Evolution and changing trends in surgery for benign Parotid tumors

• Published in: The Laryngoscope 2015-01, Vol.125 (1), p.122-127
• Main Authors: Mantsopoulos, Konstantinos, Koch, Michael, Klintworth, Nils, Zenk, Johannes, Iro, Heinrich
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; benign tumors; Child; Child, Preschool; extracapsular dissection; facial palsy; Facial Paralysis - epidemiology; Facial Paralysis - etiology; Female; Frey's syndrome; Germany; Humans; Incidence; Infant; Male; Medical research; Middle Aged; Minimally Invasive Surgical Procedures - methods; Minimally Invasive Surgical Procedures - trends; Otorhinolaryngologic Surgical Procedures - methods; Otorhinolaryngologic Surgical Procedures - trends; Parotid gland; Parotid Gland - pathology; Parotid Gland - surgery; Parotid Neoplasms - pathology; Parotid Neoplasms - surgery; partial parotidectomy; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Retrospective Studies; Surgery; Sweating, Gustatory - epidemiology; Sweating, Gustatory - etiology; Trends; Young Adult
• ISSN: 0023-852X; 1531-4995
• DOI: 10.1002/lary.24837

Objective/Hypothesis The ideal extent of surgical intervention for benign parotid tumors remains a matter of controversy. The aim of the study was to trace the development of surgical therapy in a large cohort, explore its changes in a single institution specializing in salivary gland pathologies over the last 12 years, and determine the extent to which a possible shift in the surgical therapy of parotid benign tumors toward less radical methods was correlated with a change in the incidence of facial palsy and Frey's syndrome. Study Design Retrospective clinical study. Methods A retrospective evaluation of the records for all patients treated for benign parotid tumors between 2000 and 2012 at a tertiary referral center was carried out. Surgical methods were classified into four groups: extracapsular dissection, partial superficial parotidectomy, superficial parotidectomy, and complete parotidectomy. Results A total of 1,624 patients were included in the study. Our analysis demonstrated an increase in the total number of parotidectomies for benign lesions from 71 (2000) to 184 (2012), mostly due to the increase in extracapsular dissections (from 9 to 123). Increased performance of less radical surgery was associated with a significantly decreased incidence of temporary and permanent facial palsies (from 22.8% to 9% and 9.8% to 5.9%, respectively) and Frey's syndrome (from 11.3% to 1.6%). Conclusions One of the most controversial issues in the treatment of benign parotid tumors is the best therapeutic approach to be taken in such patients. Our study showed that increased performance of less radical surgery was associated with better functional outcomes. Level of Evidence 2b. Laryngoscope, 125:122–127, 2015