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Minimally Invasive Approach for the Parotid Gland Neoplasm: A Multicenter Retrospective Analysis

Year 2025, Volume: 8 Issue: 1, 81 - 84

Abstract

Objective: Recently extracapsular dissection (ECD) for the parotid gland neoplasm have gained popularity, but the data about functional outcomes and complication rates are still limited and surgical technique is not standard. In this multicenter study, we have evaluated the safety, complications, utility and functional outcomes of ECD and necessity of drain requirement.
Methods: This study was conducted as a retrospective multicenter study and two tertiary academic referral centers were involved. Records of the subjects who underwent extracapsular dissection between January 2015 and January 2017 were reviewed. Demographic data, size and location of tumors, results of fine needle aspiration cytology, intraoperative adverse events such as capsule rupture or facial nerve damage, postoperative complications, results of definitive pathology, and hospitalization time of the subjects were reviewed.
Results: A total of 37 subjects were included in the study. There were no subjects with permanent or transient facial nerve dysfunction in either group. No patient complained of symptoms of Frey syndrome. Seroma developed in two of 37 patients. No recurrence has been encountered during the follow up period (min: 36 and max: 72 months).
Conclusion: ECD is a safe technique with very low complications rates according to our results. Even without facial nerve monitoring, ECD could be performed without any damage to the nerve, if surgeon is experienced. Preoperative evaluation is important and patients with small, mobile and solitary benign parotid lesions are good candidates for ECD.

References

  • 1.Hugo NE, McKinney P, Griffith BH. Management of tumors of the parotid gland. Surg Clin North Am. 1973;53:105-11. https://doi.org/10.1016/S0039-6109(16)39936-4
  • 2.Spiro RH, Koss LG, Hajdu SI et al. Tumors of minor salivary origin. A clinicopathologic study of 492 cases. Cancer. 1973;31:117-29. https://doi.org/10.1002/1097-0142(197301)31:1<117::AID-CNCR2820310116>3.0.CO;2-7
  • 3.Kızıl Y, Aydil U, Ekinci O et al. Salivary gland tumors in Turkey: demographic features and histopathological distribution of 510 patients. Indian J Otolaryngol Head Neck Surg. 2013;65(Suppl 1):112-20. https://doi.org/10.1007/s12070-012-0594-6
  • 4.Benedict EB, Meigs J. Tumours of the parotid gland: a study of two hundred and twenty-five cases with complete end results in eighty cases. Surg Gynecol Obstet 1930;51:626-47

  • 5.Bradley PJ. The recurrent pleomorphic adenoma conundrum. Curr Opin Otolaryngol Head Neck Surg. 2018;26:134-41. https://doi.org/10.1097/MOO.0000000000000435
  • 6.Johnson JT, Ferlito A, Fagan JJ et al. Role of limited parotidectomy in management of pleomorphic adenoma. J Laryngol Otol. 2007;121:1126-8. https://doi.org/10.1017/S0022215107000345
  • 7.McFarland J. Three hundred mixed tumours of the salivary glands of which 69 recurred. Surg Gynecol Obstet 1936;63:457-68.

