Cross-sectional study on the occurrence of Frey's syndrome following superficial parotidectomy or extracapsular dissection

Kadletz, Lorenz; Taucher, Klaus; Janik, Stefan; Grasl, Stefan; Grasl, Matthäus C.; Gstöttner, Wolfgang; Erović, Boban M.

doi:10.1016/j.jcms.2020.01.003

Cited by 7 publications

(18 citation statements)

References 20 publications

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“…The rates of gustatory sweating following parotidectomy vary considerably in the literature, with high rates noted with the utilization of formal starch testing 37‐39 . Symptomatic Frey's syndrome is a much rarer occurrence with studies demonstrating rates from 1% to 9% 23,40 .…”

Section: Discussionmentioning

confidence: 99%

“…The rates of gustatory sweating following parotidectomy vary considerably in the literature, with high rates noted with the utilization of formal starch testing. [37][38][39] Symptomatic Frey's syndrome is a much rarer occurrence with studies demonstrating rates from 1% to 9%. 23,40 The low rate of symptomatic Frey's Syndrome noted at follow-up visits (1.5%) in this series is consistent with other large series demonstrating this infrequent event.…”

Section: Management Approachmentioning

confidence: 99%

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Single‐surgeon parotidectomy outcomes in an academic center experience during a 15‐year period

Deschler

Kozin

Kanumuri

et al. 2020

Laryngoscope Investig Oto

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Objective: As large single-surgeon series in the literature are lacking, we sought to review a single-surgeon's experience with parotidectomy in an academic center, with a focused analysis of pathology, technique, and facial nerve (FN) weakness. Benchmark values for complications and operative times with routine trainee involvement and without continuous FN monitoring are offered. Materials and Methods: All patients who underwent parotidectomy, performed by D. G. D., for benign and malignant disease between January 2004 and December 2018 at an academic center were reviewed. Results: A total of 924 parotidectomies, with adequate evaluatable data were identified. The majority of patients had benign tumors (70.9%). Partial/superficial parotidectomy was the most common approach (65.7%). Selective FN branch sacrifice was rare (12.3%), but significantly more common among patients with malignant pathology (33.8% vs 3.5% for benign, P < .0001). Among patients with intact FN, post-operative short-and long-term FN weaknesses were rare (6.5% and 1.7%, respectively). These rates were lower among patients with benign tumors (5.4% and 1.3%). Partial/superficial parotidectomy for benign tumors was associated with a low rate of short-and long-term FN weaknesses (2.7% and 0.9%). Mean OR time was 185 minutes. Conclusion: This is the largest single-surgeon series on parotidectomy, spanning 15 years. We demonstrate excellent long-and short-term FN paresis rates with acceptable operative times without regular use of continuous FN monitoring and with routine trainee involvement. These findings may provide valuable insight into parotid tumor pathology, FN outcomes, and feasibility and expectations of performing parotidectomy in an academic setting.

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Section: Discussionmentioning

confidence: 99%

Section: Management Approachmentioning

confidence: 99%

Single‐surgeon parotidectomy outcomes in an academic center experience during a 15‐year period

Deschler

Kozin

Kanumuri

et al. 2020

Laryngoscope Investig Oto

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“…One RCT 31 was assessed as a low risk of bias. Twenty-five studies 12,14,19,32,35,36,[38][39][40]42,44,47,49,[51][52][53][56][57][58]60,[63][64][65]68,69,71 were assessed as having moderate risk of bias, whereas the other 18 studies 14,[33][34]41,43,45,46,48,50,54,55,59,61,62,66,67,70,72 were assessed as having high risk of bias (Table S4). [32][33][34]36,40,44,…”

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

“…versus ECD was reported in 18 studies, 32,36,39,40,44,47,48,50,52,53,[57][58][59]62,64,65,68,71 of them 3 studies 64,65,71 reported 0 event in both groups and were excluded from the meta-analysis. The pairwise metaanalysis of the remaining 15 studies with a total of 3211 participants showed a significant higher incidence in FS T A B L E 2 Summary of incidence rates of postoperative complication of different surgical intervention of parotid gland when SP was compared to ECD and PSP (p = 0.002 and p = 0.004) (Table 1 and Figure S1).…”

Section: Spmentioning

confidence: 99%

“…of study (s) No. of participants Odd ratio 95% confidence interval (lower limit, upper limit) Heterogeneity (%) p-value [32][33][34]36,40,44,45,[47][48][49][50]53,[57][58][59]62,64,65,69 of them 5 studies 33,45,49,50,59 reported 0 event in both groups and were excluded from the meta-analysis. The pairwise meta-analysis of the remaining 14 studies with a total of 3285 participants showed no significant differences in tumor recurrence when SP was compared with ECD (p = 0.494).…”

Section: Comparisonmentioning

confidence: 99%

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

et al. 2021

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The impact of the extent of parotid surgery on postoperative complications has long been considered a topic of controversy. The aim of the current network meta-analysis (NMA) is to answer the following questions: (1) Does the extent of surgical resection of benign parotid tumors increase the risk of postoperative complications? (2) What is the best surgical intervention for treatment of benign parotid tumors that can provide an acceptable balance between tumor recurrence rate and other postoperative complications? A comprehensive search on PubMed, Embase, Scopus, and Cochrane library was conducted to identify the eligible studies. The outcome was the incidence of tumor recurrence, facial nerve weakness (temporary [TFW] or permanent [PFP]), Frey's syndrome (FS), sialocele, and salivary fistula. The Bayesian network meta-analysis (NMA) accompanied by a random effect model and 95% credible intervals (CrI) were calculated using the GeMTC R package. Forty-four studies with a total of 7841 participants were included in the current NMA comparing five surgical interventions, namely enucleation, extracapsular dissection (ECD), partial superficial parotidectomy (PSP), superficial parotidectomy (SP), and total parotidectomy (TP). Enucleation showed the highest recurrence rate compared to ECD, SPS, SP, and TP. No statistical differences were observed concerning the recurrence rate when ECD, PSP, SP, and TP were compared together. There was an increased incidence of TFW and FS with the increase in the extent of parotid resection, while no significant difference was found when comparing enucleation with ECD and PSP. SP showed the highest incidence of PFP, and salivary fistula compared to ECD, PSP, and TP. The tumor recurrence rates in enucleation, ECD, PSP, SP, and TP were 14.3%, 3.6%, 3.7%, 2.8%, and 1.4%, respectively. The current NMA demonstrated that the risk of TFW and FS increases with the increase in the extent of parotid resection and that ECD and PSP can be considered the treatment of choice for benign parotid tumors, as both provide an acceptable balance between the incidence of tumor recurrence and facial nerve dysfunction.

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Therapie der gutartigen Speicheldrüsentumoren

Eufinger

2021

MKG-Chirurg

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Cross-sectional study on the occurrence of Frey's syndrome following superficial parotidectomy or extracapsular dissection

Cited by 7 publications

References 20 publications

Single‐surgeon parotidectomy outcomes in an academic center experience during a 15‐year period

Single‐surgeon parotidectomy outcomes in an academic center experience during a 15‐year period

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

Therapie der gutartigen Speicheldrüsentumoren

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