Comparison of Frey Syndrome Rates Following Superficial Parotidectomy and Partial Superficial Parotidectomy for Pleomorphic Adenoma

Öğreden, Şahin; Ruzgar, Sedat; Alimoğlu, Yalçın; Eroglu, Sinan; Taşkın, Ümit; Oktay, Mehmet Faruk

doi:10.1097/scs.0000000000002746

Cited by 10 publications

(7 citation statements)

References 9 publications

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“…The other remaining 27 studies were excluded with reasons (Table S3). There were 1 RCTs 31 and 43 non‐RCTs 12,14,19,32–71 . The included studies were published between 1978 and 2020.…”

Section: Resultsmentioning

confidence: 99%

“…One RCT 31 was assessed as a low risk of bias. Twenty-five studies 12,14,19,32,35,36,[38][39][40]42,44,47,49,[51][52][53][56][57][58]60,[63][64][65]68,69,71 were assessed as having moderate risk of bias, whereas the other 18 studies 14,[33][34]41,43,45,46,48,50,54,55,59,61,62,66,67,70,72 were assessed as having high risk of bias (Table S4). [32][33][34]36,40,44,…”

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

“…Frey's syndrome FS was reported in 32 studies 12,14,19,31,32,[34][35][36][37][38]40,41,[45][46][47][48][49][50][51][52][53][54][56][57][58][59][61][62][63][64][65]68,71 with a total of 5996 patients. Three studies out of 32 64,65,71 reported 0 event in both groups and were excluded from NMA.…”

Section: Temporary Facial Nerve Weaknessmentioning

confidence: 99%

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Surgical interventions for management of benign parotid tumors: Systematic review and network meta‐analysis

et al. 2021

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The impact of the extent of parotid surgery on postoperative complications has long been considered a topic of controversy. The aim of the current network meta-analysis (NMA) is to answer the following questions: (1) Does the extent of surgical resection of benign parotid tumors increase the risk of postoperative complications? (2) What is the best surgical intervention for treatment of benign parotid tumors that can provide an acceptable balance between tumor recurrence rate and other postoperative complications? A comprehensive search on PubMed, Embase, Scopus, and Cochrane library was conducted to identify the eligible studies. The outcome was the incidence of tumor recurrence, facial nerve weakness (temporary [TFW] or permanent [PFP]), Frey's syndrome (FS), sialocele, and salivary fistula. The Bayesian network meta-analysis (NMA) accompanied by a random effect model and 95% credible intervals (CrI) were calculated using the GeMTC R package. Forty-four studies with a total of 7841 participants were included in the current NMA comparing five surgical interventions, namely enucleation, extracapsular dissection (ECD), partial superficial parotidectomy (PSP), superficial parotidectomy (SP), and total parotidectomy (TP). Enucleation showed the highest recurrence rate compared to ECD, SPS, SP, and TP. No statistical differences were observed concerning the recurrence rate when ECD, PSP, SP, and TP were compared together. There was an increased incidence of TFW and FS with the increase in the extent of parotid resection, while no significant difference was found when comparing enucleation with ECD and PSP. SP showed the highest incidence of PFP, and salivary fistula compared to ECD, PSP, and TP. The tumor recurrence rates in enucleation, ECD, PSP, SP, and TP were 14.3%, 3.6%, 3.7%, 2.8%, and 1.4%, respectively. The current NMA demonstrated that the risk of TFW and FS increases with the increase in the extent of parotid resection and that ECD and PSP can be considered the treatment of choice for benign parotid tumors, as both provide an acceptable balance between the incidence of tumor recurrence and facial nerve dysfunction.

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“…The other remaining 27 studies were excluded with reasons (Table S3). There were 1 RCTs 31 and 43 non‐RCTs 12,14,19,32–71 . The included studies were published between 1978 and 2020.…”

Section: Resultsmentioning

confidence: 99%

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

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Surgical interventions for management of benign parotid tumors: Systematic review and network meta‐analysis

et al. 2021

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“…11,12 In addition, the incidence of sialocele and salivary fistula was reported as 17% and 6% respectively 13 and the incidence of Frey's syndrome have been reported in the range of 3 to 22%. 14 The authors offered partial superficial parotidectomy to the patients for the management of benign parotid lesions and the purpose of this study is to evaluate the outcome of this procedure in respect to post-operative complications like facial nerve dysfunction, hematoma, sialocele, salivary fistula, Frey's syndrome and recurrence. This will be helpful in providing data for patient information during pre-operative counseling and would further help to establish the credence of partial superficial parotidectomy procedure as a less invasive option for the management of benign parotid pathologies.…”