  • 8.Janes RM. The treatment of tumours of the salivary glands by radical excision. CMAJ 1940;43:554-9.
 9.Bailey H. Treatment of tumours of the parotid gland with special reference to total parotidectomy. Br J Surg 1941;28:337-46.
 https://doi.org/10.1002/bjs.18002811102
  • 10.Roh JL, Kim HS, Park CI. Randomized clinical trial comparing partial parotidectomy versus superficial or total parotidectomy. Br J Surg. 2007;94:1081-7. https://doi.org/10.1002/bjs.5947
  • 11.Iizuka K, Ishikawa K. Surgical techniques for benign parotid tumors: segmental resection vs extracapsular lumpectomy. Acta Otolaryngol Suppl. 1998;537:75-81. https://doi.org/10.1080/00016489850182396
  • 12.Gleave EN, Whittaker JS, Nicholson A. Salivary tumours--experience over thirty years. Clin Otolaryngol Allied Sci. 1979;4:247-57. https://doi.org/10.1111/j.1365-2273.1979.tb01897.x
  • 13.Witt RL. Minimally invasive surgery for parotid pleomorphic adenoma. Ear Nose Throat J 2005;84:308-11.
 https://doi.org/10.1177/014556130508400517
  • 14.Smith SL, Komisar A. Limited parotidectomy: the role of extracapsular dissection in parotid gland neoplasms. Laryngoscope. 2007;117:1163-7. https://doi.org/10.1097/MLG.0b013e31806009fe
  • 15.McGurk M, Thomas BL, Renehan AG. Extracapsular dissection for clinically benign parotid lumps: reduced morbidity without oncological compromise. Br J Cancer. 2003;89:1610-3. https://doi.org/10.1038/sj.bjc.6601281
  • 16.Kato MG, Erkul E, Nguyen SA et al. Extracapsular Dissection vs Superficial Parotidectomy of Benign Parotid Lesions: Surgical Outcomes and Cost-effectiveness Analysis. JAMA Otolaryngol Head Neck Surg. 2017;143:1092-7. https://doi.org/10.1001/jamaoto.2017.1618
  • 17.Mantsopoulos K, Mueller S, Goncalves M et al. Completion surgery after extracapsular dissection of low-grade parotid gland malignant tumors. Head Neck. 2019;41:3383-8. https://doi.org/10.1002/hed.25863
  • 18.Lin YQ, Wang Y, Ou YM et al. Extracapsular dissection versus partial superficial parotidectomy for the treatment of benign parotid tumours. Int J Oral Maxillofac Surg. 2019;48:895-901. https://doi.org/10.1016/j.ijom.2019.01.030

Parotis Bezi Neoplazmaları İçin Minimal İnvaziv Yaklaşım: Çok Merkezli Retrospektif Bir Analiz

Year 2025, Volume: 8 Issue: 1, 81 - 84

Abstract

Amaç: Son zamanlarda parotis bezi neoplazmları için ekstrakapsüler diseksiyon (EKD) tekniği popülerlik kazanmıştır, ancak işlevsel sonuçlar ve komplikasyon oranları hakkındaki veriler hala sınırlıdır ve cerrahi teknik standart değildir. Bu çok merkezli çalışmada, EKD'nin güvenliğini, komplikasyonlarını, faydasını, işlevsel sonuçlarını ve dren gereksiniminin gerekliliğini değerlendirdik.
Materyal ve Yöntemler: Bu çalışma retrospektif çok merkezli bir çalışma olarak yürütülmüştür ve iki üçüncü basamak akademik sevk merkezi dahil edilmiştir. Ocak 2015 ile Ocak 2017 arasında ekstrakapsüler diseksiyon tekniği uygulanan hastaların kayıtları incelenmiştir. Demografik veriler, tümörlerin boyutu ve yeri, ince iğne aspirasyon sitolojisinin sonuçları, kapsül rüptürü veya fasiyal sinir hasarı gibi intraoperatif olumsuz olaylar, postoperatif komplikasyonlar, kesin patoloji sonuçları ve hastaların hastanede kalış süresi incelenmiştir.
Bulgular: Çalışmaya toplam 37 hasta dahil edilmiştir. Her iki grupta da kalıcı veya geçici fasiyal sinir disfonksiyonu olan hasta yoktu. Hiçbir hasta Frey sendromu semptomlarından şikayetçi değildi. 37 hastanın ikisinde seroma gelişti. Takip süresi boyunca (min: 36 ve maks: 72 ay) rekürrens görülmedi.
Sonuç: EKD sonuçlarımıza göre çok düşük komplikasyon oranlarına sahip güvenli bir tekniktir. Yüz siniri monitorizasyonu olmadan bile, cerrah deneyimliyse sinire herhangi bir hasar vermeden EKD uygulanabilir. Ameliyat öncesi değerlendirme önemlidir ve küçük, hareketli ve tek başına iyi huylu parotis lezyonları olan hastalar EKD için iyi adaylardır.

