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Wu JH, Zeng W, Fu MY, Ye F. Effects of acellular dermal matrix on the prevention of complications and esthetic outcome after parotidectomy: A propensity score matched analysis. EAR, NOSE & THROAT JOURNAL 2024; 103:344-350. [PMID: 34814772 DOI: 10.1177/01455613211058114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The present study was designed to investigate whether acellular dermal matrix (ADM) grafts could prevent Frey's syndrome (FS) and improve esthetic scores following parotidectomy. METHODS From January 2015 to December 2019, 175 patients underwent parotidectomy. We divided the patients into two groups: the ADM group and the control group. We included in each group 30 patients according to a propensity score matched analysis. RESULTS FS was subjective in 1 patient (3%) from the ADM group and 9 patients (30%) from the control group (P=0.015). Patients in the ADM group had a subjective esthetic score of 6.1 + 1.7 compared with 5.2 + 1.7 in the control group. The subjective esthetic score for patients in the ADM group was higher than that for patients in the control group (P =0.040). CONCLUSION The present clinical study suggests that ADM grafts are effective in preventing FS and improving esthetic scores after parotidectomy.
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Affiliation(s)
- Jian-Hui Wu
- The Department of Otolaryngology in the Zhongshan City People's Hospital, Zhongshan Affiliated Hospital of Sun Yat-sen University, Zhongshan, China
| | - Wei Zeng
- The Department of Otolaryngology in the Zhongshan City People's Hospital, Zhongshan Affiliated Hospital of Sun Yat-sen University, Zhongshan, China
| | - Min-Yi Fu
- The Department of Otolaryngology in the Zhongshan City People's Hospital, Zhongshan Affiliated Hospital of Sun Yat-sen University, Zhongshan, China
| | - Fei Ye
- The Department of Otolaryngology in the Zhongshan City People's Hospital, Zhongshan Affiliated Hospital of Sun Yat-sen University, Zhongshan, China
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2
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Kim BS, Kim MR, Kim YW, Baek MJ, Suh TK, Kim SY. Risk factors for sialocele after parotidectomy: Does tumor size really matter? Auris Nasus Larynx 2023; 50:935-941. [PMID: 36922283 DOI: 10.1016/j.anl.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 02/06/2023] [Accepted: 02/28/2023] [Indexed: 03/16/2023]
Abstract
OBJECTIVE Sialocele that develops after parotid surgery often prolongs the treatment period and stresses both the surgeon and patient. The extent of surgery and tumor size are known to be associated with sialocele occurrence. We investigated the incidence of post-parotidectomy sialocele and the associated risk factors, with a focus on tumor size. METHODS We retrospectively reviewed the medical records of 172 patients who underwent parotidectomy between January 2013 and May 2020 at Haeundae Paik Hospital, Inje University of Korea. We stratified patients into those with and without sialocele (fluid collection in the operative bed). We compared clinical data, patient demographics, and surgical details; we identified risk factors for sialocele development after parotid surgery. RESULTS Seventeen patients were diagnosed with post-parotidectomy sialocele (9.88%; 17/172). Univariate logistic regression revealed that the male sex, deep lobe tumor location, and large tumor size were significantly associated with postoperative sialocele (p = 0.015, 0.009, and 0.016, respectively). We subjected these parameters to multivariate analyses; the odds ratios were 3.70, 3.58, and 2.34, respectively. Receiver operating characteristic curve analyses showed that a tumor size > 2.50 cm was the optimal cutoff in terms of predicting post-parotidectomy sialocele. CONCLUSION Male sex, a tumor in the deep lobe, and large tumor size were strongly associated with increased risk for sialocele after parotidectomy. Tumor size > 2.50 cm serves as the cutoff identifying patients likely to experience sialocele after parotid surgery.
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Affiliation(s)
- Bo-Soo Kim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Inje University of Korea, Busan, Republic of Korea
| | - Mi Ra Kim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Inje University of Korea, Busan, Republic of Korea
| | - Yong-Wan Kim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Inje University of Korea, Busan, Republic of Korea
| | - Moo Jin Baek
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Inje University of Korea, Busan, Republic of Korea
| | - Tae-Kyung Suh
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Inje University of Korea, Busan, Republic of Korea
| | - Sang-Yeon Kim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Linn YL, Khoo MSQ, Sultana R, Iyer NG, Dharmawan R. Comparison of the use of allogenic acellular dermal matrix on rates of Frey syndrome post parotidectomy: A systematic review and meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:49-56. [PMID: 35431179 DOI: 10.1016/j.oooo.2021.12.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 11/02/2021] [Accepted: 12/12/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the efficacy of acellular dermal matrix (ADM) use in reducing Frey syndrome (FS) rates in patients postparotidectomy. STUDY DESIGN We performed a systematic review and meta-analysis of existing literature comparing rates of FS with and without ADM use. RESULTS Eight studies were shortlisted for qualitative study, of which 7 compared rates of FS with and without the use of ADM. A total of 211 patients underwent parotidectomy with the use of ADM. Of these, mean patient age was 44.7 (SD ± 7.2); 89 of 159 were pleomorphic adenoma (55.9%), 29 of 159 with histological diagoses stated were Warthin's tumor (18.2%), and 159 of 211 were other histologic diagnoses (25.7%). Subjective and objective incidence rates for FS were 23 of 211 (10.9%) and 7 of 211 (3.3%), respectively. Patients in whom ADM barriers were used had significantly lower rates of subjective and objective FS (relative risk = 0.22; 95% confidence interval, 0.09-0.57; P = .002; and relative risk = 0.07; 95% confidence interval, 0.07-0.33; P < .001), respectively, compared to patients with no ADM. CONCLUSION The use of ADM was associated with lower FS rates compared to no ADM and should be considered in routine use to prevent this condition.
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Affiliation(s)
- Yun Le Linn
- Department of Head and Neck Surgery, National Cancer Centre Singapore, Singapore.
| | | | - Rehena Sultana
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
| | - N Gopalakrishna Iyer
- Department of Head and Neck Surgery, National Cancer Centre Singapore, Singapore; Duke NUS Medical School, Singapore
| | - Rena Dharmawan
- Department of Head and Neck Surgery, National Cancer Centre Singapore, Singapore; Duke NUS Medical School, Singapore
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Zeng A, Li H, Liu J, Wu M. The Progress of Decellularized Scaffold in Stomatology. Tissue Eng Regen Med 2022; 19:451-461. [PMID: 35320505 PMCID: PMC9130370 DOI: 10.1007/s13770-022-00432-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 12/26/2021] [Accepted: 01/05/2022] [Indexed: 10/18/2022] Open
Abstract
The oral and maxillofacial region contains oral organs and facial soft tissues. Due to the complexity of the structures and functions of this region, the repair of related defects is complicated. Different degrees of defects require different repair methods, which involve a great combination of medicine and art, and the material requirements are extremely high. Hence, clinicians are plagued by contemporary oral repair materials due to the limitations of bone harvesting, immune rejection, low osteogenic activity and other problems. Decellularized extracellular matrix has attracted much attention as a bioactive scaffold material because of its nonimmunogenic properties, good osteogenic properties, slow release of growth factors, promotion of seed cell adhesion and maintenance of stem cell characteristics. This article reviews the sources, preparation methods, application and research progress of extracellular matrix materials in the repair of oral and maxillofacial defects to provide an overview for fundamental research and clinical development.
