NSQIP Outcomes of Superficial Parotidectomy: The Case for Extracapsular Dissection

Abstract

Objectives: To compare outcomes of patients with benign neoplasms undergoing superficial parotidectomy, with or without facial nerve dissection, the latter a surrogate for extracapsular dissection technique. Methods: Retrospective review of the American College of Surgeons National Surgical Quality Improvement Project (NSQIP) database providing 30-day postoperative outcome data from 676 sites nationwide. Inclusion criteria were primary diagnosis of benign salivary neoplasm, age 18-89 years, primary procedure superficial parotidectomy either with (CPT 42415 (SPwFND)) or without (CPT 42410 (SPwoFND)) facial nerve dissection between 2012-2019. We analyzed demographics, operative time, length of stay, perioperative complications, readmission, and reoperation rates between the two procedure groups. NSQIP contained no information on postoperative facial paralysis or estimated blood loss. Results: In total, 2651 patients underwent SPwFND while 764 underwent SPwoFND. Operative time was shorter (111.59 +/- 63.417) for SPwoFND than for SPwFND (135.05 +/- 64.313, p<;0.0001). Fewer patients undergoing SPwoFND required overnight stay than those undergoing SPwFND (41.5% vs 59.4%, p<0.001). There were no significant differences between rates of reoperation, unplanned readmission, or perioperative complications between the groups. Conclusion: SPwoFND nerve dissection had a shorter operative time and led to fewer postoperative overnight stays than SPwFND, with no significant differences in rates of reoperation, unplanned readmission, or perioperative complications. This suggests that for appropriately selected patients, SPwoFND may be a comparable treatment option with the benefit of lower resource utilization than SPwFND.