Surgical Management of Benign Tumors of the Parotid Gland: Extracapsular Dissection Versus Superficial Parotidectomy—Our Experience in 232 Cases

Orabona, Giovanni Dell’Aversana; Bonavolontà, Paola; İaconetta, Giorgio; Forte, Raimondo; Califano, Luigi

doi:10.1016/j.joms.2012.05.003

Cited by 94 publications

(65 citation statements)

References 10 publications

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“…Superficial or total parotidectomy has been indicated for pleomorphic adenomas because of the high recurrence rates after enucleation of this benign tumor, which is often related to the incomplete excision or capsule rupture with the dissemination of tumor cells [11, 13]. …”

Section: Discussionmentioning

confidence: 99%

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Pleomorphic Adenoma of the Parotid: Extracapsular Dissection Compared with Superficial Parotidectomy—A 10-Year Retrospective Cohort Study

Cristofaro¹,

Allegra²,

Giudice³

et al. 2014

The Scientific World Journal

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The purpose of this study was to investigate the complication rates and effectiveness of extracapsular dissection compared with superficial parotidectomy for pleomorphic adenomas of the parotid gland from 2002 to 2012. The authors carried out a retrospective cohort study of 198 patients with pleomorphic adenomas of the parotid gland. Extracapsular dissection (ED) or superficial parotidectomy (SP) was performed. The recurrence rate and complications of the two surgical techniques were measured with a univariate analysis of each variable using the appropriate statistical analysis (chi-squared test or t-test). A total of 198 patients were enrolled between January 2003 and December 2012. The study included 97 females (48.99%) and 101 males (51.01%) whose mean age was 50.97 years (range 14–75). The type of surgery performed was ED in 153 patients (77.27%, 80 males and 73 females) and SP in 45 patients (22.73%, 21 males and 24 females). The mean follow-up time was 61.02 +/− 4.9 months for the patients treated with ED and 66.4 +/− 4.5 months for the patients treated with SP. Transient facial nerve injury and facial paralysis were significantly more frequent after SP than after ED (P = 0.001 and P = 0.065, resp.). No significant differences in capsular rupture, recurrence, and salivary fistula were observed after SP or ED: 2.2% versus 3.9%, 2.2% versus 3.3%, and 2.2% versus 0.65%, respectively. Extracapsular dissection may be considered the treatment of choice for pleomorphic adenomas located in the superficial portion of the parotid gland because this technique showed similar effectiveness and fewer side effects than superficial parotidectomy.

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Section: Discussionmentioning

confidence: 99%

“…Frey's syndrome, which was not reported in our cases, is more frequent after SP than after ED, and its incidence ranges from 17% after SP to 3% after ED [7, 8, 10, 18]. ED is a microsurgery; in the hands of a novice surgeon or occasional parotid surgeon, it can become a high-risk surgery with various complications [17].…”

Section: Discussionmentioning

confidence: 99%

Pleomorphic Adenoma of the Parotid: Extracapsular Dissection Compared with Superficial Parotidectomy—A 10-Year Retrospective Cohort Study

Cristofaro¹,

Allegra²,

Giudice³

et al. 2014

The Scientific World Journal

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“…Dell’ Aversana Orabona et al .,[13] after a longterm followup (mean 46 months), found that the incidence of tumor recurrence after ECD was 4.5%.…”

Section: Discussionmentioning

confidence: 99%

Extracapsular dissection of pleomorphic adenoma in the parotid gland: A case report and review of the literature

et al. 2014

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Salivary gland tumors comprise of less than 3% of all tumors of the head and neck region. Pleomorphic adenoma represents 45 to 74% of all these salivary gland tumors and 65% of them occur in the parotid gland. Owing to the close proximity of this tumor to the facial nerve, there have been various techniques for surgical management of this tumor in the literature. Extracapsular dissection of pleomorphic adenoma is a conservative treatment modality which spares the handling of facial nerve. We are reporting a case of extracapsular dissection of pleomorphic adenoma in the lower pole of the superficial lobe of the parotid gland in a 22 year-old Indian male with a 1-year follow-up.

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“…A series from a high volume parotid center reports a non-significant difference in capsule rupture comparing ECD and superficial parotidectomy (3.4 vs. 1.8 %; p = 0.1) [37]. In a series of 76 patients with pleomorphic adenomas, treated by ECD and followed for a mean of 7.4 years, no recurrences were observed [38 • ].…”

Section: Recurrence Risk For Bmtmentioning

confidence: 99%

“…In a series of 176 cases followed for 52 months. the rate of recurrence comparing ECD and superficial parotidectomy was 4.5 versus 3.6 % [37], and in a further series of 156 patients followed for a mean of 3 years and 8 months, there were no published cases of recurrence [39 • ]. Against this pattern, there are isolated reports of increased rate of recurrence of up to 8 % with ECD [40].…”

Section: Recurrence Risk For Bmtmentioning

confidence: 99%

The Role of Extracapsular Dissection for Benign Parotid Tumors

Witt

Iro

McGurk

2014

Curr Otorhinolaryngol Rep

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Surgical treatment of benign parotid tumors has been debated for decades. Extracapsular dissection (ECD) differs markedly from classic surgical approaches to the parotid neoplasm because facial nerve dissection is not performed. ECD, its advantages, disadvantages, indications, and contra-indications for benign tumors with an emphasis on benign mixed tumor will be comprehensively explored in this chapter. Factors noted to favor this approach include mobility of the tumor within the gland, a thin covering of capsule and glandular tissue, and a tumor large enough to allow digital manipulation during dissection. Imaging, fine needle aspiration cytology, and neuromonitoring play a heightened role in ECD. Recurrence and permanent facial nerve dysfunction with ECD are not higher in high volume centers performed by experienced surgeons. Transient facial nerve dysfunction, Frey's syndrome, sensory deficits, and sialocele are lower with ECD. Devastating adverse outcomes of permanent facial nerve dysfunction and recurrence should be considered by the occasional and inexperienced parotid surgeon.

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Surgical Management of Benign Tumors of the Parotid Gland: Extracapsular Dissection Versus Superficial Parotidectomy—Our Experience in 232 Cases

Cited by 94 publications

References 10 publications

Pleomorphic Adenoma of the Parotid: Extracapsular Dissection Compared with Superficial Parotidectomy—A 10-Year Retrospective Cohort Study

Pleomorphic Adenoma of the Parotid: Extracapsular Dissection Compared with Superficial Parotidectomy—A 10-Year Retrospective Cohort Study

Extracapsular dissection of pleomorphic adenoma in the parotid gland: A case report and review of the literature

The Role of Extracapsular Dissection for Benign Parotid Tumors

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