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Affiliation(s)
- Ailin Zeng
- School of Stomatology, Zunyi Medical University, No. 6 West Xuefu Road, Xinpu District, Zunyi, 563006, Guizhou, China
| | - Huiru Li
- School of Stomatology, Zunyi Medical University, No. 6 West Xuefu Road, Xinpu District, Zunyi, 563006, Guizhou, China
| | - Jianguo Liu
- School of Stomatology, Zunyi Medical University, No. 6 West Xuefu Road, Xinpu District, Zunyi, 563006, Guizhou, China.
- Special Key Laboratory of Oral Disease Research of Higher Education Institution of Guizhou Province, Zunyi Medical University, Zunyi, Guizhou, China.
| | - Mingsong Wu
- School of Stomatology, Zunyi Medical University, No. 6 West Xuefu Road, Xinpu District, Zunyi, 563006, Guizhou, China.
- Special Key Laboratory of Oral Disease Research of Higher Education Institution of Guizhou Province, Zunyi Medical University, Zunyi, Guizhou, China.
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5
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Regenerative medicine for end-stage fibrosis and tissue loss in the upper aerodigestive tract: a twenty-first century review. The Journal of Laryngology & Otology 2021; 135:473-485. [PMID: 33988100 DOI: 10.1017/s002221512100092x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE This review assesses regenerative medicine of the upper aerodigestive tract during the first two decades of the twenty-first century, focusing on end-stage fibrosis and tissue loss in the upper airways, salivary system, oropharynx and tongue. METHOD PubMed, Embase, Google Scholar, Cochrane Library, Medline and clinicaltrials.org were searched from 2000 to 2019. The keywords used were: bioengineering, regenerative medicine, tissue engineering, cell therapy, regenerative surgery, upper aerodigestive tract, pharynx, oropharynx, larynx, trachea, vocal cord, tongue and salivary glands. Original studies were subcategorised by anatomical region. Original human reports were further analysed. Articles on periodontology, ear, nose and maxillofacial disorders, and cancer immunotherapy were excluded. RESULTS Of 716 relevant publications, 471 were original studies. There were 18 human studies included, within which 8 reported airway replacements, 5 concerned vocal fold regeneration and 3 concerned salivary gland regeneration. Techniques included cell transplantation, injection of biofactors, bioscaffolding and bioengineered laryngeal structures. CONCLUSION Moderate experimental success was identified in the restoration of upper airway, vocal fold and salivary gland function. This review suggests that a shift in regenerative medicine research focus is required toward pathology with a higher disease burden.
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Vahtsevanos K, Chatziavramidis A, Papadiochos IY, Koloutsos G, Stefanidis A, Kitikidou K, Ntomouchtsis A, Patrikidou A. Prevention of Frey's Syndrome with the Use of Porcine Dermal Collagen Graft: Retrospective Analysis of 76 "Formal" Parotidectomies for Benign Pathologies. Ann Otol Rhinol Laryngol 2021; 130:1036-1043. [PMID: 33554618 DOI: 10.1177/0003489421990185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Frey's syndrome is a well-known complication of parotid surgery; its prevention may be achieved by the use of an interpositional barrier between the overlying flaps and the exposed parenchymal bed of parotid gland. The aim of this study was to retrospectively evaluate clinical outcomes with and without the interpositional placement of a porcine dermal collagen graft (PDCG) for prevention of syndrome occurrence. METHODS We conducted a 20-year retrospective study including the patients who had undergone "formal" (superficial, total, or subtotal) parotidectomies for benign pathologies. The inclusion criteria also involved patients that were (i) regularly monitored about clinical symptoms related to syndrome, and (ii) examined with Minor starch-iodine test. The severity of the diagnosed syndrome was retrospectively evaluated according to the grading score system of Luna-Ortiz. To assess group differences in terms of the extent of dissection in operating sites, we estimated the tumor and histological specimen volumes using the available dimensions. RESULTS We included 73 patients who had undergone 76 formal parotid surgeries. The surgical sites were divided into 2 groups: (1) Group A consisted of 44 sites that were reconstructed with a SMAS flap, and (2) Group B, comprised 32 sites where a PDCG was additionally applied as an artificial preventive barrier. At a mean follow-up of 26.3 months, a significantly lower incidence of clinically diagnosed Frey's syndrome was found after the use of dermal collagen interpositional barrier (P = .031). Specifically, subjective symptoms were reported at an incidence of 31.8% in Group A and 6.7% in Group B. Minor's test was positive at an incidence of 59.09% in Group A and 21.87% in Group B (P = .004, 95% CI). Severe Frey's syndrome was observed in 31.82% of the patients of Group A and in 3.12% of the patients of Group B (P = .002, 95% CI). Since there were no statistical significant differences between the volumes of the removed tumors and the excised histological specimens, the extent of dissection was not proved to influence the occurrence of Frey's syndrome in the compared groups. CONCLUSION Porcine dermal collagen is a safe, practical, and useful means for parotid reconstruction, since it seems to contribute in prevention of Frey's syndrome when increased amount of glandular tissue has to be removed. Additional randomized controlled studies with bigger samples are required to better assess the PDCG use in parotid surgery.
