Facelift Approach for Parotidectomy

Abstract

Objective: 1) To critically evaluate the literature on the use of facelift approach (MFI) for parotidectomy, where available, in direct comparison to the traditional cervicofacial approach (CFI). 2) To provide objective evidence for its use.

Method: Retrospective review of literature up to 2011,The terms parotidectomy, parotid, face lift, and aesthetic were used to search Medline, Embase, PubMed, Cochrane, and CINHAL. Reference lists were cross-checked to include relevant studies. Only English language literature with human subjects was searched.

Results: We identified 19 relevant studies. A total of 416 patients undergoing parotidectomy via MFI have been described. Most were performed for benign lesions, and superficial/partial parotidectomy were the most commonly performed procedures. Exposure of facial nerve was adequate. Complication rates are not increased with MFI. Outcomes in terms of postoperative scarring are good as reported by patients. Major limitations were: anterior exposure, though a recent study has reported 49 cases of anterosuperior tumors successfully resected with MFI; use in obese patients; ptotic and voluminous parotid masses; and restraint by fresh trainees.

Conclusion: Objective evidence certainly justifies using the facelift approach for well-selected cases, which has been increasingly reported in literature in the last decade with expanding indications. In our opinion the limitations described are surmountable. PROMs have shown high satisfaction rates with this approach.