Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
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A MODIFIED ENDAURAL AND NECK APPROACH TO THE PAROTID GLAND TUMOR

이하선 종양에 대한 변형된 이내 및 경부접근법

  • Ryu, Sun-Youl (Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University) ;
  • Kook, Min-Suk (Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University) ;
  • Kim, Sun-Kook (Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University) ;
  • Han, Chang-Hun (Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University) ;
  • Gu, Hong (Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University) ;
  • Kwon, Jun-Kyung (Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University) ;
  • An, Jin-Suk (Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University)
  • 유선열 (전남대학교 치과대학 구강악안면외과학교실, 전남대학교 치의학연구소) ;
  • 국민석 (전남대학교 치과대학 구강악안면외과학교실, 전남대학교 치의학연구소) ;
  • 김선국 (전남대학교 치과대학 구강악안면외과학교실, 전남대학교 치의학연구소) ;
  • 한창훈 (전남대학교 치과대학 구강악안면외과학교실, 전남대학교 치의학연구소) ;
  • 구홍 (전남대학교 치과대학 구강악안면외과학교실, 전남대학교 치의학연구소) ;
  • 권준경 (전남대학교 치과대학 구강악안면외과학교실, 전남대학교 치의학연구소) ;
  • 안진석 (전남대학교 치과대학 구강악안면외과학교실, 전남대학교 치의학연구소)
  • Published : 2005.12.31
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Abstract

Generally we use the preauricular incision to access and remove the parotid gland tumor. But the preauricular approach has some complications such as damage of facial nerve and sensory nerve, Frey's syndrome, and postoperative scar. Especially, the postoperative scar can often cause an unesthetic result and mental stress in young patients. Therefore, if we avoid preauricular incision to be performed outside of tragus, the postoperative scar would be hardly remarkable, and patients would be satisfied cosmetically. We performed surgical excision using a modified endaural and neck approach in a 21-year-old female with a pleomorphic adenoma and 15-year-old male with a neurofibroma occured in the parotid gland. A new, modified endaural and neck approach is a combined method of the modified endaural incision by Starck et al and Gutierrez's neck extension. We obtained an adequate access and the cosmetically acceptable postsurgical scar. The postoperative scars were hidden in the external ear and the hairline. Moreover, except the neck dissection can this approach be applied to the surgery of temporomandibular joint as well as the parotid gland tumor.

21세 여자의 이하선에 발생한 다형성 선종과 15세 남자의 이하선에 발생한 신경섬유종에 대하여 변형된 이내 및 경부접근법을 사용한 외과적 절제술을 시행하였다. 우리가 사용한 변형된 이내 및 경부접근법은 Starck 등의 변형된 이내접근법과 Gutierrez의 경부 연장술을 병용한 새로운 접근법이다. 우리는 이 접근법을 사용하여 특별한 문제없이 이하선에 접근하여 종양을 절제하였고, 수술 후 반흔은 외이와 머리카락 내에 감춰져 심미적으로 만족할 만하였다. 이 접근법은 이하선 종양에 이용될 수 있을뿐 아니라 경부 연장을 하지 않고 변형된 이내접근법만을 시행할 경우 악관절수술에도 이용될 수 있다.

Keywords

References

  1. Horn-Ross PL, West DW, Brown SR: Recent trends in the incidence of salivary gland cancer. Int J Epidemiol 1991;20:628-633 https://doi.org/10.1093/ije/20.3.628
  2. Ferreria JL, Maurino N, Michael E, Ratinoff M, Rubio E: Surgery of the parotid region: A new approach. J Oral Maxillofac Surg 1990;48:803-807 https://doi.org/10.1016/0278-2391(90)90337-2
  3. Laccourrey H, Cauchois R, Jouffre V, Brasnu D: Total conservative parotidectomy for primary benign pleomorphic adenoma of the parotid gland: A 25-year experience with 229 patients. Laryngoscope 1994;104:1487-1494
  4. 신상훈, 허준, 김기현, 정인교: 이하선 종양의 임상적 연구. 대한구강악안면외과학회지 2000;26:80-84
  5. Appiani E, Delfino MC: Plastic incisions for facial and neck tumours. Ann Plast Surg 1984;13:335-352 https://doi.org/10.1097/00000637-198410000-00009
  6. Gutierrez A: Tumores de la glandula parotida. Su extirpacion. Rev Cirugia 1924;3:23
  7. Adson AW, Ott WO: Preservation of the facial nerve in the radical excision of the parotid tumours. Arch Surg 1923;6:739 https://doi.org/10.1001/archsurg.1923.01110190082003
  8. Martin H: Operative removal of tumors of the parotid salivary gland. Surg 1952;31:670-682
  9. Wolf JJ: Congenital hemangioma of parotid gland. Plast Reconst Surg 1962;29:692-697 https://doi.org/10.1097/00006534-196206000-00007
  10. Rongetti JR: Meniscectomy, a new approach to the temporomandibular joint. Arch Otolaryngol 1954;60:566-572 https://doi.org/10.1001/archotol.1954.00720010581005
  11. Starck WJ, Catone GA, Kaltman SI: A modified endaural approach to the temporomandibular joint. J Oral Maxillofac Surg 1993;51:33-37 https://doi.org/10.1016/S0278-2391(10)80385-4
  12. Lempert J: Modern temporal bone surgery; history of its evolution. Laryngoscope 1950;60:740-778
  13. Redon H: Chirurgie des glandes salivaires. 1st ed. Paris, Masson Ed, 1955
  14. Samengo LA: Consideraciones sobre la cirugia conservadora de la glandula parotida. Pren Med Argent 1961;48:1586-1588
  15. Appiani E: Abordaje para la parotidectomia y transplante muscular. Pren Med Argent 1967;54:1242-1243
  16. Dingman RO, Moorman WC: Meniscectomy in the treatment of lesion of the temporomandibular joint. J Oral Surg 1951;9:214-224
  17. Henny FA, Baldridge OL: Condylectomy for the persistently painful temporomandibular joint. J Oral Surg 1957;15:24-31
  18. Al-Kayat A, Bramley P: A modified pre-auricular approach to the temporomandibular joint and malar arch. Br J Oral Surg 1979;17:91-103 https://doi.org/10.1016/S0007-117X(79)80036-0