Patient‘s perspective on long‐term complications after superficial parotidectomy for benign lesions: Prospective analysis of a 2‐year follow‐up

Wolber, Philipp; Volk, Gerd Fabian; Horstmann, L.; Finkensieper, Mira; Shabli, Sami; Wittekindt, Claus; Klußmann, Jens Peter; Guntinas‐Lichius, Orlando; Beutner, Dirk; Grosheva, Maria

doi:10.1111/coa.13104

Cited by 28 publications

(40 citation statements)

References 18 publications

(84 reference statements)

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“…Only 23% of LT-study patients affirmed pain and painful sensations 12-16 years after surgery, 13.5% of them described the pain as "marginal", 9.5% of them as "slight" and "moderate", no one as "severe" or as "the worst problem". Wolber et al [7] and Nitzan et al [9] underlined our results by reporting an incidence of postoperative pain of 30-40% during a short follow-up. In accord with Kaya et al [10], we can consequently argue that pain is an important early complication following parotidectomy which improves in the long-term.…”

Section: Discussionsupporting

confidence: 67%

“…Key goal in parotid surgical approaches for treatment of benign lesions is not only to remove the entire tumour and to minimize morbidity but also to maintain patients' quality of life. However, only few studies address patients' perspective on complications and the related QoL [5,[7][8][9][11][12][13], but predominantly in a short followup after parotidectomy -usually 6 months or 1-2 years -and by using different symptom-specific QoL assessments. Beutner et al [8] reported no changes in QoL in 34 patients one year after superficial parotidectomy for benign diseases compared with preoperative answers using the EORTC QLQ-C30…”

Section: Discussionmentioning

confidence: 99%

“…From patient's perspective, hypoesthesia, followed by fear of revision surgery posed the major problems in long-term follow-up whereas facial palsy posed the minor problem. In the literature, numbness or uncomfortable sensations of the skin are well known as dominant, postoperative shortterm sequelae after parotidectomy [5,7,9,11,14]. Indeed, hypoesthesia is of greatest concern to the patients 6 months (90%) and still 2 years after surgery (78%) [7].…”

Section: Discussionmentioning

confidence: 99%

“…In the literature, numbness or uncomfortable sensations of the skin are well known as dominant, postoperative shortterm sequelae after parotidectomy [5,7,9,11,14]. Indeed, hypoesthesia is of greatest concern to the patients 6 months (90%) and still 2 years after surgery (78%) [7]. Porter and Wood [15] observed that the majority of sensory improvement occurred in the first 6 months.…”

Section: Discussionmentioning

confidence: 99%

“…The Parotidectomy Outcome Inventory (POI-8) is the first reliable and valid instrument for measuring health-related QoL in patients after parotidectomy for benign disease [6]. Several studies reported no changes in QoL in a short observation period after parotidectomy -usually 6 months to 1 year [2,5,[7][8][9][10]. However, little is known about the long-term disease-specific QOL after parotidectomy.…”

Section: Introductionmentioning

confidence: 99%

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

Plath

Sand

Plinkert

et al. 2020

Preprint

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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).

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Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Plath

Sand

Plinkert

et al. 2020

Preprint

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Impact of greater auricular nerve sacrifice during parotidectomy on quality of life

et al. 2020

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Background: Greater auricular nerve (GAN) sacrifice can alter sensation; however, the impact on quality of life (QoL) is unclear. Objective: The aim of this study was to evaluate patients' QoL following GAN sacrifice versus preservation. Methods: Patients who underwent parotidectomy from 2010 to 2019 at a single institution completed two QoL surveys. Results between GAN-sacrificed versus preserved cohorts and short (≤ 1 year) versus long-term (> 1 year) follow-up were compared. Results: Of 404 patients, 67 with known GAN status completed the surveys. GAN-sacrificed patients more frequently experienced sensation loss of the lobule and concha than GAN-preserved patients (P = .042 and P = .041, respectively). Interference with daily activities or amount of regained sensation was not different based on GAN status. Short-term follow-up patients had a higher number of symptoms and affected areas than long-term follow-up patients (P = .014 and P = .002, respectively). Conclusion: GAN sacrifice leads to sensation loss of the lobule and concha; however, it does not significantly impair QoL.

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Dermal Fat Grafting to Reconstruct the Parotidectomy Defect Normalizes Facial Attention

et al. 2020

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Objectives/Hypothesis Use validated eye‐tracking technology to objectively measure 1) the attentional distraction of facial contour defects after superficial and total parotidectomy and 2) changes in attentional distraction with abdominal dermal fat graft reconstruction. Methods Standardized frontal and oblique facial images of 16 patients who had undergone superficial or total parotidectomy with or without fat graft reconstruction; four normal controls were obtained. One hundred casual observers were recruited to view these images, and gaze data were collected using a Tobii Pro eye‐tracking system. Gaze durations for predefined facial areas of interest were analyzed using mixed‐effects linear regression to test study hypotheses. Results For frontal images, total parotidectomy increased gaze to the operated parotid area compared to the contralateral nonoperated parotid area (92 milliseconds, 95% confidence interval [CI]: 48‐138 milliseconds, P < .001). Fat grafting normalized the attentional distraction, with no difference in gaze time on the operated parotid region compared to normal control faces (P = .414). For oblique images, total parotidectomy increased gaze to the operated parotid area compared to the contralateral nonoperated parotid area (658 milliseconds, 95% CI: 463‐854 milliseconds, P < .001). Fat grafting normalized this attentional distraction, with no difference in gaze time on the operated parotid region compared to normal control faces (P = .504). In both views, superficial parotidectomy demonstrated no significant attentional distractions, with or without fat grafting. Conclusions This eye‐tracking study objectively demonstrates that total parotidectomy results in a facial contour deformity that is distracting to observers, whereas superficial parotidectomy does not. For total parotidectomy, this attentional distraction can be normalized with dermal fat graft reconstruction. Level of Evidence 3b Laryngoscope, 131:E124–E131, 2021

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Patient‘s perspective on long‐term complications after superficial parotidectomy for benign lesions: Prospective analysis of a 2‐year follow‐up

Cited by 28 publications

References 18 publications

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

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

Impact of greater auricular nerve sacrifice during parotidectomy on quality of life

Dermal Fat Grafting to Reconstruct the Parotidectomy Defect Normalizes Facial Attention

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