Parotidectomy via Individualized Mini-Blair Incision

Abstract

Background: The modified Blair incision is the standard facial incision for the vast majority of parotid gland lesions. We utilize three types of incisions: "classic mini-Blair" for parotid body tumors, "cervical mini-Blair" for parotid tail tumors, and "vertical mini-Blair" for anterior parotid tumors. In this study, we describe the surgical and esthetic outcomes of these individually tailored incisions. Methods: Patients undergoing parotidectomy between 2011 and 2013 were included. The surgical outcomes and patients' satisfaction were assessed. Results: Of 122 patients, 89 were included. All patients completed a questionnaire assessing the postoperative course and patients' satisfaction regarding the surgery in general and the scar in particular. Among these patients, 78 (87%) had a benign pathology and 11 (13%) had malignant tumors. The tumors were located at the parotid body in 57 patients (64%), at the parotid tail in 19 (21%), at the deep lobe in 8 (9%), and at the anterior parotid gland in 5 (6%). All tumors were removed successfully with negative margins on pathology. No inadvertent permanent facial nerve paralysis occurred. The median operation time was 72 min (23-211). The average patient scores of satisfaction with the surgical scar and with the surgery were 9.54 and 9.72, respectively. Conclusions: Individualized mini-Blair incision is feasible for benign as well as selected malignant parotid tumors.

Modified Blair Approach for the Treatment of Mandibular Condyle Fractures

“…Besides its significant advantages, the modified Blair approach has several disadvantages. 22 Identification of the facial nerve and its branches by this approach requires experience and increases the time of surgery. However, identifying and separating the individual branches of the nerve reduces the probability of paresthesia when performed under direct visual supervision.…”

“…However, the periauricular scar is very well camouflaged and can be invisible with a carefully designed incision in a skin crease. 6 , 22 …”

Excising Parotid Benign Mass With a Minimal Incision

“…The VSI involves only the pre-and postauricular incisions, without any hairline or upper cervical inclusion. As a result, this method can be used to handle all superficial parotid regions, including both the superior and anterior divisions, while leading to minimal scarring [9].…”

Drainless Parotidectomy Using Tissue Fibrin Sealant -- A Case-Control Study

“…The greatest change in the evolution of parotid surgery was the introduction of a modified/partial superficial parotidectomy, which leaves as much normal parotid tissue as possible and removes the tumor with a cuff of normal parotid tissue around it [ 17 , 21 ]. Other modifications for incisions, including minimal skin incisions [ 11 ] or cosmetic incisions [ 22 ] have seldom been suggested. Studies using self-assessment scores have shown that surgical drains are associated with a significant increase in patients' anxiety and pain as well as reduced comfort [ 23 ].…”

“…All surgeries were performed by the same high-volume head and neck surgeon (A.K.). An individualized modified mini-Blair incision [ 11 ] was used in all patients. The relevant facial nerve branches or trunk were identified according to the location of the tumor and the surgical needs.…”