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Affiliation(s)
- Kostas Vahtsevanos
- Department of Oral and Maxillofacial Surgery, Theagenio Cancer Hospital, Thessaloniki, Greece
| | | | | | - Georgios Koloutsos
- Department of Oral and Maxillofacial Surgery, Theagenio Cancer Hospital, Thessaloniki, Greece
| | | | - Kyriaki Kitikidou
- Department of Forestry and Management of the Environment and Natural Resources, Laboratory of Forest Biometry, Dimokritos University of Thrace, Orestias, Greece
| | - Aris Ntomouchtsis
- Department of Oral and Maxillofacial Surgery, Theagenio Cancer Hospital, Thessaloniki, Greece
| | - Anna Patrikidou
- Drug Development Unit, Sarah Cannon Research Institute and University London College Hospitals & UCL Cancer Institute, London, UK
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Kim JH, Kim DH, Lim JY, Won HR, Shin YS, Kim CH, Ban MJ, Park JH, Byeon HK, Hong HJ, Choi EC, Koh WY. Effect of human acellular dermal matrix (Megaderm™) on infra-auricular depressed deformities, Frey's syndrome, and first bite syndrome following parotidectomy: a multi-center prospective study. Gland Surg 2021; 10:670-677. [PMID: 33708549 DOI: 10.21037/gs-20-703] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Parotidectomy is the primary treatment for parotid gland tumors. However, complications may include a prominent facial scar or infra-auricular depressed deformity, Frey's syndrome, first bite syndrome, or other facial pain, numbness, and paralysis. Acellular dermal matrix (ADM) has been widely used to prevent these complications in parotid surgery, but there have been no prospective, multi-center trials documenting its efficacy. This study evaluates the effectiveness of ADM implantation in preventing infra-auricular depressed deformity, Frey's syndrome and first bite syndrome after parotidectomy. Methods We analyzed 51 cases of standard parotidectomy and 58 cases of parotidectomy with implantation of Megaderm™ ADM through prospective multicenter trial. Acute complications including infection, seroma, hematoma, skin necrosis, and acute parotid area pain were evaluated 1 week postoperatively. Clinician grading of Frey's syndrome and blinded clinician evaluation of infra-auricular depressed deformities were conducted at 3, 6, and 12 months. Patients evaluated subjective satisfaction with neck appearance, Frey's syndrome quality, and acute parotid area pain at 3, 6, and 12 months. Results There was a higher incidence of seroma in the Megaderm™ group than in the control group at week 1. The incidence and total clinician-evaluated Frey's syndrome scores were significantly lower in the Megaderm™ group than in the control group at 3, 6, and 12 months. Both the objective and subjective evaluations of the facial contour showed a better outcome in the Megaderm™ group compared to the control group at 3, 6, and 12 months. There were no significant differences between the groups in the patient-reported Frey's syndrome quality scores at 3, 6, and 12 months, but the Megaderm™ group reported significantly less acute pain than the control group. Conclusions ADM implantation can effectively reduce the occurrence of Frey's syndrome, infra-auricular depressed deformity, and first bite syndrome after parotidectomy. ADM may be especially advantageous in complex parotidectomy cases when significant complications are expected.
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Affiliation(s)
- Joo Hyun Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Da Hee Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae-Yol Lim
- Department of Otorhinolaryngology-Head and Neck Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ho-Ryun Won
- Department of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Yoo Seob Shin
- Department of Otorhinolaryngology-Head and Neck Surgery, Ajou University College of Medicine, Kungki-do, Republic of Korea
| | - Chul-Ho Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Ajou University College of Medicine, Kungki-do, Republic of Korea
| | - Myung Jin Ban
- Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea
| | - Jae Hong Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea
| | - Hyung Kwon Byeon
- Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea
| | - Hyun Jun Hong
- Department of Otorhinolaryngology-Head and Neck Surgery, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea
| | - Eun Chang Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Woon Yoo Koh
- Department of Otorhinolaryngology-Head and Neck Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
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De Virgilio A, Costantino A, Russo E, Ferreli F, Pellini R, Petruzzi G, Zocchi J, Spriano G, Mercante G. Different Surgical Strategies in the Prevention of Frey Syndrome: A Systematic Review and Meta-analysis. Laryngoscope 2021; 131:1761-1768. [PMID: 33502015 DOI: 10.1002/lary.29414] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/17/2020] [Accepted: 01/12/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE/HYPOTHESIS To define the best surgical technique able to reduce Frey syndrome (FS) incidence after parotidectomy. STUDY DESIGN Systematic review and network meta-analysis. METHODS An arm-based network analysis was conducted using a Bayesian hierarchical model. The primary and secondary outcomes were the incidence of subjective (clinical) and objective (positive starch-iodine test result) FS, respectively. RESULTS A total of 3830 patients with a median age of 50.35 years (n = 2323; IQR 44.25-54.18) were included for six interventions [temporoparietal fascia (TPFF), free fat graft (FFG), acellular dermal matrix (ADM), sternocleidomastoid muscle (SCM) flap, and superficial musculoaponeurotic system (SMAS) flap]. If compared to no treatment, the greatest reduction of subjective (clinical) FS incidence was measured for the TPFF (OR: 0.07, CI: 0.004-0.57), the ADM (OR: 0.09, CI: 0.02-0.35), and the FFG (OR: 0.11, CI: 0.03-0.42) techniques. However, a significant difference was measured also for the SCM flap (OR: 0.38, CI: 0.18-0.73) and for the SMAS flap (OR: 0.42, CI: 0.19-0.97). All treatments showed a significant reduction of the objective FS incidence if compared to no treatment (FFG, OR: 0.06, CI: 0.002-0.62; TPFF, OR: 0.07, CI: 0.01-0.33; ADM, OR: 0.11, CI: 0.03-0.44; SMAS, OR: 0.36, CI: 0.17-0.71; SCM, OR: 0.40, CI: 0.19-0.74). CONCLUSIONS TPFF, ADM, and FFG seem to be the best treatment strategies to prevent FS after parotidectomy. Further randomized controlled trials comparing these techniques should be conducted to define specific indications. Laryngoscope, 131:1761-1768, 2021.
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Affiliation(s)
- Armando De Virgilio
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele - Milan, Italy.,Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano - Milan, Italy
| | - Andrea Costantino
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele - Milan, Italy.,Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano - Milan, Italy
| | - Elena Russo
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele - Milan, Italy.,Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano - Milan, Italy
| | - Fabio Ferreli
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele - Milan, Italy
| | - Raul Pellini
- Department of Otolaryngology Head and Neck Surgery, Regina Elena National Cancer Institute, IRCCS, Rome, Italy
| | - Gerardo Petruzzi
- Department of Otolaryngology Head and Neck Surgery, Regina Elena National Cancer Institute, IRCCS, Rome, Italy
| | - Jacopo Zocchi
- Department of Otolaryngology Head and Neck Surgery, Regina Elena National Cancer Institute, IRCCS, Rome, Italy
| | - Giuseppe Spriano
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele - Milan, Italy.,Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano - Milan, Italy
| | - Giuseppe Mercante
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele - Milan, Italy.,Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano - Milan, Italy
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Mashrah MA, Aldhohrah T, Abdelrehem A, Koraitim M, Wang L. What is the best method for prevention of postparotidectomy Frey syndrome? Network meta-analysis. Head Neck 2021; 43:1345-1358. [PMID: 33439485 DOI: 10.1002/hed.26597] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/22/2020] [Accepted: 12/17/2020] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Prevention of Frey syndrome (FS) after parotidectomy using an interposition barrier has long been gaining a wide popularity; however, there is no clear evidence regarding which preventive technique is more effective. The aim of this network meta-analysis (NMA) is to answer the question: What is the best method for prevention of FS after parotidectomy? METHODS A comprehensive search of the PubMed, Embase, SCOPUS, and Cochrane library was conducted to identify the eligible studies. The outcome was the incidence of subjective Frey syndrome (SFS) and objective Frey syndrome (OFS). The Bayesian NMA accompanied with a random effects model and 95% credible intervals (CrIs) were calculated using GeMTC R package. RESULTS Thirty-four studies (n = 2987 patients) with five interventions, namely Alloderm (ADM), temporoparietal fascia (TPF), sternocleidomastoid muscle (SCM), superficial musculoaponeurotic system (SMAS), and free fat graft (FFG), were compared together and with no interposition barrier (NB). The results of NMA showed a statistically significant reduction in both SFS and OFS when ADM, TPF, SMAS, FFG, and SCM were compared with NB. No statistical differences were observed when comparing ADM, SCM, SMAS, FFG, and TPF. TPF ranked the best of all treatments (59.4%) and was associated with the least incidence of SFS; whereas ADM ranked the best of all treatments (61.1%) and was associated with the least incidence of OFS. CONCLUSIONS All interventions (TPF flap, ADM, FFG, SMAS, and SCM) were associated with a significant reduction in the incidence of FS when compared with NB. TPF and ADM showed the best outcome with the least incidence of SFS and OFS, respectively.
