The Experts below are selected from a list of 2538 Experts worldwide ranked by ideXlab platform
Pavel Dulguerov - One of the best experts on this subject based on the ideXlab platform.
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the superficial musculoaponeurotic system flap in the prevention of frey syndrome a meta analysis
2016Co-Authors: Nicolas Dulguerov, Amir Makni, Pavel DulguerovAbstract:Evaluate the difference of the incidence in clinical Frey syndrome in studies comparing classical Parotidectomy and Parotidectomy with superficial musculoaponeurotic system (SMAS) flap elevation and suturing through meta-analysis methodology.
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classification of parotidectomies a proposal of the european salivary gland society
2016Co-Authors: Miquel Quer, Orlando Guntinaslichius, Francis Marchal, Vander V Poorten, D Chevalier, Xavier Leon, David W Eisele, Pavel DulguerovAbstract:The objective of this study is to provide a comprehensive classification system for Parotidectomy operations. Data sources include Medline publications, author's experience, and consensus round table at the Third European Salivary Gland Society (ESGS) Meeting. The Medline database was searched with the term "Parotidectomy" and "definition". The various definitions of Parotidectomy procedures and parotid gland subdivisions extracted. Previous classification systems re-examined and a new classification proposed by a consensus. The ESGS proposes to subdivide the parotid parenchyma in five levels: I (lateral superior), II (lateral inferior), III (deep inferior), IV (deep superior), V (accessory). A new classification is proposed where the type of resection is divided into formal Parotidectomy with facial nerve dissection and extracapsular dissection. Parotidectomies are further classified according to the levels removed, as well as the extra-parotid structures ablated. A new classification of Parotidectomy procedures is proposed.
Edmund A. Pribitkin - One of the best experts on this subject based on the ideXlab platform.
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Superficial musculoaponeurotic system elevation and fat graft reconstruction after superficial Parotidectomy.
2008Co-Authors: Joseph Curry, Kyle W. Fisher, Ryan Heffelfinger, Marc Rosen, William M. Keane, Edmund A. PribitkinAbstract:Objective/Hypothesis: Elevation of the superficial musculoaponeurotic system (SMAS) with or without fat graft interposition during superficial Parotidectomy prevents a concave facial deformity and Frey's syndrome. Study Design: Retrospective, case-control study. Methods: Charts for 248 patients who underwent superficial Parotidectomy were reviewed for pathologic, radiographic, clinical, and operative data. Sixteen patients who underwent SMAS elevation and 34 patients who underwent SMAS elevation with fat graft interposition were included in two study groups. Nonreconstructed controls were randomly selected from a pool of patients who had unilateral, superficial Parotidectomy and were matched based on pathologic specimen volume. Patients were surveyed for their postoperative symptoms. Results: Patients undergoing SMAS elevation alone (n = 16) compared with controls (n = 19) had greater facial symmetry (12% vs. 32%, P = .147) and a lower incidence of symptomatic Frey's syndrome (6.3% vs. 18.6%, P = .382). Patients undergoing SMAS elevation and fat graft interposition (n = 34) compared with controls (n = 38) had less facial asymmetry (9% vs. 39%, P = .002) and a lower incidence of symptomatic Frey's syndrome (6% vs. 28%, P = .04). Complications among the study and control groups were comparable. Conclusions: Simultaneous reconstruction of a superficial Parotidectomy defect using SMAS elevation with or without fat grafting may improve postoperative facial symmetry and decrease the incidence of symptomatic Frey's syndrome without increasing complications.
Patrick J Bradley - One of the best experts on this subject based on the ideXlab platform.
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role of limited Parotidectomy in management of pleomorphic adenoma
2007Co-Authors: Jonas T Johnson, Alfio Ferlito, Johan Fagan, Patrick J Bradley, Alessandra RinaldoAbstract:There is continued controversy over the extent of Parotidectomy required for removal of a benign pleomorphic adenoma from the parotid gland. Currently, consensus exists that the integrity of the facial nerve must be preserved when the tumour is totally removed. As a result of experience gained in the first half of the twentieth century, it was recommended that superficial Parotidectomy with facial nerve dissection should be the minimal biopsy for pleomorphic adenoma. Since that time, however, research has indicated that partial Parotidectomy or extracapsular dissection of benign pleomorphic adenoma can be accomplished with preservation of the facial nerve without an increase in tumour recurrence. Partial Parotidectomy or extracapsular dissection results in impaired cosmetic results and a lower incidence of Frey's syndrome, and thus may be the preferred approach when undertaken by experienced surgeons.
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frey s syndrome following Parotidectomy prevention using a rotation sternocleidomastoid muscle flap
1999Co-Authors: S Sood, M S Quraishi, C R Jennings, Patrick J BradleyAbstract:The benefit of using a sternocleidomastoid flap following Parotidectomy to reduce the incidence of symptomatic gustatory sweating (Frey's syndrome) was reviewed. A retrospective study was undertaken to review subjective and objective symptoms of Frey's syndrome in two groups of patients, one of whom had undergone superficial Parotidectomy with a sternocleidomastoid flap rotated at the time of surgery and a second group of patients who had undergone a standard superficial Parotidectomy. A total of 22 patients, randomly sampled and willing to attend, were evaluated postoperatively, at a median time from surgery of 42 months (range 23-82 months) in the non-flap group and 44 months (range 14-66 months) in the flap group, by Minor's starch iodine test. In the 11 patients who had a sternocleidomastoid flap rotated, two had evidence of gustatory sweating. Of the 11 that had not undergone sternocleidomastoid flap rotation, nine patients showed evidence of gustatory sweating (P < 0.05, chi 2 test). There were two patients in total who had clinical symptoms of Frey's syndrome and both of these had not undergone flap rotation at the time of Parotidectomy.
