Function‐preserving parotid surgery for benign tumors involving the deep parotid lobe

Abstract

Limited resection of benign tumors involving the parotid deep lobe may result in improved functional outcomes, including preserved salivary flow and beneficial cosmetic aspects, without compromising local tumor control.

Preservation of Salivary Function Following Extracapsular Dissection for Tumors of the Parotid Gland

“…Regarding oncologic safety, the present study reports safety results consistent with those of previous reports [3][4][5][6][7][8][9][10][11][12][13][14]17,18 ; 0 (0%), 1 (6.67%), and 2 (12.5%) cases of ECD, PSP, and CSP were exposed at the margin, respectively. Although not statistically relevant, complications, such as temporary facial nerve paralysis, Frey syndrome, and sialocele, occurred less in the ECD group than in the PSP or CSP group.…”

“…To date, only a couple of studies have compared functional outcomes for salivary flow rates after parotidectomies. 13,14 In a randomized clinical trial by Roh et al, 13 PSP had considerably better functional outcomes compared with CSP or total parotidectomy.…”

Sacrificing the buccal branch of the facial nerve during parotidectomy

“…Evidence of lower facial weakness even in the buccal preserved group, and full recovery of function in the buccal sacrificed group support the neuropraxia hypothesis. Previous case series in which the buccal branch was not sacrificed have similarly documented early neuropraxia in 18% to 40% of cases with full recovery in the majority . In the current report, not only did the buccal sacrificed group have more cases of early weakness, but also a higher proportion with severe neuropraxia.…”

“…Previous case series in which the buccal branch was not sacrificed have similarly documented early neuropraxia in 18% to 40% of cases with full recovery in the majority. 1,2,4,5 In the current report, not only did the buccal sacrificed group have more cases of early weakness, but also a higher proportion with severe neuropraxia. This is a result of the increased difficulty of dissection imposed by the less favorably located deep and anterior lesions.…”

The Transcervical Approach for Parapharyngeal Space Pleomorphic Adenomas: Indications and Technique

“…There is close agreement among surgeons regarding the full excision of PAs as opposed to simply enucleating them, with mounting new evidence for ECD as being the preferred technique both in superficial parotid gland tumors and PPST [13], [14], [15], [16]. One of the major concerns about the use of ECD is the possibility of tumor spillage.…”