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Affiliation(s)
- Mubarak Ahmed Mashrah
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Taghrid Aldhohrah
- Guanghua Stomatology Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Ahmed Abdelrehem
- Department of Craniomaxillofacial and Plastic Surgery, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Mohamed Koraitim
- Department of Craniomaxillofacial and Plastic Surgery, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Liping Wang
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
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10
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Lambiel S, Dulguerov N, Courvoisier DS, Dulguerov P. Minor Parotidectomy Complications: A Systematic Review. Laryngoscope 2020; 131:571-579. [PMID: 32678921 DOI: 10.1002/lary.28912] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 05/12/2020] [Accepted: 05/26/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To report descriptive statistics for minor parotidectomy complications. METHODS A systematic review was performed, selecting 235 studies for analysis. The incidence of complications was tabulated, and descriptive statistics calculated. Outlier studies, 1 standard deviation above the mean, were reexamined to determine potential causal factors for each complication. All studies were examined for statistically significant differences for any potential causal factor. RESULTS The pooled incidence of minor complications reported were hematoma 2.9% (95% confidence interval [CI]: 2.4-3.5), wound infection 2.3% (95% CI: 1.8-2.9), sialocele 4.5% (95% CI: 3.5-5.7), salivary fistula 3.1% (95% CI: 2.6-3.7), flap necrosis 1.7% (95% CI: 1.1-2.5), scar issues 3.6% (95% CI: 2.4-5.4), numbness 33.9% (95% CI: 25.6-43.4), and deformity 11.8 (95% CI: 6.9-19.5). Implants result in more wound complications, such as hematoma, sialocele, or salivary fistula. Sialocele and salivary fistula appear more frequently after less extensive parotid surgery, whereas hematoma, wound infections, flap necrosis, and aesthetic considerations are worse with more extensive resections. CONCLUSIONS Minor parotidectomy complications are more frequent than generally assumed and related to certain factors that should be investigated. Laryngoscope, 131:571-579, 2021.
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Affiliation(s)
- Silvia Lambiel
- Department of Otorhinolaryngology-Head and Neck Surgery, Geneva University Hospital, Geneva, Switzerland
| | - Nicolas Dulguerov
- Department of Otorhinolaryngology-Head and Neck Surgery, Geneva University Hospital, Geneva, Switzerland
| | | | - Pavel Dulguerov
- Department of Otorhinolaryngology-Head and Neck Surgery, Geneva University Hospital, Geneva, Switzerland.,Center for Otorhinolaryngology-Maxillofacial and Head and Neck Surgery, La Tour Hospital, La Tour Medical Group, Meyrin, Switzerland
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11
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Li C, Matthies L, Hou X, Knipfer C, Gosau M, Friedrich RE. A meta-analysis of the pros and cons of partial superficial parotidectomy versus superficial parotidectomy for the treatment of benign parotid neoplasms. J Craniomaxillofac Surg 2020; 48:590-598. [DOI: 10.1016/j.jcms.2020.04.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 03/10/2020] [Accepted: 04/07/2020] [Indexed: 10/24/2022] Open
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Chiesa-Estomba CM, Larruscain-Sarasola E, González-García JA, Sistiaga-Suarez JA, Altuna-Mariezcurrena X. Cold Knife Dissection and Bipolar Diathermy Vs Harmonic Scalpel in Parotid Gland Surgery for Benign Tumours. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2020. [DOI: 10.1016/j.otoeng.2019.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Chiesa-Estomba CM, Larruscain-Sarasola E, González-García JA, Sistiaga-Suarez JA, Altuna-Mariezcurrena X. Cold knife dissection and bipolar diathermy Vs harmonic scalpel in parotid gland surgery for benign tumours. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2019; 71:93-98. [PMID: 31594557 DOI: 10.1016/j.otorri.2019.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 03/22/2019] [Accepted: 04/10/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Surgical techniques for extirpation of tumours of the parotid gland have evolved significantly in recent years. Previous data suggest the use of Harmonic Scalpel reduced operative time, intraoperative blood loss, postoperative drain production, and incidence of facial nerve injury, in comparison to cold scalpel dissection MATERIAL AND METHODS: retrospective analysis of 2group of patients operated using harmonic scalpel versus cold knife dissection and bipolar diathermy and compare operative time and post-surgical complication rate:, facial nerve injury, sialocele or salivary fístula formation, after parotidectomy for benign parotid tumours. RESULTS 108 patients were included. Regarding surgical time, the mean time to using Harmonic Scalpel was 114±39 (Min: 60/Max: 240), and the mean time using bipolar diathermy was 135±38 (Min: 90/Max: 285) and this was the only significant difference between the 2techniques (p=.049). CONCLUSIONS Harmonic scalpel is a safe and effective tool to perform parotid surgery in benign tumours. However, a shorter surgical time was the only advantage found over the traditional cold dissection and bipolar dissection method.
