32 Parotidectomy in children and young adults: a review of 10 cases

Abstract

Introduction: Parotidectomy in children and young adults is uncommon and there is a paucity of studies in this area. Methods: We retrospectively analysed clinico-pathological profile of all cases of parotidectomy in patients under the age of 25 at York Hospital by one consultant over 15 years from 1994 to 2009. Results: A total of 10 cases (M:F = 1:1.5) were identified. Eight of them were under the age of 16 (median age 8.5 years, range 7 months to 24 years). The most common symptom was painless swelling and the mean duration of symptom was 2.4 years (3 weeks to 10 years). The CT scan was the most commonly undertaken investigation followed by fine needle aspiration. A superficial parotidectomy was performed in 7 cases, while a total parotidectomy with preservation of facial nerve was performed in 3 cases. The mean inpatient stay was 2.3 days (2–5 days). The histological diagnoses included 2 cases each of pleomorphic adenoma and branchial arch remnant fistula and 1 case each of sialadenitis, haemangioma, tuberculosis, cat scratch disease, lymphangioma and sarcoidosis. The histological diagnosis matched clinical diagnosis only in 50% of the cases. The most common type of complication was transient facial nerve weakness. Conclusion: A variety of conditions which are difficult to diagnose clinically can affect the parotid gland in children and young adults requiring surgical intervention. Parotidectomy can be performed in this age group with minimal morbidity. We discuss surgical anatomy and technique as well as literature review on each condition affecting the parotid gland.