Modification of Blair Approach With a Modified Endaural Component to Access the Parotid Region

Abstract

This investigation presents our experience with a modified approach to the parotid region. This approach gives an extended and safe exposure to the region with excellent cosmetic outcomes.

A Review of Surgical Incisions Used for the Excision of Benign Parotid Tumors

“…Ruíz and Guerrero 21 suggested that this incision can better expose the posterior, anterior, and lateral sides of the parotid gland, and because the incision design allows the temporal branch of the facial nerve to be superficially located in the front of the surgical field, it can further reduce the risk of damaging it. Fernandez Olarte et al 22 indicated that this incision can fully expose the surgical area while maintaining safety and feasibility. It can be used not only for superficial lobe or total parotidectomy, but also for pharyngeal enlargement and skull base tumor resection.…”

“…A 90-degree downward incision is made through the helix crus, and another 90-degree incision is made along the slope of the helix crus toward the front of the ear notch, and finally a downward incision is made along the top and bottom of the tragus, ending at the inferior notch No major complication A 90-degree downward incision is made through the helix crus, and another 90-degree incision is made along the slope of the helix crus toward the front of the ear notch, and finally a downward incision is made along the top and bottom of the tragus, ending at the inferior notch. In a retrospective study of 12 patients, Fernandez Olarte et al 22 included patients who required parotidectomy for benign or malignant parotid tumors and excluded patients with a history of radiotherapy, infection, or surgery. The 12 patients had undergone superficial lobe or total parotidectomy, including 2 patients with deep skull base tumors, with an average age of 38 years.…”

A Review of Surgical Incisions Used for the Excision of Benign Parotid Tumors

“…Ruíz and Guerrero 21 suggested that this incision can better expose the posterior, anterior, and lateral sides of the parotid gland, and because the incision design allows the temporal branch of the facial nerve to be superficially located in the front of the surgical field, it can further reduce the risk of damaging it. Fernandez Olarte et al 22 indicated that this incision can fully expose the surgical area while maintaining safety and feasibility. It can be used not only for superficial lobe or total parotidectomy, but also for pharyngeal enlargement and skull base tumor resection.…”

“…A 90-degree downward incision is made through the helix crus, and another 90-degree incision is made along the slope of the helix crus toward the front of the ear notch, and finally a downward incision is made along the top and bottom of the tragus, ending at the inferior notch No major complication A 90-degree downward incision is made through the helix crus, and another 90-degree incision is made along the slope of the helix crus toward the front of the ear notch, and finally a downward incision is made along the top and bottom of the tragus, ending at the inferior notch. In a retrospective study of 12 patients, Fernandez Olarte et al 22 included patients who required parotidectomy for benign or malignant parotid tumors and excluded patients with a history of radiotherapy, infection, or surgery. The 12 patients had undergone superficial lobe or total parotidectomy, including 2 patients with deep skull base tumors, with an average age of 38 years.…”

Incisions for Parotidectomy

“…Some authors have operated on malignant tumors, tumors of large sizes and carried out total parotidectomies as well using these incisions. 7,13,26 However, the evidence for such indications is very sparse and mostly include retrospective study designs involving very few patients. Oncological risks include incomplete tumor resection leading to recurrence and inability to carry out neck dissection through the same incision.…”

“…Some authors have operated on malignant tumors, tumors of large sizes and carried out total parotidectomies as well using these incisions 7,13,26 . However, the evidence for such indications is very sparse and mostly include retrospective study designs involving very few patients.…”

Resección completa de un adenoma pleomórfico parotídeo mediante el enfoque modificado de Blair

“…9,10 Given this, therefore, a judicious knowledge of the anatomical characteristics of the parotid region and its limits, allows the correct selection of its approach to obtain a wide and safe surgical field, avoiding complications and obtaining the best aesthetic results. 5 Additionally, obtaining aesthetic results is also a main objective of the treatment of parotid tumors, when performing the classic approaches, depressions are frequently generated in the preauricular and retromandibular area, thus affecting the aesthetic result. In resections of large tumors, reconstruction with only the repositioning of the remaining healthy parotid tissue is difficult, for which the use of a sternocleidomastoid flap or SMAS is recommended.…”

A Review of Surgical Incisions Used for the Excision of Benign Parotid Tumors

“…Ruíz and Guerrero 21 suggested that this incision can better expose the posterior, anterior, and lateral sides of the parotid gland, and because the incision design allows the temporal branch of the facial nerve to be superficially located in the front of the surgical field, it can further reduce the risk of damaging it. Fernandez Olarte et al 22 indicated that this incision can fully expose the surgical area while maintaining safety and feasibility. It can be used not only for superficial lobe or total parotidectomy, but also for pharyngeal enlargement and skull base tumor resection.…”

