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Oral and Maxillofacial Surgery Clinics... May 2021Transoral parotidectomy allows for the management of parapharyngeal space tumors and accessory parotid gland tumors without the need for a transfacial/transparotid or... (Review)
Review
Transoral parotidectomy allows for the management of parapharyngeal space tumors and accessory parotid gland tumors without the need for a transfacial/transparotid or mandible splitting procedure. It is a minimally invasive approach that permits a faster recovery and with a lesser risk of facial palsy.
Topics: Humans; Parotid Gland; Parotid Neoplasms
PubMed: 33478916
DOI: 10.1016/j.coms.2020.12.002 -
Indian Journal of Otolaryngology and... Dec 2022Traditional parotidectomy incision was devised by Blair (1912) which was modified by Bailey (1941). Over the years various approaches and techniques have evolved to...
Traditional parotidectomy incision was devised by Blair (1912) which was modified by Bailey (1941). Over the years various approaches and techniques have evolved to improve the aesthetic outcome and at the same time for complete disease clearance with reduced complications. In this study, we evaluated the feasibility of our mini-incision parotidectomy technique along with the surgical and quality of life (QOL) outcomes. This prospective case series was conducted at Apollo Hospitals, Bangalore over a period of 2 years (June 2018-August 2020) and includes 20 patients. The surgical outcomes were assessed in terms of feasibility of mini-incision technique with respect to levels of parotid involved and functional outcomes in terms of presence or absence of complications like facial palsy (temporary or permanent), seroma and Frey's syndrome. Patient related quality of life (QOL) outcomes were assessed in terms of post-operative pain score, patient comfort score and cosmetic score by using numerical rating scale-11 (NRS-11). The mini-incision parotidectomy technique is feasible for lesions in all the parotid levels and conversion or lengthening of incision was not needed in any of the cases. 2(10%) patients had temporary facial palsy (House-Brackman grade III) which was recovered within 3 weeks after surgery. One patient (5%) with adenoid cystic carcinoma had permanent facial palsy. Out of 20 patients 2(10%) had seroma and 1(5%) patient presented with Frey's syndrome. Mean post-operative pain score at 0, 6 and 24 h were 4.8, 3.4 and 1.8 out of 10 respectively. Mean comfort score was 9 out of 10 and mean cosmetic score was 9.5 out of 10. Mini-incision parotidectomy technique can render improved functional as well as aesthetic outcomes after parotidectomy without compromising the surgical clearance of the disease process.
PubMed: 36742673
DOI: 10.1007/s12070-021-02882-5 -
Otolaryngologic Clinics of North America Apr 2016Parotidectomy for benign and malignant tumors often results in conspicuous contour abnormalities and soft tissue defects. Immediate reconstruction leads to improved... (Review)
Review
Parotidectomy for benign and malignant tumors often results in conspicuous contour abnormalities and soft tissue defects. Immediate reconstruction leads to improved patient satisfaction and local or regional flaps can be used for reconstruction in most cases. This article provides a systematic approach to parotid reconstruction.
Topics: Humans; Parotid Gland; Parotid Neoplasms; Patient Satisfaction; Plastic Surgery Procedures; Surgical Flaps
PubMed: 26897603
DOI: 10.1016/j.otc.2015.10.012 -
Indian Journal of Otolaryngology and... Oct 2022To assess the parameters' setting of the microscope during parotidectomy and the impact of microscopic parotidectomy on facial nerve functional status. A prospective...
To assess the parameters' setting of the microscope during parotidectomy and the impact of microscopic parotidectomy on facial nerve functional status. A prospective study was conducted on 28 patients in a tertiary care center, who underwent microscopic parotidectomy. Microscope's settings' like magnification, focal length, diameter of the visualized field, and clock position were recorded. Facial nerve functional status was also recorded. All surgeries were performed by right-handed surgeons using Leica F 20 M525 microscope. Clock position of microscope for right parotidectomy ranged between 7 and 10 o clock and for left, it ranged between 7 and 12 o clock. Magnification ranged between 1.3 × and 3.2 ×; magnifications of 1.3 × and 1.8 × were preferred from incision to separation of parotid from sternocleidomastoid muscle, 1.8 × and 2 × for dissection of the facial nerve trunk, and 2 × and 3.2 × for individual branches of the facial nerve. Focal length ranged between 251 and 410 mm and the diameter of the visualized field ranged between 7 and 14.7 cm. Out of 24 cases of benign lesions, 2 (8.3%) developed facial paresis which resolved in 3 months. Two out of four cases of malignancy developed permanent palsy as nerve branches were sacrificed to achieve tumor clearance. Using a microscope for parotidectomy is advantageous for facial nerve dissection, reducing chances of facial paralysis. The microscope was also found to be useful for teaching. The use of appropriate microscopic parameters avoids the glitch of transition from open to microscopic approach.
PubMed: 36452574
DOI: 10.1007/s12070-020-02106-2 -
European Archives of... Dec 2017This editorial explores the controversies concerning the surgical management of the deep portion of the parotid gland. Specifically, when should the parotid deep lobe be...
This editorial explores the controversies concerning the surgical management of the deep portion of the parotid gland. Specifically, when should the parotid deep lobe be removed if there is metastatic cancer to a superficial parotid node or when a primary aggressive cancer is found in the superficial lobe? The background, indications, rationale, and results of removing the deep lobe nodes are reviewed. Removal of the deep lobe is done to optimize the oncologic outcome for the patient. Deep lobe parotidectomy plays an important role in the treatment of many parotid gland malignancies.
