A meta-analysis of the pros and cons of partial superficial parotidectomy versus superficial parotidectomy for the treatment of benign parotid neoplasms.

OBJECTIVES: Salivary gland tumors are predominantly benign and frequently localized in the parotid gland (P). The treatment consists primarily of surgical removal; however, the appropriate extent remains a subject of debate. In suitable tumors, superficial parotidectomy (SP) may be substituted for less invasive partial superficial parotidectomy (PSP) (I C). This systematic review analyzed the available literature, comparing PSP and SP with regards to several postoperative outcome parameters (O). MATERIALS AND METHODS: Established medical databanks were screened for articles evaluating outcomes of PSP compared with SP, published between 1955 and 2019. These data were assessed by pooled risk and odds ratios via meta-analysis. RESULTS: 11 studies with 1272 patients were included. There was no significant difference in tumor recurrence between PSP and SP (primary outcome). Furthermore, no differences in the occurrence of permanent facial nerve paralysis (FNP), salivary fistula, great auricular nerve analgesia, or hematoma were observed between the groups. However, PSP displayed significantly reduced rates of transient FNP, Frey's syndrome, scar deformity, and xerostomia, as well as shorter surgical time, compared with SP (secondary outcomes). CONCLUSION: Based on these data, PSP can be recommended as a surgical technique for the treatment of superficially located, small, benign parotid tumors.

[Clinical application of midpiece facial nerve dissection in regional parotidectomy].

OBJECTIVE: To propose and evaluate the clinical effect of midpiece facial nerve dissection through transparotid approach in regional parotidectomy. METHODS: A total of 136 patients with benign parotid tumors were categorized into three groups according to the way of facial nerve dissection: anterograde dissection from main trunk (anterograde, n=70), retrograde dissection from distal branches (retrograde, n=34), and midpiece dissection through transparotid approach (middle dissection, n=32). Surgery duration, facial nerve injury, salivary fistula, earlobe sensation, Frey's syndrome, and aesthetic evaluation were compared. RESULTS: The surgery duration in the middle dissection group was significantly shorter than that in the other two groups. The proportion of salivary fistula was higher in the anterograde group (9 cases, 12.9%; P<0.05) compared with that in the other groups. Postoperative facial nerve injury was similar between the middle dissection (1 case, 3.1%) and anterograde groups (3 cases, 4.3%) with lower injury rate compared with the retrograde group (7 cases, 20.6%). The anterograde group had more cases of hypoesthesia of the earlobe (12 cases, 17.1%; P<0.05) than the other two groups. Aesthetic score was higher in the anterograde and middle dissection groups compared with that in the retrograde group (P<0.05). CONCLUSIONS: Midpiece facial nerve dissection is technically feasible and clinically viable in regional parotidectomy.

Clinical application of midpiece facial nerve dissection in regional parotidectomy / 华西口腔医学杂志

OBJECTIVE@#To propose and evaluate the clinical effect of midpiece facial nerve dissection through transparotid approach in regional parotidectomy.@*METHODS@#A total of 136 patients with benign parotid tumors were categorized into three groups according to the way of facial nerve dissection: anterograde dissection from main trunk (anterograde, n=70), retrograde dissection from distal branches (retrograde, n=34), and midpiece dissection through transparotid approach (middle dissection, n=32). Surgery duration, facial nerve injury, salivary fistula, earlobe sensation, Frey's syndrome, and aesthetic evaluation were compared.@*RESULTS@#The surgery duration in the middle dissection group was significantly shorter than that in the other two groups. The proportion of salivary fistula was higher in the anterograde group (9 cases, 12.9%; P<0.05) compared with that in the other groups. Postoperative facial nerve injury was similar between the middle dissection (1 case, 3.1%) and anterograde groups (3 cases, 4.3%) with lower injury rate compared with the retrograde group (7 cases, 20.6%). The anterograde group had more cases of hypoesthesia of the earlobe (12 cases, 17.1%; P<0.05) than the other two groups. Aesthetic score was higher in the anterograde and middle dissection groups compared with that in the retrograde group (P<0.05).@*CONCLUSIONS@#Midpiece facial nerve dissection is technically feasible and clinically viable in regional parotidectomy.

Extracapsular dissection of the upper part of parotid gland benign tumor using a tragus edge combined retroauticular hairline incision approach / 口腔疾病防治

Objective@#To investigate the clinical effect of dissection in the upper part of parotid gland benign tumor using a tragus edge combined retroauticular hairline incision approach.@*Methods@#20 cases of upper part of parotid gland benign tumor were resected using the tragus edge combined retroauticular hairline incision approach, the surgery and cosmetic effect were analyzed. @*Results@#Parotid gland tumors were checked by CT before the operation and diagnosed by frozen section analysis during the operation. The tumors were successfully complete resected in all cases. There were no complications of Frey’s syndrome, postoperative bleeding, and flap necrosis, 2 cases showed a temporary earlobe numbness, 1 case of temporary facial nerve paralysis and 1 case of salivary fistula. There were no tumor recurrence after 24 ~ 48 months followed up. Surgical incision cosmetic effect is satisfactory. @*Conclusion@#The tragus edge combined retroauticular hairline incision is safe and feasible, with less complications for the upper part of parotid gland benign tumor resecetion.