Superficial parotidectomy versus extracapsular dissection: literature review and search for a gold standard technique

Martin, Hannah M.; Jayasinghe, J.A.P.; Lowe, T.

doi:10.1016/j.ijom.2019.06.006

Cited by 31 publications

(33 citation statements)

References 39 publications

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“…Only seven (14%) patients in the current study developed temporary facial paralysis. This is in the lower range compared to rates previously demonstrated in the literature, where temporary facial paralysis following superficial parotidectomy has been found to range between 10 and 80% [4,22,23]. One possible explanation for this is that in most studies, a surgical drain was placed at the end of surgery.…”

Section: Discussionmentioning

confidence: 56%

Prospective outcomes following drainless superficial parotidectomy with sternocleidomastoid flap reconstruction

Melong

Rigby

Corsten

et al. 2020

Journal of Otolaryngology - Head & Neck Surgery

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Background Patients undergoing superficial parotidectomy for benign parotid lesions are at risk of postoperative complications, most notably cosmetic complications such as facial paralysis and contour defects, and functional complications including Frey’s syndrome. Traditionally, surgical drains have been placed at the end of surgery to prevent hematoma and sialocele formation. However, this can increase the risk of postoperative complications and contribute to a prolonged course in hospital. To try and prevent these risks and complications, we introduced a novel technique of a drainless parotidectomy by reconstructing the resulting parotid bed defect with a superiorly based sternocleidomastoid (SCM) rotational flap and by placement of gelfoam into the wound bed and a facelift dressing postoperatively to provide additional hemostasis and avoid drain placement. Methods All patients with benign parotid disease undergoing a drainless superficial parotidectomy and reconstruction with a superiorly based SCM rotational flap at our center were identified within a prospective cohort database between July 2010–2018. Primary outcomes included postoperative cosmetic and functional outcomes, complications and length of hospital stay. A secondary cost analysis was done to compare this novel technique to traditional superficial parotidectomy with surgical drain placement. Results Fifty patients were identified within the database and were included in the final analysis. The average length of hospital stay was 1.02 days. All patients were satisfied with their aesthetic outcome at 1 year. During long term follow-up, 63% of patients reported normal appearance of the operated side. Seven patient’s (14%) developed temporary facial paresis following surgery. All patients had resultant normal facial function at follow-up in 1 year. No patients developed subjective Frey’s Syndrome. Two patients (4%) developed a postoperative sialocele requiring drainage and one patient (2%) developed a hematoma on extubation requiring evacuation and drain placement. Cost analysis demonstrated a cost savings of approximately $975 per person following surgery. Conclusion In the current study, we introduced a novel approach of a drainless superficial parotidectomy using a superiorly based SCM flap, gelfoam and placement of a post-operative facelift dressing. This drainless approach was associated with good long-term cosmetic and functional outcomes with few postoperative complications. This new technique may also offer the potential for long-term savings to the health care system.

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Section: Discussionmentioning

confidence: 56%

Prospective outcomes following drainless superficial parotidectomy with sternocleidomastoid flap reconstruction

Melong

Rigby

Corsten

et al. 2020

Journal of Otolaryngology - Head & Neck Surgery

View full text Add to dashboard Cite

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“…Literature illustrates that the risk of Frey syndrome after superficial parotidectomy is more as compared to extracapsular dissection. 9,10 Unlike extracapsular dissection, superficial parotidectomy exposes large raw surfaces of the gland to the subcutaneous layer, which could be a possible reason for this difference. Frey syndrome was not reported in any of our patients.…”

Section: Discussionmentioning

confidence: 99%

Frequency of surgical complications and recurrence rate after extracapsular dissection of benign tumors of the parotid.

Arham

Khan

Arish

et al. 2021

TPMJ

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Objective: To determine surgical complications and recurrence rate in patients with benign lesions of the parotid undergoing extracapsular dissection. Study Design: Case Series. Setting: Department of Surgery, Rawalpindi Medical University, Rawalpindi. Period: January 2010 and December 2018. Material & Methods: The hospital records of all 50 patients who underwent extracapsular dissection with a diagnosis of either Pleomorphic adenoma or War thin tumor between reviewed retrospectively. Data regarding demographics, tumor, complications and recurrence was collected. Results: Out of 50 patients, 40 were males and 10 were females with age ranging from 26 to 52 years and mean age of 42 years. 44 of 50 parotid lumps were diagnosed as Pleomorphic adenoma and 6 were cases of Warthin tumor. The range of lesion size was 1.5 to 3 cm. 15 (30%) patients suffered from transient facial nerve weakness, whereas only 1 (2%) sustained a facial nerve injury which required repair. There was no case of Frey syndrome, sialocele and hematoma, however, salivary fistula was seen in 1 (2%) patient. Capsule rupture during surgery occurred in 15 (30%) patients and recurrence was seen in only 1 patient (2%). Conclusion: Extracapsular dissection has low recurrence rate, very few complications and is a safe and effective treatment for Pleomorphic adenoma and Warthin tumor.

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“…In contrast, ECD carries out a precise blunt prosection across the parotid gland tissue by performing a cruciate incision directly above the tumor [12]. ECD is a good choice for small mobile superficial tumors and is gaining more popularity due to low morbidity [13]. Understanding the various philosophies beyond superficial parotidectomy and ECD is essential.…”

Section: Discussionmentioning

confidence: 99%

Extracapsular Dissection for Small Benign Tumors of Parotid Gland: A Case Report on Contemporary Technique

Saripalli¹,

Alluri²,

Jakkula³

et al. 2021

Cureus

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Salivary gland tumor looms as painless enlarging mass which may embrace in both major or minor glands. Pleomorphic adenoma (PA) accord about 40-70% of all salivary gland tumors, where Warthin tumor, basal cell adenoma (BCA), adenoid cystic carcinoma (ACC), and sebaceous tumors have a strong predilection for major salivary gland. However, polymorphous low-grade adenocarcinoma (PLGA) has a marked predilection for the minor salivary gland. We present a case of PA in a 26-year-old male patient that has been successfully managed by extracapsular dissection (ECD) without any post-operative complications.

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Superficial parotidectomy versus extracapsular dissection: literature review and search for a gold standard technique

Cited by 31 publications

References 39 publications

Prospective outcomes following drainless superficial parotidectomy with sternocleidomastoid flap reconstruction

Prospective outcomes following drainless superficial parotidectomy with sternocleidomastoid flap reconstruction

Frequency of surgical complications and recurrence rate after extracapsular dissection of benign tumors of the parotid.

Extracapsular Dissection for Small Benign Tumors of Parotid Gland: A Case Report on Contemporary Technique

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