Total conservative parotidectomy for management of benign parotid neoplasms

Tarek Abd El-Rahman Abd El-Hafez,Ashraf Ali El-Demerdash,Ahmad Helmy Zayan,Mohamed El Noaman,Yasser Abd El-Wahab Khalil

doi:10.1186/s43163-020-00046-w

Tarek Abd El-Rahman Abd El-Hafez, Ashraf Ali El-Demerdash + Show 3 more

Open Access

https://doi.org/10.1186/s43163-020-00046-w

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Abstract

BackgroundThis study assesses the outcomes of total conservative parotidectomy in the management of benign parotid neoplasms. A retrospective review was conducted for all parotidectomies for benign superficial parotid neoplasms from 2013 to 2018. Facial nerve dysfunction, recurrence, and other side-effects were collected and statistically analyzed.ResultsA total of 21 patients were included in our study. Our series included a pleomorphic adenoma (16 patients), Warthin tumor (4 patients), and oncocytoma (1 patient). Overall, 12 patients had temporary facial nerve paresis (57.1%), 3 patients had temporary paralysis (14.3%)—no reported cases of permanent paralysis—and 6 patients sustained postoperative good facial nerve function (28.6%). No recurrence was reported in our study period. Other side effects included hemorrhage (1 patient), hematoma (2 patients), seroma (4 patients), and partial skin flap necrosis (2 patients). As well, Frey’s syndrome was reported in 11 patients, and most of them were managed conservatively.ConclusionsTotal conservative parotidectomy is a valuable approach for removing parotid tumors. The rate of complications after this procedure (facial nerve dysfunction and recurrence) is low provided that the technique was performed with meticulous care.

Highlights

This study assesses the outcomes of total conservative parotidectomy in the management of benign parotid neoplasms
Tumors of the parotid gland constitute more than 75% of these neoplasms, and most of them are benign in nature
This study was conducted at university hospital after ethical approval from institutional review board, and we reviewed retrospectively all parotidectomies for benign parotid neoplasms from 2013 to 2018

Summary

Introduction

This study assesses the outcomes of total conservative parotidectomy in the management of benign parotid neoplasms. A retrospective review was conducted for all parotidectomies for benign superficial parotid neoplasms from 2013 to 2018. Recurrence, and other side-effects were collected and statistically analyzed. Three to 10% of head and neck tumors occur in salivary glands [1]. Tumors of the parotid gland constitute more than 75% of these neoplasms, and most of them are benign in nature. Pleomorphic adenoma is the most encountered benign neoplasm among them with 60–70% incidence [2]. Surgical resection of benign parotid lesions remains challenging being doubleedged by recurrence and significant risk of facial nerve injury [3]. In the 1940s, intracapsular enucleation was introduced as management for pleomorphic adenoma. Leaving the tumor capsule in situ resulted in 45% of recurrence.

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