Abstract
Surgical removal is the treatment of choice for many neoplasms of the parotid gland. This meta-analysis aimed to evaluate the differences between parotidectomy using a modified facelift incision (MFI) and parotidectomy using a modified Blair incision (MBI). A systematic search of the available literature in PubMed, Embase and the Cochrane Library was performed. Studies of adult patients who underwent open parotidectomy with presumed benign parotid neoplasms based on preoperative examinations were reviewed. The surgical outcomes of the MFI and MBI groups were collected. Intraoperative and postoperative parameters, including operative time, tumor size, cosmetic satisfaction, and incidences of facial palsy, Frey’s syndrome and salivary complications, were compared. Dichotomous data and continuous data were analyzed by calculating the risk difference (RD) and the mean difference (MD) with the 95% confidence interval (CI), respectively. Seven studies were included in the final analysis. The pooled analysis demonstrated that the cosmetic satisfaction score was significantly higher in the MFI group (MD = 1.66; 95% CI 0.87–2.46). The operative duration in the MFI group was significantly longer than that in the MBI group (MD = 0.07; 95% CI 0.00–0.14). The MFI group exhibited a smaller tumor size (MD = − 2.27; 95% CI − 4.25 to − 0.30) and a lower incidence of Frey’s syndrome (RD = − 0.18; 95% CI − 0.27 to − 0.10). The incidence of postoperative temporary facial palsy (RD = − 0.05; 95% CI − 0.12 to 0.03), permanent facial palsy (RD = − 0.01; 95% CI − 0.06 to 0.03) and salivary complications (RD = − 0.00; 95% CI − 0.05 to 0.05) was comparable between the two groups. Based on these results, MFI may be a feasible technique for improving the cosmetic results of patients who need parotidectomy when oncological safety can be ensured.
Highlights
Salivary gland tumors account for less than 3% of all neoplasms
The PICO components were as follows: P, I, C, O
Studies without a control group, review articles, studies including fascia or flap reconstruction, short reports, studies using incisions other than the modified facelift incision (MFI), studies including known parotid cancer patients before surgery, cadaveric studies and studies not published in the English language were excluded
Summary
Salivary gland tumors account for less than 3% of all neoplasms. Approximately 80% of these tumors are of parotid origin, and of these tumors, 80% are b enign[1]. Surgical removal is the treatment of choice for most neoplasms of the parotid gland. MBI is able to provide excellent surgical exposure to the parotid gland but leaves a visible cervical scar after surgery, leading to cosmetic dissatisfaction in some patients. Most authors preferred using the modified facelift incision (MFI) in parotid surgeries. The MFI differs from the traditional facelift incision in that there is no temporal scalp incision, and the retroauricular incision continues. With the use of MFI, the cervical incision needed for surgery is moved further back into the hairline; a visible cervical scar is avoided. The authors conducted a systemic review of related articles and presented the combined results of the postoperative and intraoperative parameters after the use of MFI and MBI in parotidectomy
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