【 文献重点摘要 】
 

Background: The indications for reduction of excessive submandibular gland volume in aesthetic rejuvenation of the neck have been well described, as has the surgical anatomy and the surgical technique. Despite this, submandibular gland reduction does not appear to be widely adopted, nor have significant case series been reported in the literature. This review of a consecutive series of aesthetic submandibular gland reductions was undertaken to provide a perspective about its place in neck contouring.

Methods: A retrospective chart review was conducted of all patients on whom the senior author (B.C.M.) had performed submandibular gland reduction for aesthetic reasons. Complications and reoperations were specifically analyzed.

Results: Submandibular gland reduction was performed in 112 of 736 consecutive face lifts between 2002 and 2013, an incidence of 13 percent in primary face lifts and 25 percent in secondary face lifts. The median patient age was 57 years, and 87 percent were women. Major complications were those requiring early reoperation (1.8 percent) to manage significant hematomas; one was potentially fatal. Minor complications (10.8 percent) were managed nonoperatively. Submandibular sialocele (4.5 percent) and marginal mandibular branch neurapraxia (4.5 percent) were the most frequent, and all resolved fully by 3 months. Significantly, no patient reported a permanent dry mouth.

Conclusions: The complication rate with submandibular gland reduction is comparable to that of a neck lift with platysma plication alone, with some additional specific risks: (1) catastrophic airway compression from bleeding deep in the neck, (2) significant increase of neurapraxias in secondary neck lifts, and (3) a moderate incidence of benign submandibular sialocele.

背景：在颈部美容修复中缩小过大的颌下腺体积的适应症已经很好地描述了，手术解剖学和外科技术也是如此。尽管如此，颌下腺减少术似乎没有被广泛采用，在文献中也没有重大的病例系列报道。本研究回顾了一系列美观的颌下腺减压术，以期对其在颈部塑形中的地位提供一个视角。

方法：对资深作者(B.C.M.)治疗的所有患者进行了回顾性图表回顾。出于美观的原因进行了颌下腺减少术。具体分析并发症和再手术情况。

结果：2002至2013年间，在连续的736例面部提升术中，有112例进行了颌下腺缩小手术，一次提升术的发生率为13%，二次提升术的发生率为25%。患者年龄中值为57岁，87%是女性。主要并发症是那些需要早期再次手术以处理重大血肿的并发症(1.8%)；其中一例可能是致命的。轻微并发症(10.8%)采用非手术治疗。颌下涎腺膨出(4.5%)和下颌缘支神经失用(4.5%)最常见，均在3个月后完全消失。值得注意的是，没有患者报告永久性口干。

结论：颌下腺减压术的并发症发生率与单纯颈阔肌提升术相当，但有一些额外的特殊风险：(1)颈部深部出血造成的灾难性气道压迫，(2)二期提颈术中神经失用症的显著增加，(3)良性颌下涎腺膨出的中度发生率。