“…A 90-degree downward incision is made through the helix crus, and another 90-degree incision is made along the slope of the helix crus toward the front of the ear notch, and finally a downward incision is made along the top and bottom of the tragus, ending at the inferior notch No major complication A 90-degree downward incision is made through the helix crus, and another 90-degree incision is made along the slope of the helix crus toward the front of the ear notch, and finally a downward incision is made along the top and bottom of the tragus, ending at the inferior notch. In a retrospective study of 12 patients, Fernandez Olarte et al 22 included patients who required parotidectomy for benign or malignant parotid tumors and excluded patients with a history of radiotherapy, infection, or surgery. The 12 patients had undergone superficial lobe or total parotidectomy, including 2 patients with deep skull base tumors, with an average age of 38 years.…”

Incisions for Parotidectomy

“…Some authors have operated on malignant tumors, tumors of large sizes and carried out total parotidectomies as well using these incisions. 7,13,26 However, the evidence for such indications is very sparse and mostly include retrospective study designs involving very few patients. Oncological risks include incomplete tumor resection leading to recurrence and inability to carry out neck dissection through the same incision.…”

“…Some authors have operated on malignant tumors, tumors of large sizes and carried out total parotidectomies as well using these incisions 7,13,26 . However, the evidence for such indications is very sparse and mostly include retrospective study designs involving very few patients.…”

Resección completa de un adenoma pleomórfico parotídeo mediante el enfoque modificado de Blair

“…9,10 Given this, therefore, a judicious knowledge of the anatomical characteristics of the parotid region and its limits, allows the correct selection of its approach to obtain a wide and safe surgical field, avoiding complications and obtaining the best aesthetic results. 5 Additionally, obtaining aesthetic results is also a main objective of the treatment of parotid tumors, when performing the classic approaches, depressions are frequently generated in the preauricular and retromandibular area, thus affecting the aesthetic result. In resections of large tumors, reconstruction with only the repositioning of the remaining healthy parotid tissue is difficult, for which the use of a sternocleidomastoid flap or SMAS is recommended.…”

A Review of Surgical Incisions Used for the Excision of Benign Parotid Tumors

“…Ruíz and Guerrero 21 suggested that this incision can better expose the posterior, anterior, and lateral sides of the parotid gland, and because the incision design allows the temporal branch of the facial nerve to be superficially located in the front of the surgical field, it can further reduce the risk of damaging it. Fernandez Olarte et al 22 indicated that this incision can fully expose the surgical area while maintaining safety and feasibility. It can be used not only for superficial lobe or total parotidectomy, but also for pharyngeal enlargement and skull base tumor resection.…”

“…A 90-degree downward incision is made through the helix crus, and another 90-degree incision is made along the slope of the helix crus toward the front of the ear notch, and finally a downward incision is made along the top and bottom of the tragus, ending at the inferior notch No major complication A 90-degree downward incision is made through the helix crus, and another 90-degree incision is made along the slope of the helix crus toward the front of the ear notch, and finally a downward incision is made along the top and bottom of the tragus, ending at the inferior notch. In a retrospective study of 12 patients, Fernandez Olarte et al 22 included patients who required parotidectomy for benign or malignant parotid tumors and excluded patients with a history of radiotherapy, infection, or surgery. The 12 patients had undergone superficial lobe or total parotidectomy, including 2 patients with deep skull base tumors, with an average age of 38 years.…”

Incisions for Parotidectomy

“…Some authors have operated on malignant tumors, tumors of large sizes and carried out total parotidectomies as well using these incisions. 7,13,26 However, the evidence for such indications is very sparse and mostly include retrospective study designs involving very few patients. Oncological risks include incomplete tumor resection leading to recurrence and inability to carry out neck dissection through the same incision.…”

“…Some authors have operated on malignant tumors, tumors of large sizes and carried out total parotidectomies as well using these incisions 7,13,26 . However, the evidence for such indications is very sparse and mostly include retrospective study designs involving very few patients.…”

Resección completa de un adenoma pleomórfico parotídeo mediante el enfoque modificado de Blair

“…9,10 Given this, therefore, a judicious knowledge of the anatomical characteristics of the parotid region and its limits, allows the correct selection of its approach to obtain a wide and safe surgical field, avoiding complications and obtaining the best aesthetic results. 5 Additionally, obtaining aesthetic results is also a main objective of the treatment of parotid tumors, when performing the classic approaches, depressions are frequently generated in the preauricular and retromandibular area, thus affecting the aesthetic result. In resections of large tumors, reconstruction with only the repositioning of the remaining healthy parotid tissue is difficult, for which the use of a sternocleidomastoid flap or SMAS is recommended.…”