Extracapsular dissection by the sternocleidomastoid muscle–parotid space approach reduces the risks of postparotidectomy sialocele and salivary fistula
Abstract:Background
Postoperative sialoceles and fistulas are frequent surgical complications of parotid tumor resection. Extracapsular dissection by the sternocleidomastoid muscle–parotid space approach (ECD‐SMPSA) is a minimally invasive technique. To our knowledge, the characteristics of sialoceles and fistulas secondary to ECD‐SMPSA have not been reported.
Methods
This prospective study enrolled 52 patients who underwent ECD‐SMPSA without sialocele/fistula prevention measures. Postoperative sialoceles and fistulas … Show more
“…1 However, a very low sialocele incidence of 1.9% was reported in extracapsular dissection requiring minimal salivary parenchyma dissection for tumor removal. 9 The literature has also reported other risk factors associated with sialocele formation. Tumor location, the use of hemostatic agents, surgical drain placement, time to drain removal, and the method of reconstructing the parotidectomy bed may contribute to the risk factors and increasing rate of sialocele formation.…”
Section: Introductionmentioning
confidence: 99%
“…Although it does not occur in total or near total parotidectomy, a high incidence of up to 39% has been reported in partial superficial parotidectomy 1 . However, a very low sialocele incidence of 1.9% was reported in extracapsular dissection requiring minimal salivary parenchyma dissection for tumor removal 9 . The literature has also reported other risk factors associated with sialocele formation.…”
Background
This study compared the complete closure versus the exposure of remnant parotid parenchyma in sialocele formation.
Methods
This study included 151 patients with benign parotid lesions who underwent partial parotidectomy plus the complete closure or exposure of remnant parotid parenchyma. Two surgical methods of closed or exposed parenchyma were alternatively allocated to consecutive patients without randomization and blinding processes.
Results
Complete closure and exposure of the remnant parotid parenchyma were performed in 81 and 70 patients. Early postoperative complications occurred with temporary events: transient facial weakness, 24 (16%); hematoma, 9 (6%); wound infection, 1 (0.7%) without statistical difference between the two groups (p > 0.1). Postoperative sialocele was more frequently found in the exposure group (n = 15) than the closure group (n = 4; p = 0.003).
Conclusions
The complete closure of remnant parotid parenchyma is preferred over the exposure of injured parenchymal parenchyma to prevent postparotidectomy sialocele.
“…1 However, a very low sialocele incidence of 1.9% was reported in extracapsular dissection requiring minimal salivary parenchyma dissection for tumor removal. 9 The literature has also reported other risk factors associated with sialocele formation. Tumor location, the use of hemostatic agents, surgical drain placement, time to drain removal, and the method of reconstructing the parotidectomy bed may contribute to the risk factors and increasing rate of sialocele formation.…”
Section: Introductionmentioning
confidence: 99%
“…Although it does not occur in total or near total parotidectomy, a high incidence of up to 39% has been reported in partial superficial parotidectomy 1 . However, a very low sialocele incidence of 1.9% was reported in extracapsular dissection requiring minimal salivary parenchyma dissection for tumor removal 9 . The literature has also reported other risk factors associated with sialocele formation.…”
Background
This study compared the complete closure versus the exposure of remnant parotid parenchyma in sialocele formation.
Methods
This study included 151 patients with benign parotid lesions who underwent partial parotidectomy plus the complete closure or exposure of remnant parotid parenchyma. Two surgical methods of closed or exposed parenchyma were alternatively allocated to consecutive patients without randomization and blinding processes.
Results
Complete closure and exposure of the remnant parotid parenchyma were performed in 81 and 70 patients. Early postoperative complications occurred with temporary events: transient facial weakness, 24 (16%); hematoma, 9 (6%); wound infection, 1 (0.7%) without statistical difference between the two groups (p > 0.1). Postoperative sialocele was more frequently found in the exposure group (n = 15) than the closure group (n = 4; p = 0.003).
Conclusions
The complete closure of remnant parotid parenchyma is preferred over the exposure of injured parenchymal parenchyma to prevent postparotidectomy sialocele.
“…Consequently, surgical complications, postoperative sialocele, and salivary fistulas can generally be avoided without using any specific intraoperative and/or postoperative measures to prevent or treat sialocele/fistula (e.g., medication sealant, pressure dressing, and dietary restrictions). 3 …”
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
