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Partial Superficial, Superficial, and Total Parotidectomy in the Management of Benign Parotid Gland Tumors: A 10-Year Prospective Study of 205 Patients.
Journal of Oral and Maxillofacial Surgery 2018 Februrary
PURPOSE: The aim of this report is to present an overview of the authors' experience in treating parotid gland tumors for a period of 10 years. This report describes patients' demographics, surgical outcomes, and complications and discusses the management of benign disease with particular emphasis on the importance of facial nerve dissection.
PATIENTS AND METHODS: A total of 205 consecutive patients with different parotid gland tumors underwent surgery at Northampton General Hospital (Northampton, UK) from October 2000 to November 2010. Data were prospectively collected and entered into an electronic database. Patients' demographics, clinical tumor size, type of operation, fine-needle aspiration result, facial nerve status, final histopathologic report, and intraoperative and postoperative complications were recorded and analyzed.
RESULTS: This study confirmed that good results in low recurrence rate and minimal risk of facial nerve weakness can be achieved with operations less aggressive than traditional superficial parotidectomy, such as partial superficial parotidectomy. Transient facial nerve palsy was significantly more frequent after total (40%; P < .001) and superficial (28%; P < .05) parotidectomy, respectively, than after partial superficial parotidectomy (9.6%).
CONCLUSION: Because the risk or recurrence is higher when surgery is performed by inexperienced surgeons, the authors advocate that parotid gland surgery should be performed by adequately trained operators and the surgical specimen ideally should be examined by a histopathologist experienced in the diagnosis of salivary gland tumors. Recurrence rate for these tumors increases with time; therefore, long-term follow-up is required for these patients.
PATIENTS AND METHODS: A total of 205 consecutive patients with different parotid gland tumors underwent surgery at Northampton General Hospital (Northampton, UK) from October 2000 to November 2010. Data were prospectively collected and entered into an electronic database. Patients' demographics, clinical tumor size, type of operation, fine-needle aspiration result, facial nerve status, final histopathologic report, and intraoperative and postoperative complications were recorded and analyzed.
RESULTS: This study confirmed that good results in low recurrence rate and minimal risk of facial nerve weakness can be achieved with operations less aggressive than traditional superficial parotidectomy, such as partial superficial parotidectomy. Transient facial nerve palsy was significantly more frequent after total (40%; P < .001) and superficial (28%; P < .05) parotidectomy, respectively, than after partial superficial parotidectomy (9.6%).
CONCLUSION: Because the risk or recurrence is higher when surgery is performed by inexperienced surgeons, the authors advocate that parotid gland surgery should be performed by adequately trained operators and the surgical specimen ideally should be examined by a histopathologist experienced in the diagnosis of salivary gland tumors. Recurrence rate for these tumors increases with time; therefore, long-term follow-up is required for these patients.
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