Nicolas Dulguerov - One of the best experts on this subject based on the ideXlab platform.
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the superficial musculoaponeurotic system flap in the prevention of frey syndrome a meta analysis
2016Co-Authors: Nicolas Dulguerov, Amir Makni, Pavel DulguerovAbstract:Evaluate the difference of the incidence in clinical Frey syndrome in studies comparing classical Parotidectomy and Parotidectomy with superficial musculoaponeurotic system (SMAS) flap elevation and suturing through meta-analysis methodology.
Orlando Guntinaslichius - One of the best experts on this subject based on the ideXlab platform.
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frey s syndrome after superficial Parotidectomy role of the sternocleidomastoid muscle flap a prospective nonrandomized controlled trial
2016Co-Authors: Maria Grosheva, Claus Wittekindt, Luisa Horstmann, Gerd Fabian Volk, Claudia Holler, L Ludwig, Verena Weis, Mira Finkensieper, Jens Peter Klussmann, Orlando GuntinaslichiusAbstract:Abstract Background The prevalence of Frey's syndrome (FS) after superficial Parotidectomy in correlation to the sternocleidomastoid muscle flap (SCMMF) interposition is analyzed. Methods A prospective nonrandomized controlled multicenter trial included 130 patients. During superficial Parotidectomy, SCMMF was dissected, if excised specimens' volume exceeded 25 mL (SCMMF group). Follow-up examinations took place after 6, 12, and 24 months and included a Minor's test. Results SCMMF was dissected in 30 (23.1%) patients. A total of 104, 80, and 68 patients completed the 1st, 2nd, and the 3rd follow-up, respectively. FS was detectable with nonvarying prevalence (46.3%, 45.6%, and 43.4%, respectively) during follow-up. The prevalence was higher in the SCMMF group (59.9%) than in the non-SCMMF group (41.8%; P = .92). The sweating area increased during follow-up ( P = .12). Overall, 89.5% of patients characterized FS as not disturbing after 2 years. Conclusions FS occurred with a steady and high prevalence after superficial Parotidectomy. In particular, SCMMF did not lower the risk of FS.
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classification of parotidectomies a proposal of the european salivary gland society
2016Co-Authors: Miquel Quer, Orlando Guntinaslichius, Francis Marchal, Vander V Poorten, D Chevalier, Xavier Leon, David W Eisele, Pavel DulguerovAbstract:The objective of this study is to provide a comprehensive classification system for Parotidectomy operations. Data sources include Medline publications, author's experience, and consensus round table at the Third European Salivary Gland Society (ESGS) Meeting. The Medline database was searched with the term "Parotidectomy" and "definition". The various definitions of Parotidectomy procedures and parotid gland subdivisions extracted. Previous classification systems re-examined and a new classification proposed by a consensus. The ESGS proposes to subdivide the parotid parenchyma in five levels: I (lateral superior), II (lateral inferior), III (deep inferior), IV (deep superior), V (accessory). A new classification is proposed where the type of resection is divided into formal Parotidectomy with facial nerve dissection and extracapsular dissection. Parotidectomies are further classified according to the levels removed, as well as the extra-parotid structures ablated. A new classification of Parotidectomy procedures is proposed.
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Parotidectomy for benign parotid disease at a university teaching hospital outcome of 963 operations
2006Co-Authors: Orlando Guntinaslichius, Peter J Klussmann, Claus Wittekindt, E StennertAbstract:Objective/Hypothesis: The objective of this study was to analyze the perioperative and long-term complications after standardized lateral and total Parotidectomy for benign parotid tumors and chronic parotitis with special regard on the training skill of the surgeons at a university teaching center. All teaching operations were performed under strict microscopic control and supervision of experienced surgeons. Study Design: The authors conducted a retrospective unicentric study in a tertiary university center. Methods: Medical records of 963 lateral and total parotidectomies treated from 1986 to 2004 were analyzed with regard to perioperative and long-term complications. The surgeons' expertise to perform a Parotidectomy was classified as beginner (0–20 parotidectomies performed), advanced (21–50), experienced (51–100), or highly experienced (>100). Results: Eighty-five percent of the cases were primary operations (85%) and 15% revision operations. A lateral Parotidectomy was necessary in 61% and total Parotidectomy in 39%. The mean operation time was 192 minutes. The incidence of transient facial nerve dysfunction was 25%, and 6% for permanent weakness, respectively. Treatment for Frey's syndrome was performed in 5%. First recurrence for pleomorphic adenoma was observed in 2% and for Warthin's tumor in 3%. Significantly more complications were seen after total Parotidectomy and in revision cases. Beginners and advanced surgeons (operated 41% of the cases) needed a longer operation time than experienced and highly experienced surgeon (59% of the cases). The surgeon's expertise had no influence on the incidence of complications. Conclusions: Standardized education in lateral and total Parotidectomy for treatment of benign parotid disease under precise microscopic control is safe, demonstrates good results, and has low perioperative and long-term morbidity.
