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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 -
Annals of Plastic Surgery Oct 2021In the last 2 decades, authors have gained considerable interest in modifying the age-old classical parotidectomy incisions to address cosmetic concerns of their... (Review)
Review
In the last 2 decades, authors have gained considerable interest in modifying the age-old classical parotidectomy incisions to address cosmetic concerns of their patients. The article reviews all the incisions that have been introduced over time after modified facelift and Blair incision for performing parotidectomy. These include retroauricular hairline approach, Arden technique, trichophytic incision, periauricular incision, intraauricular modification of facelift approach, endaural approach, postaural approach, Panda technique, preauricular crutch approach, and mini Blair incision. Although these have been reported to be safe, feasible, and cosmetically better approaches, at present, the absence of well-designed prospective observational and interventional studies do not warrant them to be widely used in clinical practice. This will guide surgeons in making patient curated parotidectomy incisions under special circumstances. Currently, these remain limited to the hands of experienced surgeons in high volume centers.
Topics: Humans; Observational Studies as Topic; Parotid Neoplasms; Rhytidoplasty
PubMed: 33625025
DOI: 10.1097/SAP.0000000000002757 -
Otolaryngologic Clinics of North America Jun 2021This article provides a review of soft tissue reconstructive options for the parotidectomy defect, including skin incision, primary closure, acellular dermis, autologous... (Review)
Review
This article provides a review of soft tissue reconstructive options for the parotidectomy defect, including skin incision, primary closure, acellular dermis, autologous fat transfer, local and regional flaps, and free tissue transfer. The authors discuss considerations for volume enhancement, skin coverage, prevention of Frey syndrome, tumor surveillance, and potential complications.
Topics: Humans; Plastic Surgery Procedures; Surgical Flaps; Sweating, Gustatory
PubMed: 34024484
DOI: 10.1016/j.otc.2021.02.009 -
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 tumors is undergoing constant evolution. The potential for recurrence and malignant transformation of pleomorphic adenomas creates complexities... (Review)
Review
Parotidectomy for benign tumors is undergoing constant evolution. The potential for recurrence and malignant transformation of pleomorphic adenomas creates complexities that have forced head and neck surgeons to undertake more comprehensive parotid surgery with facial nerve dissection. This approach carries inherent morbidities, including facial nerve injury, Frey syndrome, and facial asymmetry, that have to be addressed. Extracapsular dissection is compared with conventional superficial parotidectomy; surgical histologic findings are discussed as well as outcome data. More novel approaches are discussed as well. This article provides a systematic approach to benign parotid tumor surgery.
Topics: Adenoma, Pleomorphic; Facial Nerve Injuries; Humans; Neoplasm Recurrence, Local; Parotid Gland; Parotid Neoplasms; Postoperative Complications; Sweating, Gustatory
PubMed: 27040586
DOI: 10.1016/j.otc.2015.10.006 -
The Journal of Laryngology and Otology Oct 2021To report the clinical outcomes of patients with chronic parotid sialadenitis treated with superficial parotidectomy, and to review the literature. (Comparative Study)
Comparative Study Review
OBJECTIVES
To report the clinical outcomes of patients with chronic parotid sialadenitis treated with superficial parotidectomy, and to review the literature.
METHODS
A retrospective case series was conducted of all patients undergoing parotidectomy for chronic parotid sialadenitis at our institution between 2009 and 2018.
RESULTS
Eighteen superficial parotidectomies were performed, resulting in complete symptom resolution in 17 patients. There was only one recurrence, of a milder form of the disease, requiring no specific treatment. Eight temporary post-operative facial nerve palsies and one permanent palsy occurred. Further complications included post-operative wound haematoma, seroma, Frey's syndrome, neuropathic pain and wound infection.
CONCLUSION
Superficial parotidectomy is sufficient to control patient symptoms, avoiding the increased morbidity associated with near-total parotidectomy. The literature does not point to a clear difference in either the incidence of recurrence or the risk of a facial nerve palsy between the two procedures. Furthermore, the symptoms attributed to recurrence are often not severe enough to warrant salvage near-total parotidectomy.
