Extracapsular dissection versus superficial parotidectomy in treatment of benign parotid tumors: evidence from 3194 patients

Xie, Shang; Wang, K.; Xu, Hua-jian; Hua, Rui; Li, T.; Shan, Xiaofeng; Cai, Zhengdong

doi:10.1016/j.ijom.2015.08.873

Cited by 17 publications

(52 citation statements)

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“…The subjective definition of surgery correlated neither to the number of dissected peripheral facial branches nor to the amount of the excised tissue nor to the visible remaining parotid tissue in the ultrasound. Xie et al clearly emphasized the discrepancy in classification of different types of surgery in their recent meta‐analysis . Contradictory study results might be explained by lack of clear objectively assessed definition of the extent of surgery and by lack of prospective studies on this matter.…”

Section: Discussionsupporting

confidence: 88%

“…The appropriate amount of dissection for treatment of benign parotid tumors is an ongoing debate . The goal of limited surgery is to minimize perioperative and postoperative morbidity.…”

Section: Introductionmentioning

confidence: 99%

“…Large tissue dissection and skin incisions may be avoided when performing extracapsular dissection . However, this limited approach is still reserved for experienced surgeons and for preselected patients . Therefore, the data on perioperative and postoperative morbidity of extracapsular dissection (1) cannot be directly compared to classic techniques and (2) do not reflect the surgical routine.…”

Section: Introductionmentioning

confidence: 99%

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Impact of extent of parotidectomy on early and long‐term complications: A prospective multicenter cohort trial

et al. 2019

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Background In this prospective nonrandomized multicenter trial, we analyze the incidence of early and late complications after parotidectomy in correlation to the extent of dissection. Methods A total of 148 patients underwent a parotidectomy for a benign lesion in the superficial lobe. The number of intraoperatively dissected main facial nerve branches was photo‐documented and defined the extent of tissue dissection. Early postoperative complications including sialocele were evaluated until 4 weeks after surgery. Late complications as facial nerve palsy, Frey's syndrome (FS) and the outcome of the scar and substance loss were furthermore assessed after 6 and 12 months. Results Early complications occurred in 22 patients (14%) and did not depend on the extent of facial nerve dissection (all P > .05). However, patients with higher number of intraoperatively dissected facial nerve branches showed significantly higher palsy scores on the first postoperative day (P = .026). FS occurred with incidence of 69% and correlated significantly to the extent of dissection (P = .003). Appearance of the scar and substance loss improved significantly during the follow‐up (P < .001 and P < ,005, respectively) without significant correlation to the extent of dissection (P > .05 for both variables after 12 months). Conclusions Less extensive tissue dissection resulted in better postoperative facial nerve function on the first postoperative day and in lower incidence of FS after 12 months. However, incidence of early complications did not depend on the extent of surgery. The study was registered in the German Clinical Trials Register prior to conducting the research. DRKS‐ID: DRKS00008967, URL:http://apps.who.int/trialsearch/.

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Section: Discussionsupporting

confidence: 88%

“…The appropriate amount of dissection for treatment of benign parotid tumors is an ongoing debate . The goal of limited surgery is to minimize perioperative and postoperative morbidity.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impact of extent of parotidectomy on early and long‐term complications: A prospective multicenter cohort trial

et al. 2019

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“…Thus, our findings suggest that careful attention must be paid to cases that lack a typical clear cytological picture of WT. [27][28][29] An understanding of the complication rates of surgery and the diagnostic accuracy of cytological assessment is vital in order to facilitate an informed discussion with patients on the management options of surveillance vs surgical excision in suspected WT. 24 Malignant transformation in WT is an anecdotal event and it is unclear whether this is an evolution of the lesion or represents the lack of diagnosis of a concomitant second neoplasm.…”

Section: Discussionmentioning

confidence: 99%

The diagnostic value of cytology in parotid Warthin's tumors: international multicenter series

et al. 2019

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Introduction: Warthin's tumor (WT) is a common benign salivary gland neoplasm with a negligible risk of malignant transformation. However, there is a risk of malignant tumors being misdiagnosed as WT on cytology and inappropriately managed conservatively. Methods: Patients from nine centers in Italy and the United Kingdom undergoing parotid surgery for cytologically diagnosed WT were included in this Daniele Borsetto and Jonathan M. Fussey contributed equally to this study. /journal/hed multicenter retrospective series. Definitive histology was compared with preoperative cytological diagnoses. Surgical complications were recorded.Results: A total of 496 tumors were identified. In 88.9%, the final histological diagnosis was WT. In 21 cases (4.2%) a malignant neoplasm was diagnosed, which had been incorrectly labeled as WT on cytology. Conclusions:The risk of undiagnosed malignancy should be balanced against surgical risks when considering the management of WT. Although nonsurgical management remains an appropriate option, there may be a rationale for serial clinical or radiological evaluation if surgical excision is not performed.K E Y W O R D S extracapsular dissection, facial nerve palsy, fine needle aspiration cytology, parotid, parotidectomy, Warthin's tumor

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“…After careful comparison, we find the included articles in table 3 are similar to the published meta-analysis. 2 To objectively estimate the data in table 3, we carried out a meta-analysis according to the data of table 3, and the results showed that the risk ratio value is 0.61 (95% confidence interval 0.33-1.12; P 5 .11), indicating that the recurrence rate between the 2 groups has no significant difference, which also is in accordance with the results from Mantsopoulos et al 3 (this article concluded the largest sample size in this subject). …”

mentioning

confidence: 99%

Letter to the Editor‐2 regarding “Extracapsular dissection versus superficial parotidectomy in benign parotid gland tumors: The Vienna Medical School experience”

Xie

2017

Head & Neck

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Extracapsular dissection versus superficial parotidectomy in treatment of benign parotid tumors: evidence from 3194 patients

Cited by 17 publications

References 0 publications

Impact of extent of parotidectomy on early and long‐term complications: A prospective multicenter cohort trial

Impact of extent of parotidectomy on early and long‐term complications: A prospective multicenter cohort trial

The diagnostic value of cytology in parotid Warthin's tumors: international multicenter series

Letter to the Editor‐2 regarding “Extracapsular dissection versus superficial parotidectomy in benign parotid gland tumors: The Vienna Medical School experience”

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