Minor Parotidectomy Complications: A Systematic Review

Abstract

Objectives To report descriptive statistics for minor parotidectomy complications. Methods A systematic review was performed, selecting 235 studies for analysis. The incidence of complications was tabulated, and descriptive statistics calculated. Outlier studies, 1 standard deviation above the mean, were reexamined to determine potential causal factors for each complication. All studies were examined for statistically significant differences for any potential causal factor. Results The pooled incidence of minor complications reported were hematoma 2.9% (95% confidence interval [CI]: 2.4‐3.5), wound infection 2.3% (95% CI: 1.8‐2.9), sialocele 4.5% (95% CI: 3.5‐5.7), salivary fistula 3.1% (95% CI: 2.6‐3.7), flap necrosis 1.7% (95% CI: 1.1‐2.5), scar issues 3.6% (95% CI: 2.4‐5.4), numbness 33.9% (95% CI: 25.6‐43.4), and deformity 11.8 (95% CI: 6.9‐19.5). Implants result in more wound complications, such as hematoma, sialocele, or salivary fistula. Sialocele and salivary fistula appear more frequently after less extensive parotid surgery, whereas hematoma, wound infections, flap necrosis, and aesthetic considerations are worse with more extensive resections. Conclusions Minor parotidectomy complications are more frequent than generally assumed and related to certain factors that should be investigated. Laryngoscope, 131:571–579, 2021

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

“…Nonetheless, tumor recurrence, facial nerve paralysis, and other complications (Frey's syndrome [FS], sialocele, and salivary fistula) continue to be reported following all the above‐mentioned surgical interventions 5,19–20 …”

“…17,18 Nonetheless, tumor recurrence, facial nerve paralysis, and other complications (Frey's syndrome [FS], sialocele, and salivary fistula) continue to be reported following all the above-mentioned surgical interventions. 5,[19][20] To date, all published meta-analyses provide a headto-head comparison for only two interventions 10,15,21,22 ; however, there is a lack of evidence regarding which type of parotid surgery is associated with the least facial nerve paralysis (temporary or permanent), recurrence, FS, sialocele, and salivary fistula. Therefore, a comprehensive comparative study of different parotid surgical interventions for benign tumors would be of a great value to guide surgeons and help for presurgical counseling of patients who are scheduled for parotid surgery.…”

Systematic review and meta-analysis of modified facelift incision versus modified Blair incision in parotidectomy

“…However, an obvious scar on the face and neck after using the MBI is unavoidable, even with meticulous closure. According to previous studies regarding parotid surgeries, long-term evaluation by questionnaires seems to indicate high scar dissatisfaction 22 , 23 . Some authors have even reported that scars represent the most important long-term issue 22 .…”

Outpatient Parotidectomy, a Safety and Financial Review

“…Both rates are well below the reported incidence of 2.9%. 24,25 A similar amount of patients in the outpatient vs inpatient cohorts experienced a postoperative seroma (2.21% vs 0.5%, P = .16) and a postoperative infection (2.21% vs 3.02%, P = .65) (Table 2). Additionally, the readmission rate was 1.47% in the outpatient group and 2.01% in the inpatient group (P = .71), both lower than the national reported rate of 3.9%.…”