Section: Introductionmentioning

confidence: 99%

Management of Benign Parotid Lesions: An Overview of Complications and Extent of Surgical Resection

Mohammed¹

2020

ENT Open A Open J

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Background The surgical management of benign lesions of the parotid gland is focused on the complete removal of the lesion, minimizing the chances of recurrence and to preserve facial nerve function. There is a relative paucity of literature regarding the post-operative complications of the surgical procedures for benign parotid lesions. The aim of this study is to evaluate the post- operative complications of a limited surgical procedure, namely partial superficial parotidectomy. Material and Method This retrospective cohort study included all parotid surgeries performed for benign parotid pathology from January 2008 to December 2018. The patient’s demographic data, presenting symptoms, type of surgery performed, complications, presence of post operative facial nerve paralysis and grade, histopathology type and follow up period were collected from hospital records of Al Shifa system. The mean follow-up time was 12.5 months. Results The study yielded a total of 125 partial superficial parotidectomies performed on 123 patients with a mean age of 44.5 years (range 8-87 years). Pleomorphic adenoma (n= 68, 54.4%) and Warthins tumor (n=32, 25.6%), were the most common neoplastic lesions. Non-neoplastic lesions were 18 (14.4%). Temporary facial nerve weakness occurred in 11 patients (8.8%). All cases of facial nerve weakness improved within three months post-operatively. The rate of salivary fistula and sialocele were 5.5% and 1.5% respectively. One patient who had histologically proven pleomorphic adenoma had recurrence of tumor (0.8%). Conclusion Partial superficial parotidectomy was associated with low incidence of facial nerve dysfunction which was mostly transient, and no permanent facial nerve dysfunction was reported. Other complications like sialocele, salivary fistula and Frey’s syndrome were reported at lower rates than the reported rates in the literature for the conventional superficial parotidectomy. The findings support partial superficial parotidectomy approach for the treatment of benign parotid pathology, which entails less extensive resection of parotid parenchyma and less extensive dissection of facial nerve branches thereby minimizing the risk of post-operative complications.

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“…Incidence of Frey’s syndrome after parotid gland surgery has been reported as wide as 2% to 96% [ 1 ] and it is various in authors, according to the types of surgical approach. Ogreden et al [ 2 ] compared partial superficial parotidectomy to superficial parotidectomy in terms of Frey’s syndrome development and had found no significant difference among them. On the other hand, Papadogeorgakis et al [ 3 ] reported Frey syndrome ratio among patients they performed partial superficial parotidectomy as 5%, and among patients who underwent superficial parotidectomy as 18%.…”

Section: Introductionmentioning

confidence: 99%

A better facial contour accomplished by parotid duct preserving superficial parotidectomy

Park

Choi

Wee

et al. 2018

Arch Craniofac Surg

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Depression of facial contour after parotidectomy is still challenging to many of surgeons. A 68-year-old man presented with a 4-month history of a painless swelling in both parotid area. The mass was multiple and fixed at the parotid region. We conducted a parotid duct preserving bilateral superficial parotidectomy by one-stage operation to remove the multiple tumors. A lazy S incision was made in both preauricular area and the peripheral branches of the facial nerve were identified using surgical landmark. After dissecting the branches of the facial nerve and parotid duct, main parotid duct was preserved but only small fine ductules from the superficial lobe were ligated. Parotid gland was excised from its anterior aspect with about 1 cm of normal parotid tissue margin. The patient was followed up for 6 years to evaluate postoperative parotid gland function and the computed tomography (CT) was taken. Patient was satisfied with no significant complication such as sunken changes in facial contour, facial nerve function. As far as we know, it is the first study to compare long-term soft tissue contours of soft tissue of duct preserving superficial parotidectomy with duct sacrificing superficial parotidectomy by means of CT findings.

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Comparison of Frey Syndrome Rates Following Superficial Parotidectomy and Partial Superficial Parotidectomy for Pleomorphic Adenoma

Cited by 10 publications

References 9 publications

Surgical interventions for management of benign parotid tumors: Systematic review and network meta‐analysis

Surgical interventions for management of benign parotid tumors: Systematic review and network meta‐analysis

Management of Benign Parotid Lesions: An Overview of Complications and Extent of Surgical Resection

A better facial contour accomplished by parotid duct preserving superficial parotidectomy

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