Topics: Humans; Lymphatic Metastasis; Parotid Gland; Parotid Neoplasms
PubMed: 29026985
DOI: 10.1007/s00405-017-4767-5 -
Advances in Oto-rhino-laryngology 2016Facial nerve monitoring has been increasingly routinely used as an intraoperative adjunctive method to help the head and neck surgeon to identify and minimize facial... (Review)
Review
Facial nerve monitoring has been increasingly routinely used as an intraoperative adjunctive method to help the head and neck surgeon to identify and minimize facial nerve injury during parotid surgery. The goals, current applications, recent technical advances, and limitations of the method are reviewed. A main focus of this chapter is a review of several prospective clinical trials that have been performed in recent years that have analyzed the benefit of electrophysiological nerve monitoring during parotid surgery. It has been demonstrated that nerve monitoring reduces the risk of early postoperative facial nerve dysfunction in primary surgery, but not in revision surgery. The effect is more pronounced in total than in superficial parotidectomy. Monitoring is associated with shorter surgical times in primary superficial parotidectomy compared to total parotidectomy. Facial nerve stimulation at the completion of parotidectomy helps to prognosticate the facial nerve functional outcome. A lower postdissection to predissection ratio of the maximal response amplitude is associated with early postoperative facial dysfunction. Facial nerve monitoring also helps the surgeon to avoid facial nerve injury when the facial nerve is not exposed during parotid surgery, such as during extracapsular dissection of a parotid neoplasm or sentinel node biopsy.
Topics: Electrophysiological Phenomena; Facial Nerve; Facial Nerve Injuries; Humans; Monitoring, Physiologic; Parotid Gland; Parotid Neoplasms; Postoperative Complications
PubMed: 27093339
DOI: 10.1159/000442124 -
American Journal of Otolaryngology 2023Parotidectomies are rarely performed on an outpatient basis. The specific perioperative outcomes and their management remains insufficiently described to change daily...
PURPOSE
Parotidectomies are rarely performed on an outpatient basis. The specific perioperative outcomes and their management remains insufficiently described to change daily practice. The objectives were to study the outcomes, the complications and the patient satisfaction rate in parotidectomy performed on an outpatient basis.
MATERIALS AND METHODS
We conducted a retrospective monocentric database study on 85 patients who underwent parotidectomy as a first and sole procedure from 2015 to 2020. We analyzed perioperative outcomes between outpatients and inpatients.
RESULTS
Among 28 outpatients and 57 inpatients, no significant differences in total perioperative complications (p = .66; OR = 1.25; 95 % confidence interval (CI) [0.47; 3.36]), reoperations (p = .55), readmissions (p = 1), or unplanned visits (p = .52) were shown in multivariate analysis. The conversion rate for surgical reasons was 8.6 %, and the satisfaction rate was high.
CONCLUSION
Although outpatient parotidectomies should be as safe as for inpatients, the high rate of minor complications requires specific perioperative management, such as a systematic early postoperative visit and optimized preoperative information in order to be carried out with minimal issues.
Topics: Humans; Retrospective Studies; Outpatients; Postoperative Complications; Ambulatory Surgical Procedures; Personal Satisfaction
PubMed: 37437335
DOI: 10.1016/j.amjoto.2023.103974 -
Otolaryngologic Clinics of North America Jun 2021The parotid gland is located in a cosmetically sensitive area. Given cultural emphasis on cosmesis, using minimally invasive or hidden incisions, when appropriate, can... (Review)
Review
The parotid gland is located in a cosmetically sensitive area. Given cultural emphasis on cosmesis, using minimally invasive or hidden incisions, when appropriate, can significantly improve patient satisfaction and quality of life following surgery. Facelift-style incisions have been used since the late 1960s to approach parotid pathology. Several alternative incisions, including technology-assisted approaches, also have been described in the literature. To that end, this article explore the existing data regarding several historical and emerging cosmetic approaches to the parotid gland comparing relative advantages and disadvantages of each.
Topics: Humans; Parotid Gland; Parotid Neoplasms; Patient Satisfaction; Quality of Life; Rhytidoplasty
PubMed: 34024485
DOI: 10.1016/j.otc.2021.02.010 -
Otolaryngologic Clinics of North America Apr 2016Frey syndrome is a common sequela of parotidectomy, and although it is not frequently manifested clinically, it can cause significant morbidity for those affected. Frey... (Review)
Review
Frey syndrome is a common sequela of parotidectomy, and although it is not frequently manifested clinically, it can cause significant morbidity for those affected. Frey syndrome results from synkinetic autonomic reinnervation by transected postganglionic parasympathetic nerve fiber within the parotid gland to the overlying sweat glands of the skin. Many surgical techniques have been proposed to prevent the development of Frey syndrome. For those who develop clinical symptoms of Frey syndrome, objective testing can be performed with a Minor starch-iodine test. Some of the current methods to prevent and treat symptomatic Frey syndrome are reviewed.
Topics: Botulinum Toxins, Type A; Humans; Parotid Gland; Postoperative Complications; Sweat Glands; Sweating, Gustatory
PubMed: 26902982
DOI: 10.1016/j.otc.2015.10.010