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Affiliation(s)
- Carlos Miguel Chiesa-Estomba
- Servicio de Otorrinolaringología, Cirugía de Cabeza y Cuello, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España.
| | - Ekhiñe Larruscain-Sarasola
- Servicio de Otorrinolaringología, Cirugía de Cabeza y Cuello, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España
| | - Jose Angel González-García
- Servicio de Otorrinolaringología, Cirugía de Cabeza y Cuello, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España
| | - Jon Alexander Sistiaga-Suarez
- Servicio de Otorrinolaringología, Cirugía de Cabeza y Cuello, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España
| | - Xabier Altuna-Mariezcurrena
- Servicio de Otorrinolaringología, Cirugía de Cabeza y Cuello, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España
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Choi J, Park SI, Rha EY, Seo BF, Kwon H, Jung SN. Acellular dermal matrix (Insuregraf) in the prevention of Frey's syndrome and surgical site depression after parotidectomy. Arch Craniofac Surg 2019; 20:176-180. [PMID: 31256554 PMCID: PMC6615418 DOI: 10.7181/acfs.2019.00248] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 06/07/2019] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Parotidectomy is the treatment of choice in many parotid tumors. Due to the extensive nature of the procedure, unfavorable complications such as gustatory sweating, surgical site depression are common. Various techniques using fascia, muscle or AlloDerm have been developed but debate still remains regarding its availability and affordability. We applied a newly developed acellular dermal matrix (Insuregraf) to the parotidectomy field to act as a physical barrier and to provide adequate filling effect for prevention of functional and aesthetic complications. METHODS From March 2010 to March 2017, 30 patients with parotid tumors underwent superficial parotidectomy. Twenty patients underwent only superficial parotidectomy. Ten patients had Insuregraf applied to the surgical site after superficial parotidectomy. We evaluated the incidence of Frey's syndrome, surgical site depression, and patient satisfaction rate in both groups. RESULTS The incidence of Frey's syndrome was lower in the Insuregraf group (0 vs. 2). Surgical site depression was also lower in the Insuregraf group (2 vs. 20). Satisfaction score for facial contour in Insuregraf group was 9.2 out of 10, which was comparable to 6.2 out of 10 in the control group. CONCLUSION Application of Insuregraf after superficial parotidectomy is an effective surgical procedure to prevent complications such as Frey's syndrome and surgical site depression. This technique is affordable and safe with no immune reactions. Above all this surgical method should be considered as an option for patients who are concerned about the contour of the face after surgery.
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Affiliation(s)
- Jangyoun Choi
- Department of Plastic and Reconstructive Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
| | - Song I Park
- Department of Plastic and Reconstructive Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
| | - Eun Young Rha
- Department of Plastic and Reconstructive Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Bommie Florence Seo
- Department of Plastic and Reconstructive Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
| | - Ho Kwon
- Department of Plastic and Reconstructive Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
| | - Sung-No Jung
- Department of Plastic and Reconstructive Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
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15
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Cosmetic outcome of implantation of cross-linked human acellular dermal matrix after parotidectomy. Br J Oral Maxillofac Surg 2019; 57:301-305. [DOI: 10.1016/j.bjoms.2019.01.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 01/25/2019] [Indexed: 11/21/2022]
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Gallo A, Manciocco V, Pagliuca G, Martellucci S, de Vincentiis M. Transdermal Scopolamine in the Management of Postparotidectomy Salivary Fistula. EAR, NOSE & THROAT JOURNAL 2019. [DOI: 10.1177/0145561313092010-1113] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Andrea Gallo
- Department of Otorhinolaryngology, “Sapienza” University of Rome, Italy
| | - Valentina Manciocco
- Department of Otolaryngology/Head and Neck Surgery, National Cancer Institute Regina Elena, Rome
| | - Giulio Pagliuca
- Department of Otorhinolaryngology, “Sapienza” University of Rome, Italy
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Huang Y, Liu YW, Pan HZ, Zhang XL, Li J, Xiang L, Meng J, Wang PH, Yang J, Jing ZC, Zhang H. Transthoracic Pulmonary Artery Denervation for Pulmonary Arterial Hypertension. Arterioscler Thromb Vasc Biol 2019; 39:704-718. [DOI: 10.1161/atvbaha.118.311992] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objective—
Pulmonary arterial hypertension is characterized by progressive pulmonary vascular remodeling and persistently elevated mean pulmonary artery pressures and pulmonary vascular resistance. We aimed to investigate whether transthoracic pulmonary artery denervation (TPADN) attenuated pulmonary artery (PA) remodeling, improved right ventricular (RV) function, and affected underlying mechanisms. We also explored the distributions of sympathetic nerves (SNs) around human PAs for clinical translation.
Approach and Results—
We identified numerous SNs in adipose and connective tissues around the main PA trunks and bifurcations in male Sprague Dawley rats, which were verified in samples from human heart transplant patients. Pulmonary arterial hypertensive rats were randomized into TPADN and sham groups. In the TPADN group, SNs around the PA trunk and bifurcation were completely and accurately removed under direct visualization. The sham group underwent thoracotomy. Hemodynamics, RV function, and pathological changes in PA and RV tissues were measured via right heart catheterization, cardiac magnetic resonance imaging, and pathological staining, respectively. Compared with the sham group, the TPADN group had lower mean pulmonary arterial pressures, less PA and RV remodeling, and improved RV function. Furthermore, TPADN inhibited neurohormonal overactivation of the sympathetic nervous system and renin-angiotensin-aldosterone system and regulated abnormal expressions and signaling of neurohormone receptors in local tissues.
Conclusions—
There are numerous SNs around the rat and human main PA trunks and bifurcations. TPADN completely and accurately removed the main SNs around PAs and attenuated pulmonary arterial hypertensive progression by inhibiting excessive activation of the sympathetic nervous system and renin-angiotensin-aldosterone system neurohormone-receptor axes.
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Affiliation(s)
- Yuan Huang
- From the State Key Laboratory of Cardiovascular Diseases and Center for Pediatric Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases (Y.H., Y.-W.L., X.-L.Z., J.L., L.X., J.M., P.-H.W., H.Z.), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing
| | - Yi-Wei Liu
- From the State Key Laboratory of Cardiovascular Diseases and Center for Pediatric Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases (Y.H., Y.-W.L., X.-L.Z., J.L., L.X., J.M., P.-H.W., H.Z.), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing
| | - Hai-Zhou Pan
- Children’s Heart Center, the Second Affiliated Hospital and Yuying Children’s Hospital, Institute of Cardiovascular Development and Translational Medicine, Wenzhou Medical University, Zhejiang, China (H.-Z.P.)
| | - Xiao-Ling Zhang
- From the State Key Laboratory of Cardiovascular Diseases and Center for Pediatric Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases (Y.H., Y.-W.L., X.-L.Z., J.L., L.X., J.M., P.-H.W., H.Z.), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing
| | - Jun Li
- From the State Key Laboratory of Cardiovascular Diseases and Center for Pediatric Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases (Y.H., Y.-W.L., X.-L.Z., J.L., L.X., J.M., P.-H.W., H.Z.), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing
| | - Li Xiang
- From the State Key Laboratory of Cardiovascular Diseases and Center for Pediatric Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases (Y.H., Y.-W.L., X.-L.Z., J.L., L.X., J.M., P.-H.W., H.Z.), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing
| | - Jian Meng
- From the State Key Laboratory of Cardiovascular Diseases and Center for Pediatric Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases (Y.H., Y.-W.L., X.-L.Z., J.L., L.X., J.M., P.-H.W., H.Z.), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing
| | - Pei-He Wang
- From the State Key Laboratory of Cardiovascular Diseases and Center for Pediatric Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases (Y.H., Y.-W.L., X.-L.Z., J.L., L.X., J.M., P.-H.W., H.Z.), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing
| | - Jun Yang
- Institute of Basic Medical Sciences (J.Y.), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing
| | - Zhi-Cheng Jing
- Key Laboratory of Pulmonary Vascular Medicine, Fuwai Hospital, National Center for Cardiovascular Diseases (Z.-C.J.), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing
| | - Hao Zhang
- From the State Key Laboratory of Cardiovascular Diseases and Center for Pediatric Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases (Y.H., Y.-W.L., X.-L.Z., J.L., L.X., J.M., P.-H.W., H.Z.), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing
- Heart Center and Shanghai Institution of Pediatric Congenital Heart Diseases, Shanghai Children’s Medical Center, National Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, China (H.Z.)
