The role of partial parotidectomy for benign parotid tumors: A case-control study

Plaza, Guillermo; Amarillo, Elizabeth; Hernández‐García, Estefanía; Hernando, Mónica

doi:10.3109/00016489.2015.1020394

Cited by 12 publications

(21 citation statements)

References 19 publications

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“…Wound infection was reported in 94 studies 6,9,12,14,15,17,21–25,27,28,31,35,36,39–44,49,55,57–67,69–72,74,75,79,81,85–90,92,93,95,96,98–103,105–107,111,112,115–122,124,125,128,131–149 reporting on 15,861 patients (Table I and Fig. 2B).…”

Section: Resultsmentioning

confidence: 95%

“…Sialocele was reported in 102 studies 10,14,15,17,23,25,33–36,38,39,41–44,46,48,50,51,56–62,64,66,67,69,70,72–77,79–85,87–90,92,95,96,98,100–103,106–108,110–116,118–121,125,128,135–138,141,144,146,147,150–169 reporting on 13,760 patients (Table I and Fig. 2C).…”

Section: Resultsmentioning

confidence: 97%

“…Parotidectomy for sialadenitis probably results in increased rates of wound infections and salivary fistula. Correlations between the extent of parotidectomy and complications have been examined in several cohorts, 43,85,100,101,109,119,200,205,225 sometimes with, 85,100,101,225 and more often without, 109,117,119,200,205 statistical significance. In general, sialocele and salivary fistula appear more frequently after less extensive surgery, whereas hematoma, wound infection, flap necrosis, and aesthetic considerations such as scarring and depression are worse with more extensive resections.…”

Section: Discussionmentioning

confidence: 99%

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Minor Parotidectomy Complications: A Systematic Review

et al. 2020

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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

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Section: Resultsmentioning

confidence: 95%

Section: Resultsmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

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Minor Parotidectomy Complications: A Systematic Review

et al. 2020

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“…Facial paresis following parotidectomy is a common finding that is typically self-limiting and limited to marginal mandibular nerve weakness [11]. This risk may be mitigated by performing a limited surgical approach [12–14], or if there is reconstruction with a muscular flap, with or without an abdominal fat graft [15, 16]. Frey syndrome is a historically common complication following parotidectomy described as gustatory sweating due to aberrant reinnervation of secretory parasympathetic fibers from parotid tissue to dermal tissue.…”

Section: Discussionmentioning

confidence: 99%

Reconstructive trends and complications following parotidectomy: Incidence and predictors in 11,057 cases

Bovenzi

Ciolek

Crippen

et al. 2019

Journal of Otolaryngology - Head & Neck Surgery

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BackgroundParotidectomy is a common treatment option for parotid neoplasms and the complications associated with this procedure can cause significant morbidity. Reconstruction following parotidectomy is utilized to address contour deformity and facial nerve paralysis. This study aims to demonstrate national trends in parotidectomy patients and identify factors associated with adverse postoperative outcomes. This study includes the largest patient database to date in determining epidemiologic trends, reconstructive trends, and prevalence of adverse events following parotidectomy.MethodsA retrospective review was performed for parotidectomies included in the ACS-NSQIP database between January 2012 and December 2017. CPT codes were used to identify the primary and secondary procedures performed. Univariate and multivariate analysis was utilized to determine associations between pre- and perioperative variables with patient outcomes. Preoperative demographics, surgical indications, and common medical comorbidities were collected. CPT codes were used to identify patients who underwent parotidectomy with or without reconstruction. These pre- and perioperative characteristics were compared with 30-day surgical complications, medical complications, reoperation, and readmission using uni- and multivariate analyses to determine predictors of adverse events.ResultsThere were 11,057 patients who underwent parotidectomy. Postoperative complications within 30 days were uncommon (1.7% medical, 3.8% surgical), with the majority of these being surgical site infection (2.7%). Free flap reconstruction, COPD, bleeding disorders, smoking, and presence of malignant tumor were the strongest independent predictors of surgical site infection. Readmission and reoperation were uncommon at an incidence of 2.1% each. The strongest factors predictive of readmission were malignant tumor and corticosteroid usage. The strongest factors predictive of reoperation were free flap reconstruction, malignant tumor, bleeding disorder, and disseminated cancer. Surgical volume/contour reconstruction was relatively uncommon (18%). Facial nerve sacrifice was uncommon (3.7%) and, of these cases, only 25.5% underwent facial nerve reinnervation and 24.0% underwent facial reanimation.ConclusionsThere are overall low rates of complications, readmissions, and reoperations following parotidectomy. However, certain factors are predictive of adverse postoperative events and this data may serve to guide management and counseling of patients undergoing parotidectomy. Concurrent reconstructive procedures are not commonly reported which may be due to underutilization or underreporting.

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“…In attempts to minimize the incidence of facial dysfunction, parotid surgeons showed renewed interest in conservative resection of PA. Although enucleation remains universally prohibited, extra-capsular dissection (ECD) ( 5 , 6 , 9 , 10 ) and PSP ( 11 , 12 ) are two widely practiced procedures. Both techniques maintain a surgical safety margin around the tumor.…”

Section: Introductionmentioning

confidence: 99%

Parotid Quadrantectomy Is a Safe Management for Localized Pleomorphic Adenoma

et al. 2018

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AimPleomorphic adenoma is the most common benign tumor of the parotid gland and is classically treated with superficial or total parotidectomy. Less radical surgeries have been proposed to minimize the risk of facial nerve injury. The oncological safety of these procedures remains controversial. We conducted this study to evaluate the safety of superficial hemi-lobectomy (quadrantectomy).Patients and methodsRetrospective analysis was conducted on the paraffin sections of archived superficial parotidectomy specimens from 11 male and 6 female patients (median age 33 years). The microscopic extent of extra-capsular extension was determined on pathological revision. In addition, prospective evaluation of 12 quadrantectomy procedures (M/F = 7/5, median age = 36 years) compared to 24 radical surgeries (M = F, median age = 40 years) regarding temporary and persistent facial nerve dysfunction on routine clinical assessment and recurrence rate.ResultsOn retrospective pathological revision, pleomorphic adenomata had a median microscopic spread of 3 mm beyond capsule in paraffin sections (SD = 3.6). On prospective analysis with a median follow-up of 33 months (range = 18–54 months), quadrantectomy had similar relative risk of temporary facial nerve dysfunction evaluated at the immediate postoperative period as well as persistent nerve dysfunction assessed at 3 months (P = 0.701 and P = 0.902, respectively). Of the whole study population, one case of recurrence after total parotidectomy was observed at mid-term follow-up (P = 1.000).ConclusionParotid quadrantectomy is a safe management for smaller pleomorphic adenomata localized close to one of the two divisions of the facial nerve.

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The role of partial parotidectomy for benign parotid tumors: A case-control study

Abstract: Partial parotidectomy achieves less early and late complications than superficial parotidectomy, with similar recurrence rates.

Cited by 12 publications

References 19 publications

Minor Parotidectomy Complications: A Systematic Review

Minor Parotidectomy Complications: A Systematic Review

Reconstructive trends and complications following parotidectomy: Incidence and predictors in 11,057 cases

Parotid Quadrantectomy Is a Safe Management for Localized Pleomorphic Adenoma

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