Long-term Outcomes and Quality of Life Following Parotidectomy for Benign Disease: A Cohort Study

Abstract

Backround:Parotidectomy may be burdened by numerous complications that may worsen subjects' quality of life (QoL). So far, the literature still lacks of long-term data (> 10 years) answering to the question what impacted the patients the most on QOL after parotidectomy compared to well-published short-term data.Methods:A prospective long-term follow-up study was carried out. Participants were divided into three groups concerning the follow-up: short-term (ST; 6 postoperative weeks), long-term (LT; 13 years postoperative) and short- and long-term (SLT) on same patient collective. QOL was assessed by the Parotidectomy Outcome Inventory (POI-8). Demographic and clinical data were collected from all patients. Operative reports were used to classify all parotidectomies as great nerve auricular (GAN) “preserving” or GAN “sacrificing” surgical preparations.Results:74 LT, 57 ST and 33 SLT patients were enrolled in this study. Hypoesthesia posed the major short- and long-term problem whereas facial palsy posed the minor problem. Pain (p < 0.01) and hypoesthesia (p < 0.001) significantly improved from six weeks to 13 years after parotidectomy as well as the overall POI-8 score (p = 0.04). The disease-specific impairment rate decreased from short (≈ 70%) to long-term (≈ 30%) follow-up. Sacrifice of the auricular nerve was associated with hypoesthesia in the ST-cohort (p = 0.028).Conclusion:To our knowledge, this study represents the longest follow-up of patients undergoing parotidectomy. Hypoesthesia significantly improved but still remains on long-follow-up without impacting QOL. As part of the preoperative informed consent, prolonged or permanent hypoesthesia should be explicitly emphasized.Trial registration:This study was prospectively approved and registered by the local Ethics Committee (Project Trial No: S-300/2007 and S-443/2018).

Readability and quality of online patient health information on parotidectomy

“…Literature available on the patient's perspective has shown that sensory impairment, facial nerve dysfunction, Frey's syndrome and cosmetic outcomes impact quality of life the most, leading to significant morbidity. [3][4][5][6] Thus, the decision-making process and consent for parotidectomy need to be supportive, clear, accurate and well-informed. 7 The internet, with its wealth of information, has undoubtedly been a source of information for patients.…”