Functional outcomes of superficial and conservative total parotidectomy: a 4-year experience from Benha, Egypt

Abstract

Purposes The aim of this study was to find out the frequency of the functional outcomes related to superficial and conservative total parotidectomy. Background Functional outcomes especially facial nerve injury and Frey's syndrome during parotid surgery represent annoying problem, as it is associated with cosmetic problems and multiple physician visits; 'to minimize these outcomes' remains in question. Patients and methods The study included 52 patients; 6 (11.5%) were below 35 years of age, 28 (53.8%) were between 35 and 50 years of age, and 18 (34.7%) were above 50 years of age. All patients underwent clinical evaluation, laboratory assessment, ultrasound, computed tomography scan, and MRI examination. All patients underwent either superficial or conservative total parotidectomy. Results In this study, immediately postoperatively, facial nerve injury was observed in 20 patients; in this series, 14 (70%) developed temporary facial palsy, whereas 6 (30%) developed permanent facial paralysis. Cervical branch was the most commonly injured nerve 8 (40%). Symptomatic Frey's syndrome was observed in 5 (9.6%), and parotid leak was observed in 11 (27.5%); all were observed in superficial parotidectomy as sialocele in 5 (12.5%), glandular fistula in 4 (10%), and ductal fistula in 2 (5%). Conclusion Facial nerve injury is more common in total conservative parotidectomy than in superficial parotidectomy. Early detection of nerve injury is quite helpful to reduce the facial deformity by early reconstruction and other procedures. However, parotid leak is only observed in superficial parotidectomy; most of this leak can be managed conservatively except ductal fistula. Symptomatic Frey's syndrome is more common in superficial parotidectomy.