Parotid Gland Tumors: A Survey of UK Management Practice

Abstract

Objective: Identify if practice variations exist in the management of parotid lesions between otolaryngologists and oral maxillofacial specialists (OMFS). Benign and malignant parotid surgery is undertaken by both otolaryngologists and OMFS. Between the specialties there is debate about the surgical approach to parotid tumors. Method: An online questionnaire (SurveyMonkey) was sent to members of ENT-UK via email. The members of the British Association of Oral and Maxillofacial Surgeons (BAOMS) were posted a questionnaire that was either returned by post or completed online. Results: A total of 108 otolaryngologists and 98 OMFS res-ponded to the questionnaire, all of whom performed parotid surgery. The majority (75.2%) of otolaryngologists used facial nerve monitors in all/most cases whereas 73.1% OMFS used them never/seldom. In revision surgery 88.3% of otolaryngologists mostly/always used a facial monitor compared to 38% of OMFS with 39.1% never/seldom using one. The choice of surgery for a presumed pleomorphic adenoma showed the most difference between the two groups: 87.6% of otolaryngologists would perform a partial parotidectomy, yet 34.5% of OMFS would remove the tumor by extracapsular dissection of the tumor without a cuff. Conclusion: There are marked differences in the approach to parotid disease between OMFS and otolaryngologists, particularly in the intra-operative monitoring and the surgical approach.