Parotid gland surgery: 5â€years review and short and mediumâ€term results of morbidity

Isabel Esteves Costa, António Fontes Lima, Cátia Azevedo, Fernando Mar, Berta Madureira Rodrigues, Luís Dias

Resumen

Objective: Analysis of the impact of clinical and surgical variables on post-operative complications in patients submitted to parotid surgery in the last 5 years in our institution. 

Material and methods: Retrospective study through collection of sociodemographic, clinical and surgical data, such as age/gender, presenting symptoms, type of surgery, post-operative complications and recurrence/cure rates.

Results: Thirty patients underwent parotidectomy due to benign (76.7%) and malignant (23.3%) pathology, with an average age of 55.3 years (SD 17.7). Pleomorphic adenoma was the most common diagnosis (n=17). Partial parotidectomy was performed in 83.7% of cases (n=26). The extent of surgery was correlated with more postoperative morbidity (p=.038). Neck dissection (ND) was performed in 33% of patients, who did not presented higher risk of post-operative complications. Post-operative complications were seen in 33.3% (n=10), and of these, 6 patients described a transitory cutaneous sensory deficit of the incision area. Permanent facial nerve injury (FNI) was seen in 10% of cases (n=3) and this particular group had significantly larger parotid lesions (p=.01).

Conclusions: Because of function preservation and less complication rates, the authors advice that minimally invasive surgery should always be considered, especially in benign tumors. FNI is one of the most concerning complications, with temporary and permanent FN dysfunction incidence reports of 18-65% and 0-19%, respectively. In this study, permanent dysfunction of the FN seemed to be influenced by dimensions of tumor. In parotid gland carcinoma, our study and other reports suggests that the risk of occult nodal disease is high enough to warrant elective ND, without significant associated morbidity.

Palabras clave

parotid cancer, minimally invasive surgical procedures, postoperative complications, facial nerve injuries

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Referencias

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