Title:
Dissection with harmonic scalpel versus cold instruments in parotid surgery
Authors:
A. Deganello , G. Meccariello , M. Busoni , G. Parrinello ,R. Bertolai and O. Gallo
Institutions:
Academic Clinic of Otolaryngology and Head-Neck Surgery, Department of Translational Medicine, University of Florence, Italy; Unit of MaxilloFacial Surgery, Department of Translational Medicine, University of Florence, Italy
Keywords:
Harmonic scalpel; head-neck surgery; parotidectomy; surgical procedures; technical innovation
Pages:
175 - 178
Abstract:
Dissection with harmonic scalpel versus cold instruments in parotid surgery. Background: The harmonic scalpel (HS) has been used successfully in several head and neck surgical procedures. Some authors highlighted its advantages in reducing operative time, blood loss, and damages to surrounding tissue. In our study, we compared the results obtained during parotidectomy using the HS with the traditional approach to determine the benefits of the HS. Methods: 130 patients with benign parotid tumors were enrolled and randomized into two groups for this prospective study. 63 patients underwent HS parotidectomy, and 67 patients received a parotidectomy using cold instruments and bipolar electrocautery hemostatic control (CI). 20 HS and 2 CI patients did not meet the inclusion criteria requirements, and were excluded. Results: The admission time was significantly shorter in the HS group than the CI group (3.9±1.2 days and 4.7±1.4 days, respectively, p< 0.01). In the early post-operative period, 84% of HS patientsand 60% of CI cases showed no facial nerve impairment (p=0.01). Significantly more CI patients than HS patients showed the onset of Freys syndrome (29% and 9%, respectively, p=0.01). Multivariate stepwise regression analysis confirmed the reduction in admission length (Odds Ratio (OR): 0.62; p=0.02) and the lowerrisk of Freys syndrome (OR: 0.29p ; =0.04) in HS comparedto CI parotidectomies. Conclusions: In parotid surgery,the HS is useful in preventing Freys syndrome and reducing early transitory facial nerve dysfunction and admission times, and results in decreased medical costs and increased quality of life.
Issue:
Vol. 10, 2014, 3rd trimester


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Dissection with harmonic scalpel versus cold instruments in parotid surgery