Classification of parotidectomies: a proposal of the European Salivary Gland Society

Abstract

The objective of this study is to provide a comprehensive classification system for parotidectomy operations. Data sources include Medline publications, author's experience, and consensus round table at the Third European Salivary Gland Society (ESGS) Meeting. The Medline database was searched with the term "parotidectomy" and "definition". The various definitions of parotidectomy procedures and parotid gland subdivisions extracted. Previous classification systems re-examined and a new classification proposed by a consensus. The ESGS proposes to subdivide the parotid parenchyma in five levels: I (lateral superior), II (lateral inferior), III (deep inferior), IV (deep superior), V (accessory). A new classification is proposed where the type of resection is divided into formal parotidectomy with facial nerve dissection and extracapsular dissection. Parotidectomies are further classified according to the levels removed, as well as the extra-parotid structures ablated. A new classification of parotidectomy procedures is proposed.

Classification of GLOSSECTOMIES: Proposal for tongue cancer resections

“…[24][25][26][27][28][29][30][31][32][33] Some of these classifications have entered into daily clinical practice, while some others less so. To clarify such confusion, we decided to base our proposal on the surgical anatomy of the tongue.…”

Why Do Parotid Pleomorphic Adenomas Recur? A Systematic Review of Pathological and Surgical Variables

“…A recent publication from a Dutch registry covering close to 5,500 patients followed for 15 years and treated with formal parotidectomy (3) puts the incidence of recurrent PA to 2.9% and the rate of malignant transformation to 3.3% (88). …”

“…This led to the further exclusion of 49 additional publications for various reasons detailed in Table 1. References from the relevant articles were also searched, which yielded an additional 22 publications (1–3, 5–23). …”

“…The standard surgical treatment is an open parotidectomy I-V (3), which is associated with recurrence rates below 2–3% (4). By contrast, in earlier studies, recurrence rates following enucleation were as high as 40% (5, 6).…”

Fluorescein sodium-guided surgery of parotid gland tumors as a technical advance

“…Transient post-operative facial nerve impairment is observed in 25% to 60% of patients [4]. A current review by Quer et al comments on the history and classification of parotidectomies by the European Salivary Gland Society [5]. There exist conflicting reports, especially concerning the appropriate technique to remove pleomorphic adenoma, the most frequent type of parotid tumors.…”