HN05 AN ANALYSIS OF COMPLICATIONS FOLLOWING SURGICAL TREATMENT OF BENIGN PAROTID DISEASE

Abstract

The purpose of this study was to review the incidence of and risk factors for, developing complications following parotidectomy for benign disease. In an 11 year period, 162 parotidectomies were performed for benign disease, the commonest being PSA (43%), Warthin’s (30%) and sialadenitis (22%). There were 71 males/91 females, mean age was 58 years and 79% presented with a painless mass of 26 months. 134 patients underwent a superficial parotidectomy and the mean follow‐up was 23 months. Post‐operatively 40% developed a temporary facial palsy, 11% had Frey’s syndrome and 10% developed a salivary fistula. Sialadenitis was a significant risk factor for the development of facial nerve palsy (p < 0.01) and increased the risk of salivary fistulae. Parotid duct ligation increased the risk of nerve palsy in the distribution of the zygomatic and buccal branches. Operations for Warthin’s tumour were associated with an elevated risk of dysfunction of the cervical branch of the facial nerve. Half of the patients had intra‐operative facial nerve stimulation and this uninfluenced the liklehood of facial paresis. The recovery of facial nerve function showed a biphasic distribution, with 90% of patients having normal function within 12 months, followed by a slower recovery rate for up to two years. In conclusion, the incidence of post‐operative complications was influenced by the pathology, with inflammatory lesions significantly increasing the risk of facial nerve dysfunction and other complications, but also by variations in surgical practice, such as parotid duct ligation. Overall, the incidence of permanent facial palsy was under 2%, but a temporary nerve palsy was common at 40%, with most patients regaining normal function within one year of surgery.