Randomized clinical trial comparing partial parotidectomy versus superficial or total parotidectomy

Abstract

In recent decades the treatment of benign parotid tumours has shifted from superficial or total parotidectomy to partial parotidectomy. This study examined whether current surgical techniques improved functional outcomes after surgery for benign parotid tumours. One hundred and one patients were assigned randomly to conventional (49 patients) or function-preserving (52) surgery. The latter consisted of modified facelift incision, greater auricular nerve preservation, partial parotidectomy and coverage with parotid fascia. The mean duration of operation was 0.7 h shorter and the overall complication rate significantly lower in the functional surgery group. In this group, more patients were satisfied with their scars and facial contours, the auricular nerve sensory recovery rate was high, and transient facial paralysis and Frey's syndrome were infrequent (12 and 6 per cent respectively). Stimulated salivary flow on the operated side decreased to 71.9 per cent after function-preserving surgery compared with 20.7 per cent after conventional operation. There was no tumour recurrence in either group during a mean follow-up of 48 months. Compared with conventional procedures, function-preserving surgery for benign parotid tumours improved cosmetic, sensory and salivary functions, and reduced the duration of surgery and operative morbidity.