Functional outcomes after extracapsular dissection with partial facial nerve dissection for small and large parotid neoplasms.

Abstract

Multiple surgical options exist for benign parotid tumors without agreement upon a single, best approach. We evaluated the short-term outcomes and rate of complications using the ECD-FND technique for small and large parotid neoplasms involving the superficial and deep lobes of the parotid gland using a categorical approach. A single surgeon retrospective cohort study with analysis of patient demographics, outcomes, and complication rates was conducted of patients undergoing the ECD-FND for benign parotid neoplasm. Cases from May 2014 to May 2020 with at least 6months follow up were considered. Complications were assessed by chart review and tumors were categorized by size and by European Salivary Gland Society (ESGS) classification assigned by a neuroradiologist. Fifty-one patients who underwent ECD-FND of suspected benign parotid mass met inclusion criteria. The most common histology was pleomorphic adenoma (56.9%) followed by Warthin's tumor (19.6%). Overall rate of complications was 31.4% with no major complications. Most patients (88.2%) had normal facial nerve function immediately after surgery and all recovered completely in the post operative period. Sialocele occurred in 15.7% of patients with 87.5% resolved within one month and seromas occurred in four patients (7.8%). There was no significant difference in complication rates between the size of tumor (p=0.889), depth (p=0.770), or ESGS classification (p=0.846). The ECD-FND technique achieved excellent facial nerve outcomes among our cohort, which included a - proportion of large (>3cm) and deep lobe tumors. Complications rates and outcomes were similar for larger and deep lobe tumors that underwent a ECD-FND approach. 3.