Prevention of Frey syndrome during parotidectomy
| Autor: | Francis Marchal, Pierre Piletta, Didier Quinodoz, Willy Lehmann, Pavel Dulguerov, Grégoire Cosendai |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 1999 |
| Předmět: |
Adult
Male Sweating Gustatory/prevention & control/surgery medicine.medical_specialty Adolescent Polydioxanone/therapeutic use Dura mater Polytetrafluoroethylene/therapeutic use Sweating Gustatory Bone and Bones Hematoma Postoperative Complications medicine Parotid Gland Frey's syndrome Humans Prospective Studies Desiccation Prospective cohort study Child Polyglactin 910 Polytetrafluoroethylene Aged ddc:616 Aged 80 and over business.industry Incidence General Medicine Parotidectomy Polyglactin 910/therapeutic use Prostheses and Implants Middle Aged Surgical Mesh medicine.disease Parotid Gland/surgery Surgery ddc:616.8 body regions medicine.anatomical_structure surgical procedures operative Otorhinolaryngology Polydioxanone Seroma Female Implant Complication business |
| Zdroj: | Archives of Otolaryngology-Head and Neck Surgery, Vol. 125, No 8 (1999) pp. 833-9 Scopus-Elsevier |
| ISSN: | 0886-4470 |
| Popis: | To evaluate the incidence of Frey syndrome (auriculotemporal nerve syndrome) after parotidectomy with and without placement of a subcutaneous implant and to examine the relationship between different implants and postoperative wound complications (hematoma, seroma, salivary fistula).A prospective nonrandomized controlled trial.A primary care and referral university hospital center.All patients scheduled for parotidectomy from April 1994 through August 1998 were eligible. Seventy patients were enrolled (2 refused). All 70 patients were evaluated for wound complications. Sixty patients with a follow-up of more than 1 year were evaluated for Frey syndrome.The choice of implant was left to the individual surgeon: 24 patients had no implant; 7, lyophilized dura implant; 7, polyglactin 910-polydioxanone (Ethisorb) implant; and 32, expanded polytetrafluoroethylene (e-PTFE) implant.The incidence of Frey syndrome was evaluated (1) subjectively by history (clinical Frey syndrome) and (2) objectively by using 2 newly developed tests. Both hemifaces were tested, with the normal side being used as a control.Clinical Frey syndrome was present in 12 patients: 11 without implants (11/24 [53%]) and 1 with an implant (1/46 [2%]) (P.001). Objective tests were positive in 24 patients: 16 (76%) of 21 without implants and 8 (20%) of 39 with implants (P.001). In the implanted patients, the objective tests were positive in 71% (5/7) of those with lyophilized dura, 14% (1/7) of those with Ethisorb, and 8% (2/29) of those with e-PTFE implants (P.001). Wound complications included hematoma in 5 patients (7%), seroma in 4 patients (6%), and salivary fistula in 15 (21%). Salivary fistula occurred more frequently with Ethisorb (57%) and e-PTFE (25%) implants (P = .04).In patients without an implant, the incidence of Frey syndrome is 50% for subjective and 80% for objective evaluation. In patients with an implant, these incidences are 3% and 10%, respectively. Some implants are associated with a higher incidence of salivary fistula. |
| Databáze: | OpenAIRE |
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