Topics: Adult; Aged; Facial Nerve Diseases; Facial Paralysis; Female; Hematoma; Humans; Incidence; Male; Middle Aged; Neuralgia; Parotid Diseases; Postoperative Complications; Recurrence; Retrospective Studies; Seroma; Sialadenitis; Surgical Wound Infection; Sweating, Gustatory; Treatment Outcome; Wounds and Injuries
PubMed: 34353395
DOI: 10.1017/S0022215121002115 -
Head & Neck Feb 2021The primary aim of this study was to conduct a systematic review and meta-analysis to compare complications between outpatient vs inpatient parotidectomy. A systematic... (Meta-Analysis)
Meta-Analysis Review
The primary aim of this study was to conduct a systematic review and meta-analysis to compare complications between outpatient vs inpatient parotidectomy. A systematic review was performed to identify patients undergoing either outpatient or inpatient partodiectomy, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, using PUBMED, SCOPUS, CINAHL, and the Cochrane library. Risk of bias was assessed using the Newcastle-Ottawa Scale. Postoperative complications (hematoma, seroma/sialocele, salivary fistula formation, Frey syndrome, surgical site infection [SSI]) were compared. Our search yielded 4958 nonduplicate articles, of which 13 studies were ultimately included (11 retrospective cohort, 2 prospective cohort), encompassing a total of 1323 patients (outpatient 46.33% vs inpatient 53.67%). There was no significant difference in total complications, hematoma, seroma, salivary fistula, or SSI rates between outpatient and inpatient groups. No significant difference in total complications was found between outpatient and inpatient groups when stratified by surgical approach (partial/superficial and total parotidectomy). Our findings suggest outpatient parotidectomy may be as safe as inpatient parotidectomy in appropriately selected patients.
Topics: Humans; Inpatients; Outpatients; Parotid Gland; Postoperative Complications; Prospective Studies; Retrospective Studies
PubMed: 33009691
DOI: 10.1002/hed.26482 -
Healthcare (Basel, Switzerland) Apr 2022Surgery with parotidectomy is the preferable treatment for most parotid tumors. Our meta-analysis compared the differences between the use of the LigaSure (LS) device... (Review)
Review
Surgery with parotidectomy is the preferable treatment for most parotid tumors. Our meta-analysis compared the differences between the use of the LigaSure (LS) device and the conventional suture ligation technique (CT) in parotidectomies. A literature search in databases including EMBASE, MEDLINE, and the Cochrane Library was carried out. Studies including parotidectomy using LS and CT were included with the intraoperative and postoperative parameters collected. Continuous operative time data were measured by mean differences (MDs). Discrete data on postoperative complications, including facial palsy, postoperative bleeding, and salivary complications, were evaluated with risk differences (RDs). All values were reported with 95% confidence intervals (CIs). Five studies were included in our meta-analysis. The pooled analysis demonstrated a significant reduction in operative time in the LS group (MD: -21.92; 95% CI, -30.18 to -13.66). In addition, the analysis indicated that the incidence of postoperative complications, including permanent facial palsy (RD, -0.01; 95% CI, -0.06 to 0.05), temporary facial palsy (RD, 0.00; 95% CI, -0.03 to 0.04), salivary complications (RD, -0.01; 95% CI, -0.08 to 0.06), and postoperative bleeding (RD, -0.02; 95% CI, -0.07 to 0.04), were all similar between the LS group and the CT group. According to the results, the LS device appears to be a safe and useful tool and could shorten the operative time in patients needing parotidectomy.
PubMed: 35455883
DOI: 10.3390/healthcare10040706 -
Ear, Nose, & Throat Journal Dec 2022First bite syndrome (FBS) is a rare but potentially debilitating complication observed after surgery involving the upper cervical region. Patients classically complain... (Review)
Review
INTRODUCTION
First bite syndrome (FBS) is a rare but potentially debilitating complication observed after surgery involving the upper cervical region. Patients classically complain of severe facial pain in the ipsilateral parotid region with the first few bites of a meal.
OBJECTIVE
The aim of this study is to shed light on the incidence and potential risk factors of FBS, including a series of cases depicting FBS observed after parotidectomy.
METHODS
Retrospective review of 419 patients who underwent parotidectomy at a single tertiary care facility between December 2016 and June 2020.
RESULTS
With a mean follow-up time of 16.5 months, 8 (2%) patients were documented to have symptoms of FBS after parotid gland surgery. Six of these patients underwent partial parotidectomy by dissection of the deep lobe of the parotid (DLP).
CONCLUSION
Patients undergoing dissection of the DLP are particularly at risk for the development of FBS. All patients should be appropriately counseled during informed consent discussions, especially in high-risk cases.
Topics: Humans; Mastication; Parotid Gland; Parotid Region; Syndrome; Retrospective Studies; Facial Pain; Parotid Neoplasms; Postoperative Complications
PubMed: 33314982
DOI: 10.1177/0145561320980179 -
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