Minor Parotidectomy Complications: A Systematic Review

Abstract

Objectives To report descriptive statistics for minor parotidectomy complications. Methods A systematic review was performed, selecting 235 studies for analysis. The incidence of complications was tabulated, and descriptive statistics calculated. Outlier studies, 1 standard deviation above the mean, were reexamined to determine potential causal factors for each complication. All studies were examined for statistically significant differences for any potential causal factor. Results The pooled incidence of minor complications reported were hematoma 2.9% (95% confidence interval [CI]: 2.4‐3.5), wound infection 2.3% (95% CI: 1.8‐2.9), sialocele 4.5% (95% CI: 3.5‐5.7), salivary fistula 3.1% (95% CI: 2.6‐3.7), flap necrosis 1.7% (95% CI: 1.1‐2.5), scar issues 3.6% (95% CI: 2.4‐5.4), numbness 33.9% (95% CI: 25.6‐43.4), and deformity 11.8 (95% CI: 6.9‐19.5). Implants result in more wound complications, such as hematoma, sialocele, or salivary fistula. Sialocele and salivary fistula appear more frequently after less extensive parotid surgery, whereas hematoma, wound infections, flap necrosis, and aesthetic considerations are worse with more extensive resections. Conclusions Minor parotidectomy complications are more frequent than generally assumed and related to certain factors that should be investigated. Laryngoscope, 131:571–579, 2021

Surgical, histopathological, and clinical outcomes of parotid gland neoplasms: a 10-year tertiary single-center experience

“…Frey syndrome, which is characterized by gustatory sweating, flushing and swelling in the parotid region, is a common complication after parotidectomy, particularly after superficial parotidectomy. The reported incidence of Frey syndrome (1.9%) is consistent with previous studies [37,38]. Hematoma and seroma formation are common complications of parotidectomy, particularly after total parotidectomy.…”

“…The reported surgical complications in our study are consistent with previous literature on parotidectomy [34]. Transient facial nerve palsy is a common complication of superficial parotidectomy and occurs due to manipulation of the facial nerve during surgery However, the incidence of complete permanent facial paralysis (5.1%) reported in this study is higher than the reported incidence of 1-3% in previous studies.…”

Surgical, histopathological, and clinical outcomes of parotid gland neoplasms: a 10-year tertiary single-center experience

“…Frey syndrome, which is characterized by gustatory sweating, flushing and swelling in the parotid region, is a common complication after parotidectomy, particularly after superficial parotidectomy. The reported incidence of Frey syndrome (1.9%) is consistent with previous studies [37,38]. Hematoma and seroma formation are common complications of parotidectomy, particularly after total parotidectomy.…”

“…The reported surgical complications in our study are consistent with previous literature on parotidectomy [34]. Transient facial nerve palsy is a common complication of superficial parotidectomy and occurs due to manipulation of the facial nerve during surgery However, the incidence of complete permanent facial paralysis (5.1%) reported in this study is higher than the reported incidence of 1-3% in previous studies.…”

Outpatient parotidectomy with or without the use of a post‐operative drain: A retrospective bi‐institutional study

“…A recently conducted systematic review found a pooled incidence of 2.9% for hematoma's (9), which is similar to the hematoma rate in the current study (3.1%). Of note, no hematomas occurred in the drain-less cohort.…”

“…Surgical site infection occurrence rates were similar in both studies (drain: 14.3%, drainless: 13.8%, p = 1). This is on the high spectrum compared to the pooled incidence of 2.1% that was reported in the earlier cited systematic review 9 . This is most likely caused by the definition used for surgical site infection in this retrospective study.…”

Application of the ORBEYE Three-Dimensional Exoscope for Parotidectomies

“…The levels of complications other than facial nerve palsy in the exoscope group were significantly lower compared with those in the loupe group. In the systematic review of minor parotidectomy complications, hematoma, wound infection, and sialocele were at 2.9, 2.3, and 4.5%, respectively [14]. However, in the present study, hematoma, wound infection, and sialocele were all at 1.11% in the exoscope group and at 1.19, 1.19, and 7.14%, respectively, in the loupe group.…”

