Abstract
Background: Parotid surgery with dissection of the facial nerve branches is a technically challenging surgery. Even in experienced hands, parotidectomy has well-documented post-operative complications. We aim to evaluate complications following parotid surgery. Methods: We retrospectively reviewed the charts of 187 patients who underwent parotidectomy from January 2010 to January 2020 performed in surgical oncology department South Egypt Cancer Institute, Assiut University, from patients (57.3% males and 42.7% females, average age 42.96 years). Results: 78.4% Patients had benign tumors, the most frequent being pleomorphic adenoma 55.1% followed by Warthin’s tumour 16.9%, and 21.6% malignant tumors, mucoepidermoid carcinoma being the most frequent. Superficial parotidectomy was the most common surgery 40.4% performed followed by 25.3%, total conservative parotidectomy, while 1.1%, underwent radical parotidectomy, (extended radical parotidectomy was performed 2.2%), and revision total parotidectomy (Recurrence 6.7%, and parotidectomy with modified radical neck dissection (MRND) 7.9%. The most common complication following parotidectomy was transient facial nerve palsy 21.3%. Permanent facial nerve paresis was observed in 3.9%, sensory deficit in 20.2%, sialocele in 6.7%, hematoma formation 3.4% and wound infection in 7.3%, and recurrence 7.3%. Frey’s syndrome occurred in 7.3% and salivary fistula 5.1%. Conclusion: Parotidectomy is safe procedure causing minimal complications. Transient facial palsy is the most common postoperative complication.
Highlights
Salivary gland tumors represent 3% - 10% of all head and neck neoplasms
We retrospectively reviewed the charts of 187 patients who underwent parotidectomy from January 2008 to January 2018 performed in surgical oncology department South Egypt Cancer Institute, Assiut University, from patients (57.3% males and 42.7% females, average age 42.96 years)
Superficial parotidectomy was the most common surgery 40.4% performed followed by 25.3%, total conservative parotidectomy, while 1.1%, underwent radical parotidectomy, and revision total parotidectomy (Recurrence 6.7%, and parotidectomy with modified radical neck dissection (MRND) 7.9%
Summary
Salivary gland tumors represent 3% - 10% of all head and neck neoplasms. About 80% of the salivary gland tumors occur in the parotid gland. Today the widely accepted procedures for benign parotid gland tumours are superficial parotidectomy and extra capsular resection while for malignant disorders range from total to extended parotidectomy [3]. The complications of parotid surgery are facial nerve damaging, bleeding, hematoma, seroma, sialocele, saliva fistula, infection, keloid formation, and Frey syndrome [10]. Superficial parotidectomy was the most common surgery 40.4% performed followed by 25.3%, total conservative parotidectomy, while 1.1%, underwent radical parotidectomy, (extended radical parotidectomy was performed 2.2%), and revision total parotidectomy (Recurrence 6.7%, and parotidectomy with modified radical neck dissection (MRND) 7.9%. The most common complication following parotidectomy was transient facial nerve palsy 21.3%. Permanent facial nerve paresis was observed in 3.9%, sensory deficit in 20.2%, sialocele in 6.7%, hematoma formation 3.4% and wound infection in 7.3%, and recurrence 7.3%.
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