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Movassaghi K, Lewis M, Shahzad F, May JW. Optimizing the Aesthetic Result of Parotidectomy with a Facelift Incision and Temporoparietal Fascia Flap. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2019; 7:e2067. [PMID: 30881826 PMCID: PMC6416109 DOI: 10.1097/gox.0000000000002067] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 10/19/2018] [Indexed: 11/27/2022]
Abstract
The 3 most common problems after a parotidectomy are cheek contour deformity, Frey syndrome (gustatory sweating), and a visible scar on the neck. These problems can potentially be prevented by (1) facelift type incisions, which eliminate the neck incision and (2) interposition of temporoparietal fascia at the parotidectomy site that fills the defect and provides a barrier to aberrant neuronal regeneration. We followed 11 patients who underwent parotidectomy (9 superficial and 2 total parotidectomies) for a variety of parotid tumors between December 2001 and January 2018. Facelift type incisions were used in all patients, and temporoparietal fascia flaps were used to fill the parotidectomy defects. The last 6 patients were tested for objective evidence of Frey syndrome with the Minor Starch Iodine test. Patients were then followed for up to 7 years (11 months to 7 years, average 3 years). All patients had well-hidden scars and good contour of the cheeks. None of the patients developed subjective or objective evidence of Frey syndrome. This small series suggests that the aesthetic result after parotidectomy can be improved by using a facelift incision and placement of a temporoparietal fascia flap into the parotidectomy defect. Additionally, the tissue barrier thus provided may also help to prevent Frey syndrome.
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Affiliation(s)
- Kiya Movassaghi
- Massachusetts General Hospital, Harvard Medical School, Boston, Mass
| | - Matthew Lewis
- From the Department of Surgery, Division of Plastic Surgery, Oregon Health & Science University, Portland, Ore
| | - Farooq Shahzad
- From the Department of Surgery, Division of Plastic Surgery, Oregon Health & Science University, Portland, Ore
- Department of Surgery, Division of Plastic Surgery, Northwestern University, Chicago, Ill
| | - James W. May
- Massachusetts General Hospital, Harvard Medical School, Boston, Mass
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20
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Reconstruction of parotidectomy and lateral skull base defects. Curr Opin Otolaryngol Head Neck Surg 2017; 25:431-438. [DOI: 10.1097/moo.0000000000000391] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Byun JH, Lim JS, Lee HK. Mixed Tumor in Deep Lobe and Versatility of Acellular Dermal Matrix. Arch Craniofac Surg 2017; 18:132-136. [PMID: 28913321 PMCID: PMC5556895 DOI: 10.7181/acfs.2017.18.2.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Revised: 05/31/2017] [Accepted: 05/31/2017] [Indexed: 11/11/2022] Open
Abstract
Frey's syndrome and infra-auricular depressed deformities are the ones of the most common complications that can occur after total parotidectomy. We report 1 case of pleomorphic adenoma occurred in the deep lobe that obtained good results from using acellular dermal matrix (ADM) after total parotidectomy. A 24-year-old man visited the hospital with oval shape mass in right mandibular angle which of 4 cm in size was found in the deep lobe of right parotid gland from Magnetic resonance imaging scanning and a pleomorphic adenoma was suspected. A total parotidectomy was performed while preserving the facial nerve. The material known as ADM were placed in the depressed part from where the mass was removed, and the site was sutured. The surgery site was healed well without any complications such as Frey's syndrome or infra-auricular depressed deformities. The pathological result was confirmed as pleomorphic adenoma. In addition to these advantages, it does not have little potential of deformation by the gravity after the surgery, and there is no restraint on circulation, which makes fabrication free and each deformation into various shapes can be described as another advantage of the reconstruction using the ADM.
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Affiliation(s)
- Jin Hwan Byun
- Department of Plastic and Reconstructive Surgery, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
| | - Jung Soo Lim
- Department of Plastic and Reconstructive Surgery, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
| | - Hye Kyung Lee
- Department of Plastic and Reconstructive Surgery, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
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22
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Comparison of Complications in Parotid Surgery With Harmonic Scalpel Versus Cold Instruments. J Craniofac Surg 2017; 28:e342-e344. [DOI: 10.1097/scs.0000000000003581] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Abstract
Frey syndrome is a common sequela of parotidectomy, and although it is not frequently manifested clinically, it can cause significant morbidity for those affected. Frey syndrome results from synkinetic autonomic reinnervation by transected postganglionic parasympathetic nerve fiber within the parotid gland to the overlying sweat glands of the skin. Many surgical techniques have been proposed to prevent the development of Frey syndrome. For those who develop clinical symptoms of Frey syndrome, objective testing can be performed with a Minor starch-iodine test. Some of the current methods to prevent and treat symptomatic Frey syndrome are reviewed.
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Affiliation(s)
- Kevin M Motz
- Otolaryngology-Head and Neck Surgery, Johns Hopkins Hospital, JHOC 6150, 601 North Caroline Street, Baltimore, MD 21231, USA
| | - Young J Kim
- Otolaryngology-Head and Neck Surgery, Johns Hopkins Hospital, JHOC 6150, 601 North Caroline Street, Baltimore, MD 21231, USA.
