Surgical management and side effects of parotid gland surgery for benign lesions: a retrospective analysis of our experience from 2012 to 2021

• Published in: British journal of oral & maxillofacial surgery 2023-07, Vol.61 (6), p.411-415
• Main Authors: Committeri, Umberto, Arena, Antonio, Iaquino, Vincenzo, Salzano, Giovanni, Blasi, Fabio Di, Esposito, Maria, Giovacchini, Francesco, Calvanese, Carlo, Abbate, Vincenzo, Bonavolontà, Paola, Califano, Luigi, Orabona, Giovanni Dell'Aversana
• Format: Article
• Language: English
• Subjects: Adenoma, Pleomorphic - surgery; Benign tumours; Complications; Extracapsular dissection; Facial nerve; Facial Paralysis - complications; Humans; Neoplasm Recurrence, Local - pathology; Parotid Gland - pathology; Parotid Gland - surgery; Parotid Neoplasms - pathology; Parotid Neoplasms - surgery; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Retrospective Studies; Salivary gland surgery; Superficial Parotidectomy; Sweating, Gustatory - etiology
• ISSN: 0266-4356; 1532-1940
• DOI: 10.1016/j.bjoms.2023.03.011

Surgery is the treatment of choice for tumours in the parotid gland. We evaluated complications following parotid surgery. We conducted a retrospective study on 554 patients undergoing parotid surgery for benign parotid tumours from 2012 to 2021. We analysed complication rates between extracapsular dissection (ECD) and superficial parotidectomy (SP). We found 19 capsular ruptures in patients undergoing ECD (5.34%) and five among those undergoing SP (2.52%) [p < 0,05]; 16 cases of temporary facial paralysis among those undergoing ECD (4.49%) and 35 in patients undergoing SP (17.67%) [p < 0,05]; and eight instances of permanent facial nerve paralysis in patients undergoing ECD (2.25%) [p > 0,05] and 13 in patients undergoing SP (6.56%). Among the mid-term complications described were: 22 salivary fistulas among patients operated with ECD (6.18%) [p > 0,05] and 17 in patients with SP (8.58%) 17 sialoceles in those who underwent ECD (4.77%) and seven with SP (3.53%) [p > 0,05]. Regarding late complications, we found: surgical wound dehiscence, pathological scarring (keloid), Frey's syndrome, and recurrence, which affected 45 patients with ECD (12.64%) and 21 with SP for dehiscence (10.6%) [p < 0,05]; 28 keloids in patients with ECD (7.86%) and 15 in patients with SP (7.57%) [p > 0,05]; 12 cases of Frey's syndrome in patients with ECD (3.37%) and 36 with SP (18.18%) [p < 0,05]; and finally 22 recurrences in patients who underwent ECD (6.18%) and 13 in patients who underwent SP (6.56%) [p > 0,05], including 30 in the 273 patients with pleomorphic adenoma and five in the 214 patients with Warthin’s tumour. We can conclude that the onset of the different complications after parotid gland surgery are related to the surgery performed. Our data confirm that there is a tight relationship between type of surgery performed and type of complication.