الفهرس 
Aim of the studyOnly 14 pages are availabe for public view
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Abstract
The traditional approach to the parotid gland tumors is the bayonet- shaped incision described by Blair. This access is relatively easy to perform and provides a good surgical exposure. However, it is associated with a noticeable scar in the pre-auricular and cervical region, a tissue deficiency in the parotid region with a corresponding postoperative imprint and Frey’s syndrome.
These significant drawbacks led head and neck surgeons to develop various techniques for parotid surgery. In 1967, Appiani introduced the use of facelift incision for tumor excision to avoid the postoperative visible scar. Ten years later, Mitz and coauthors described the use of the superficial musculoaponeurotic system advancement flap in the parotid to avoid the postoperative imprint. Additionally, the superficial musculoaponeurotic system flap also succeeded in reducing the incidence of Frey’s syndrome.
Parotid resection is performed when surgical treatment is required for inflammatory lesions of the parotid gland, benign and malignant tumors and the guidelines for surgery for parotid tumors were first described by Gutierrez in 1903. Modified Blair incision has been most commonly used since Blair incision, a bayonet-type incision, was introduced in 1912 as an incision for parotid gland resection.
The traditional approach to the parotid gland tumors is the bayonet- shaped incision described by Blair. This access is relatively easy to perform and provides a good surgical exposure. However, it is associated with a noticeable scar in the pre-auricular and cervical region, a tissue deficiency in the parotid region with a corresponding postoperative imprint and Frey’s syndrome.
There are two major complications in dealing with the parotidectomy. There are the functional problems which are associated with morbidity of the facial nerve and Frey’s syndrome. Another is esthetic problems such as neck scarring and hollow space of the parotid region which affects the post-operative social life of the patient.
Recently, the modified facelift incision has gained increasing popularity for its cosmetic benefits in parotidectomy. However, many surgeons remain concerned with the adequacy of the exposure and are unwilling to use the face lift incision for anterior or superior tumors of the parotid gland because these tumors are closer to the superficially positioned facial nerve branch.
The modified facelift incision is feasible for most benign parotid, even for anterior or superior tumors. Using the modified facelift incision may be extended with a surgeon’s accumulated experience, but for a large deep-lobe tumor, the modified Blair incision is still considered useful.
The aim of this study was to compare modified Blair’s incision versus modified face lift incision in parotidectomy.
This is a combined prospective and retrospective study carried out in surgery department, faculty of medicine, Menoufia University. The study started since January 2019. The included cases were divided into:
group (A): 10 patients had done parotidectomy with modified Blair’s incision.
group (B): 10 patients had done parotidectomy with modified face lift incision.
Summary
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The main results of the study revealed that:
The mean age of the patients in group (A) was 39.50 ± 18.45 years, 6 patients (60%) were males and 4 (40%) were females. The mean age of the patients in group (B) was 32.17 ± 16.35 years, 5 patients (50%) were males and 5 (50%) were females. There is no significant difference found between the groups regarding age and sex.
Regarding group (A), 2 patients (20%) were diabetic and 3 patients (30%) were smokers. Regarding group (B), 2 patients (20%) were diabetic and 2 patients (20%) were smokers. There is no significant difference found between the groups.
Regarding group (A), the mean tumor size was 1.94 ± 0.879 cm, 10 patients had superficial tumor. Regarding group (B), the mean tumor size was 2.13 ± 1.10 cm, 10 patients had superficial tumor. There is no significant difference found between the groups.
Pleomorphic adenoma was the most prevalent tumor among the two groups. There is no significant difference found between the groups.
There is a no significant difference between the two groups regarding hospital stay.
There is no significant difference between the two groups regarding complications.
Regarding group (A) there was two patients was not satisfied, 2 patients (20%) were poor and one patient (10%) was good and five patients (50%) were excellent with overall VAS 3.11 ±0.947
Regarding group (B) there was one patient (10%) poor, two patients were good and 7 patients (70%) were excellent with overall VAS 4.2 ±0.758.
There is a significant difference between the two groups regarding visual analogue scale.
Based on our findings, we recommend for further studies on large geographical scale and on larger sample size to emphasize our conclusion.