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24
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Zhang SE, Su YX, Zheng GS, Liang YJ, Liao GQ. Reinnervated nerves contribute to the secretion function and regeneration of denervated submandibular glands in rabbits. Eur J Oral Sci 2014; 122:372-81. [PMID: 25363784 DOI: 10.1111/eos.12154] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Si-en Zhang
- Department of Oral and Maxillofacial Surgery; Guanghua School of Stomatology; Hospital of Stomatology; Guangdong Provincial Key Laboratory of Stomatology; Sun Yat-Sen University; Guangzhou China
| | - Yu-xiong Su
- Department of Oral and Maxillofacial Surgery; Guanghua School of Stomatology; Hospital of Stomatology; Guangdong Provincial Key Laboratory of Stomatology; Sun Yat-Sen University; Guangzhou China
| | - Guang-sen Zheng
- Department of Oral and Maxillofacial Surgery; Guanghua School of Stomatology; Hospital of Stomatology; Guangdong Provincial Key Laboratory of Stomatology; Sun Yat-Sen University; Guangzhou China
| | - Yu-jie Liang
- Department of Oral and Maxillofacial Surgery; Guanghua School of Stomatology; Hospital of Stomatology; Guangdong Provincial Key Laboratory of Stomatology; Sun Yat-Sen University; Guangzhou China
| | - Gui-qing Liao
- Department of Oral and Maxillofacial Surgery; Guanghua School of Stomatology; Hospital of Stomatology; Guangdong Provincial Key Laboratory of Stomatology; Sun Yat-Sen University; Guangzhou China
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25
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Sharma R. Prevention of Frey syndrome with superficial temporal fascia interpositioning: a retrospective study. Int J Oral Maxillofac Surg 2014; 43:413-7. [DOI: 10.1016/j.ijom.2013.12.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 11/13/2013] [Accepted: 12/11/2013] [Indexed: 10/25/2022]
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Tuckett J, Glynn R, Sheahan P. Impact of extent of parotid resection on postoperative wound complications: A prospective study. Head Neck 2014; 37:64-8. [DOI: 10.1002/hed.23558] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2013] [Revised: 09/28/2013] [Accepted: 11/26/2013] [Indexed: 11/08/2022] Open
Affiliation(s)
- Joel Tuckett
- Dept of Otolaryngology - Head and Neck Surgery; South Infirmary Victoria University Hospital; Cork Ireland
| | - Ronan Glynn
- Dept of Otolaryngology - Head and Neck Surgery; South Infirmary Victoria University Hospital; Cork Ireland
| | - Patrick Sheahan
- Dept of Otolaryngology - Head and Neck Surgery; South Infirmary Victoria University Hospital; Cork Ireland
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Systematic Evaluation on the Use of Acellular Dermis Matrix Graft in Prevention Frey Syndrome After Parotid Neoplasm Surgery. J Craniofac Surg 2013; 24:1526-9. [DOI: 10.1097/scs.0b013e31828dcdb3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Kamath RAD, Bharani S, Prabhakar S. Frey's Syndrome Consequent to an Unusual Pattern of Temporomandibular Joint Dislocation: Case Report with Review of Its Incidence and Etiology. Craniomaxillofac Trauma Reconstr 2013; 6:1-8. [PMID: 24436729 PMCID: PMC3699238 DOI: 10.1055/s-0032-1332210] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Accepted: 06/10/2012] [Indexed: 10/27/2022] Open
Abstract
Frey's syndrome was first described in the 18(th) century. Recognizing it as a nonspecific condition, the symptom of gustatory sweating in patients with parotid gland inflammation was described by Duphenix and Baillarger. However, as a specific diagnostic entity, gustatory sweating, following trauma to parotid glands, was first described by Polish neurologist Lucie Frey, in 1923, and hence he proposed the term auriculotemporal syndrome. The condition is characterized by sweating, flushing, a sense of warmth, and occasional pain in the preauricular and temporal areas, following the production of a strong salivary stimulus. Several etiologies of Frey's syndrome have been mentioned in the literature; however, none attribute dislocation of the "intact" mandibular condyle as a cause of the syndrome. Reviewing its pathophysiology, etiology, and incidence in detail, we describe a case of Frey's syndrome subsequent to superolateral dislocation of the intact mandibular condyle following fracture of the anterior mandible. Its management and prevention are also discussed in brief.
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Affiliation(s)
- Rajay A. D. Kamath
- Department of Oral and Maxillofacial Surgery, College of Dental Sciences and Hospital, Davangere, Karnataka, India
| | - Shiva Bharani
- Department of Oral and Maxillofacial Surgery, College of Dental Sciences and Hospital, Davangere, Karnataka, India
| | - Suhas Prabhakar
- Department of Oral and Maxillofacial Surgery, College of Dental Sciences and Hospital, Davangere, Karnataka, India
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Wang W, Zhu J, Li M, Xia B, Xu B. Usefulness of platysma muscle flap following superficial parotidectomy. J Craniomaxillofac Surg 2013; 41:10-4. [DOI: 10.1016/j.jcms.2012.05.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2012] [Revised: 05/12/2012] [Accepted: 05/14/2012] [Indexed: 10/28/2022] Open
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30
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A Systematic Review of Acelluar Dermal Matrices in Head and Neck Reconstruction. Plast Reconstr Surg 2012; 130:35S-43S. [DOI: 10.1097/prs.0b013e31825eff7a] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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31
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Shi LJ, Wang Y, Yang C, Jiang WW. Application of acellular dermal matrix in reconstruction of oral mucosal defects in 36 cases. J Oral Maxillofac Surg 2012; 70:e586-91. [PMID: 22921754 DOI: 10.1016/j.joms.2012.07.024] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2012] [Revised: 05/09/2012] [Accepted: 07/11/2012] [Indexed: 12/20/2022]
Abstract
PURPOSE Artificial grafts have been investigated for use in the repair of oral mucosal defects. The aim of this retrospective study was to present the outcomes of the use of acellular dermal matrix (ADM) grafts to repair oral mucosal defects. MATERIALS AND METHODS Data from 36 patients with oral mucosal defects reconstructed with ADM grafts from 2003 through 2009 were reviewed. All patients were followed-up for at least 6 months to observe the graft repair, wound-healing time, contracture, color, infection, pain, immunologic reaction, texture of the graft, and clinical course. Graft success was defined as the ADM graft being replaced by new mucosa-like tissue and the oral mucosal defect being covered with the new mucosa-like tissue. Any evidence of incomplete graft re-epithelialization or graft sloughing was considered a graft failure (complete or incomplete). RESULTS Of the 36 cases, 34 grafts (94.4%) were successfully replaced with new mucosa-like tissues and only 2 grafts (5.6%) failed. No complaints such as pain, immunologic reaction, or infection were observed during the follow-up. Mild graft contraction occurred in 7 patients with lip or buccal defects, especially at approximately 3 to 5 weeks after the reconstructive surgery. CONCLUSIONS The ADM grafts for oral mucosal defects were safe and effective. The present data support the clinical application of ADM grafts in reconstructing oral mucosal defects caused by various oral diseases.
