three-year experience using modified Blair's incision
Keywords:Parotidectomy, Superficial lesions, Blair's incision, Facial nerve function, House-Brackmann facial nerve grading system
Background: This study presents a series of parotidectomy for superficial benign parotid tumors.
Methods: 18 patients had freely mobile superficial benign parotid lesions of grade zero on House-Brackmann facial nerve grading system underwent parotidectomy through modified Blair incision, with meticulous dissection of the main trunk and branches of facial and the greater auricular nerves with parotid duct sparing. Postoperative (PO) facial nerve functions were assessed and graded after patient was fully conscious, on the 5th PO day, and 6th PO month. Collected data included operative time, intraoperative blood loss, duration of hospital stay, wound drainage and PO complications.
Results: Mean operative time was 115 (±20.4) minutes and mean intraoperative blood loss was 250 (±60). PO analgesia was provided as non-steroidal anti-inflammatory drugs injection on patient's request. Mean duration of PO hospital stay was 8 (±1.9) hours and of wound drainage was 3 (±0.7) days. No wound infection nor seroma had developed and stitches were allowed for spontaneous removal. Immediate postoperatively 4 patients (22.2%) had incomplete facial nerve weakness; 3 of grade II and one of grade III, at the 5th day PO, two patients still had grade II nerve affection and at the 6th PO month, one patient (5.5%) still had grade II nerve affection.
Conclusions: superficial parotidectomy through modified Blair's incision is feasible, safe and allows nerve, vessels and duct sparing even for cases with recurrent swelling. Incomplete facial weakness was encountered in only one patient at the 6th month PO, but was of grade II.
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