Surgical, histopathological, and clinical outcomes of parotid gland neoplasms: a 10-year tertiary single-center experience

“…Frey syndrome, which is characterized by gustatory sweating, flushing and swelling in the parotid region, is a common complication after parotidectomy, particularly after superficial parotidectomy. The reported incidence of Frey syndrome (1.9%) is consistent with previous studies [37,38]. Hematoma and seroma formation are common complications of parotidectomy, particularly after total parotidectomy.…”

“…The reported surgical complications in our study are consistent with previous literature on parotidectomy [34]. Transient facial nerve palsy is a common complication of superficial parotidectomy and occurs due to manipulation of the facial nerve during surgery However, the incidence of complete permanent facial paralysis (5.1%) reported in this study is higher than the reported incidence of 1-3% in previous studies.…”

Outpatient parotidectomy with or without the use of a post‐operative drain: A retrospective bi‐institutional study

“…A recently conducted systematic review found a pooled incidence of 2.9% for hematoma's (9), which is similar to the hematoma rate in the current study (3.1%). Of note, no hematomas occurred in the drain-less cohort.…”

“…Surgical site infection occurrence rates were similar in both studies (drain: 14.3%, drainless: 13.8%, p = 1). This is on the high spectrum compared to the pooled incidence of 2.1% that was reported in the earlier cited systematic review 9 . This is most likely caused by the definition used for surgical site infection in this retrospective study.…”

Application of the ORBEYE Three-Dimensional Exoscope for Parotidectomies

“…The levels of complications other than facial nerve palsy in the exoscope group were significantly lower compared with those in the loupe group. In the systematic review of minor parotidectomy complications, hematoma, wound infection, and sialocele were at 2.9, 2.3, and 4.5%, respectively [14]. However, in the present study, hematoma, wound infection, and sialocele were all at 1.11% in the exoscope group and at 1.19, 1.19, and 7.14%, respectively, in the loupe group.…”

Surgical, histopathological, and clinical outcomes of parotid gland neoplasms: a 10-year tertiary single-center experience

“…Frey syndrome, which is characterized by gustatory sweating, flushing and swelling in the parotid region, is a common complication after parotidectomy, particularly after superficial parotidectomy. The reported incidence of Frey syndrome (1.9%) is consistent with previous studies [37,38]. Hematoma and seroma formation are common complications of parotidectomy, particularly after total parotidectomy.…”

“…The reported surgical complications in our study are consistent with previous literature on parotidectomy [34]. Transient facial nerve palsy is a common complication of superficial parotidectomy and occurs due to manipulation of the facial nerve during surgery However, the incidence of complete permanent facial paralysis (5.1%) reported in this study is higher than the reported incidence of 1-3% in previous studies.…”

Outpatient parotidectomy with or without the use of a post‐operative drain: A retrospective bi‐institutional study

“…A recently conducted systematic review found a pooled incidence of 2.9% for hematoma's (9), which is similar to the hematoma rate in the current study (3.1%). Of note, no hematomas occurred in the drain-less cohort.…”

“…Surgical site infection occurrence rates were similar in both studies (drain: 14.3%, drainless: 13.8%, p = 1). This is on the high spectrum compared to the pooled incidence of 2.1% that was reported in the earlier cited systematic review 9 . This is most likely caused by the definition used for surgical site infection in this retrospective study.…”

Application of the ORBEYE Three-Dimensional Exoscope for Parotidectomies

“…The levels of complications other than facial nerve palsy in the exoscope group were significantly lower compared with those in the loupe group. In the systematic review of minor parotidectomy complications, hematoma, wound infection, and sialocele were at 2.9, 2.3, and 4.5%, respectively [14]. However, in the present study, hematoma, wound infection, and sialocele were all at 1.11% in the exoscope group and at 1.19, 1.19, and 7.14%, respectively, in the loupe group.…”