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Affiliation(s)
- Lin-Jun Shi
- Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Militsakh ON, Sanderson JA, Lin D, Wax MK. Rehabilitation of a parotidectomy patient-A systematic approach. Head Neck 2012; 35:1349-61. [DOI: 10.1002/hed.23095] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2012] [Indexed: 11/10/2022] Open
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33
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Graft for prevention of Frey syndrome after parotidectomy: a systematic review and meta-analysis of randomized controlled trials. J Oral Maxillofac Surg 2012; 71:419-27. [PMID: 22884117 DOI: 10.1016/j.joms.2012.06.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2012] [Revised: 05/27/2012] [Accepted: 06/08/2012] [Indexed: 11/20/2022]
Abstract
PURPOSE To detect the effect and safety of different types of grafts for the prevention of Frey syndrome after parotidectomy. MATERIALS AND METHODS The following data bases were searched electronically: MEDLINE (using OVID, from 1948 to July 2011), Cochrane Central Register of Controlled Trials (CENTRAL, issue 2, 2011), EMBASE (available from: http://embase.com, 1984 to July 2011), World Health Organization International Clinical Trials Registry Platform (July 2011), Chinese BioMedical Literature Database (1978 to July 2011), and the China National Knowledge Infrastructure (1994 to July 2011). The relevant journals and reference lists of the included studies were manually searched for randomized controlled trials studying the effect and safety of different types of grafts for preventing Frey syndrome after parotidectomy. The risk of bias assessment using Cochrane Collaboration's tool and data extraction was independently performed by 2 reviewers. The meta-analysis was performed using Review Manager, version 5.1. RESULTS A total of 14 randomized clinical trials and 1,098 participants were included. All had an unclear risk of bias. The meta-analysis results showed that the use of an acellular dermis matrix can reduce by 82% the risk of Frey syndrome compared with the no-graft group using an objective assessment (relative risk [RR] 0.18, 95% confidence interval [CI] 0.12 to 0.26; P < .00001; Grading of Recommendations, Assessment, Development, and Evaluation [GRADE] quality of evidence: high). The acellular dermis matrix can also reduce by 90% the risk of Frey syndrome compared with the no-graft group using a subjective assessment (RR 0.10, 95% CI 0.05 to 0.22; P < .00001; GRADE quality of evidence: high). The muscle flaps can reduce by 81% the risk of Frey syndrome compared with the no-graft group (RR 0.19, 95% CI 0.13 to 0.27; P < .00001; GRADE quality of evidence: high). No statistically significant difference was found between the acellular dermal matrix and muscle flap groups (RR 0.73, 95% CI 0.15 to 3.53, P = .70; GRADE quality of evidence: low). No serious adverse events were reported. CONCLUSIONS The present clinical evidence suggests that grafts are effective in preventing Frey syndrome after parotidectomy. More randomized clinical trials are needed to confirm our conclusions and prove the safety of the grafts.
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Zeng XT, Tang XJ, Wang XJ, Li MZ, Guo Y, Huang W, Niu YM, Leng WD. AlloDerm implants for prevention of Frey syndrome after parotidectomy: a systematic review and meta-analysis. Mol Med Rep 2012; 5:974-80. [PMID: 22266670 PMCID: PMC3493056 DOI: 10.3892/mmr.2012.762] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Accepted: 01/18/2012] [Indexed: 11/05/2022] Open
Abstract
Although Frey syndrome is not life-threatening, it is identified as the most serious and widely recognized sequela of parotidectomy and has significant potential negative social and psychological implications. Several studies have investigated whether AlloDerm® implants prevent Frey syndrome effectively and safely, however, the conclusions are inconsistent. We aimed to evaluate the precise effectiveness of AlloDerm implants for preventing Frey syndrome after parotidectomy, using a systematic review and meta-analysis. We searched randomized and quis-randomized controlled trials in which AlloDerm implants were compared to blank controls for preventing Frey syndrome after parotidectomy, from the PubMed, Embase, the Cochrane Library and the ISI Web of Knowledge databases, without any language restriction. Two reviewers independently searched, identified, extracted data and assessed methodological quality. Relative risks with 95% confidence intervals were calculated and pooled. Five articles involving 409 patients met the inclusion criteria. Meta-analyses showed a significant 85% relative risk reduction in objective incidence (RR=0.15, 95% CI 0.08-0.30; P<0.00001) and 68% in subjective incidence (RR=0.32, 95% CI 0.19-0.57; P<0.00001) of Frey syndrome with AlloDerm implants; there was a significant 91% relative risk reduction in salivary fistula (RR=0.09, 95% CI 0.01-0.66; P=0.02); there was no statistical significance for the incidence of facial nerve paralysis (RR=0.96, 95% CI 0.84-1.09; P=0.51); there was no statistical significance for the incidence of seroma/sialocele (RR=1.36, 95% CI 0.66-2.80; P=0.40); there was a trend for a small effect in improving facial contour. Adverse events related to AlloDerm implants were not found. There is evidence that AlloDerm reduces the incidence of Frey syndrome effectively and safely, and also has the potential to improve facial contour and decrease salivary fistula. However, it is unclear whether AlloDerm implants improve facial contour and decrease other complications. Thus, further controlled evaluative studies incorporating more precise measures are required.
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Affiliation(s)
- Xian-Tao Zeng
- Department of Stomatology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, PR China
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Granell J, Sánchez-Jara JL, Gavilanes J, Velasco MJ, Collazo T, Herrero J, Martín G. [Management of the surgical pathology of the parotid gland: A review of 54 cases]. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2010; 61:189-95. [PMID: 20097321 DOI: 10.1016/j.otorri.2009.11.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2009] [Revised: 11/21/2009] [Accepted: 11/25/2009] [Indexed: 11/18/2022]
Abstract
INTRODUCTION AND AIM OF THE STUDY The management of the surgical pathology of the parotid gland and its results are relatively uniform. However, both in the diagnostic and the therapeutic aspects, there are some controversial issues which we discuss from the point of view of recent experience at our department. METHODS A descriptive and retrospective study was conducted on patients who underwent parotidectomy for any indication between July 2004 and June 2009 (5 years). RESULTS Fifty four parotidectomies were performed in 52 patients. CT was the most commonly used preoperative diagnostic imaging study. The accuracy of FNAB was 93.3%. 76% were benign processes; among them 7.3% with inflammatory causes. All of the surgical procedures from April 2005 onwards were performed with electrophysiological monitoring of the facial nerve. Superficial parotidectomy was performed in 75.6% of benign cases. The incidence of transient facial paresis in benign pathologies was of 14.6% (all of them of grades II and III). Two cases (both with total parotidectomy) had permanent facial mobility sequelae. The rhytidectomy incision was used preferentially in young women. CONCLUSIONS The controversial issues identified, due either to discrepancies or lack of enough evidence, were: the diagnostic role of MRI, the validity and usefulness of FNAB, the indications of surgical treatment, the need for facial nerve monitoring and the consideration of cosmetic aspects, in particular the indications of rhytidectomy incision.
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Affiliation(s)
- José Granell
- Servicio de Otorrinolaringología, Complejo Asistencial de Avila, Avila, España.
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Granell J, Sánchez-Jara JL, Gavilanes J, Velasco MJ, Collazo T, Herrero J, Martín G. Management of the surgical pathology of the parotid gland: A review of 54 cases. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2010. [DOI: 10.1016/s2173-5735(10)70033-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Shekar K, Singh M, Godden D, Puxeddu R, Brennan PA. Recent advances in the management of salivary gland disease. Br J Oral Maxillofac Surg 2009; 47:594-7. [DOI: 10.1016/j.bjoms.2009.07.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2009] [Indexed: 11/28/2022]
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