References

  • 1.Hugo NE, McKinney P, Griffith BH. Management of tumors of the parotid gland. Surg Clin North Am. 1973;53:105-11. https://doi.org/10.1016/S0039-6109(16)39936-4
  • 2.Spiro RH, Koss LG, Hajdu SI et al. Tumors of minor salivary origin. A clinicopathologic study of 492 cases. Cancer. 1973;31:117-29. https://doi.org/10.1002/1097-0142(197301)31:1<117::AID-CNCR2820310116>3.0.CO;2-7
  • 3.Kızıl Y, Aydil U, Ekinci O et al. Salivary gland tumors in Turkey: demographic features and histopathological distribution of 510 patients. Indian J Otolaryngol Head Neck Surg. 2013;65(Suppl 1):112-20. https://doi.org/10.1007/s12070-012-0594-6
  • 4.Benedict EB, Meigs J. Tumours of the parotid gland: a study of two hundred and twenty-five cases with complete end results in eighty cases. Surg Gynecol Obstet 1930;51:626-47

  • 5.Bradley PJ. The recurrent pleomorphic adenoma conundrum. Curr Opin Otolaryngol Head Neck Surg. 2018;26:134-41. https://doi.org/10.1097/MOO.0000000000000435
  • 6.Johnson JT, Ferlito A, Fagan JJ et al. Role of limited parotidectomy in management of pleomorphic adenoma. J Laryngol Otol. 2007;121:1126-8. https://doi.org/10.1017/S0022215107000345
  • 7.McFarland J. Three hundred mixed tumours of the salivary glands of which 69 recurred. Surg Gynecol Obstet 1936;63:457-68.

  • 8.Janes RM. The treatment of tumours of the salivary glands by radical excision. CMAJ 1940;43:554-9.
 9.Bailey H. Treatment of tumours of the parotid gland with special reference to total parotidectomy. Br J Surg 1941;28:337-46.
 https://doi.org/10.1002/bjs.18002811102
  • 10.Roh JL, Kim HS, Park CI. Randomized clinical trial comparing partial parotidectomy versus superficial or total parotidectomy. Br J Surg. 2007;94:1081-7. https://doi.org/10.1002/bjs.5947
  • 11.Iizuka K, Ishikawa K. Surgical techniques for benign parotid tumors: segmental resection vs extracapsular lumpectomy. Acta Otolaryngol Suppl. 1998;537:75-81. https://doi.org/10.1080/00016489850182396
  • 12.Gleave EN, Whittaker JS, Nicholson A. Salivary tumours--experience over thirty years. Clin Otolaryngol Allied Sci. 1979;4:247-57. https://doi.org/10.1111/j.1365-2273.1979.tb01897.x
  • 13.Witt RL. Minimally invasive surgery for parotid pleomorphic adenoma. Ear Nose Throat J 2005;84:308-11.
 https://doi.org/10.1177/014556130508400517
  • 14.Smith SL, Komisar A. Limited parotidectomy: the role of extracapsular dissection in parotid gland neoplasms. Laryngoscope. 2007;117:1163-7. https://doi.org/10.1097/MLG.0b013e31806009fe
  • 15.McGurk M, Thomas BL, Renehan AG. Extracapsular dissection for clinically benign parotid lumps: reduced morbidity without oncological compromise. Br J Cancer. 2003;89:1610-3. https://doi.org/10.1038/sj.bjc.6601281
  • 16.Kato MG, Erkul E, Nguyen SA et al. Extracapsular Dissection vs Superficial Parotidectomy of Benign Parotid Lesions: Surgical Outcomes and Cost-effectiveness Analysis. JAMA Otolaryngol Head Neck Surg. 2017;143:1092-7. https://doi.org/10.1001/jamaoto.2017.1618
  • 17.Mantsopoulos K, Mueller S, Goncalves M et al. Completion surgery after extracapsular dissection of low-grade parotid gland malignant tumors. Head Neck. 2019;41:3383-8. https://doi.org/10.1002/hed.25863
  • 18.Lin YQ, Wang Y, Ou YM et al. Extracapsular dissection versus partial superficial parotidectomy for the treatment of benign parotid tumours. Int J Oral Maxillofac Surg. 2019;48:895-901. https://doi.org/10.1016/j.ijom.2019.01.030
There are 17 citations in total.

Details

Primary Language English
Subjects Otorhinolaryngology
Journal Section Articles
Authors

Çağlar Eker 0000-0003-4433-0194

Özgür Sürmelioğlu 0000-0001-5041-2802

Muhammed Dağkıran 0000-0002-1923-3731

Özgür Tarkan 0000-0002-0689-6632

Süleyman Özdemir 0000-0002-6146-9609

Yusuf Kızıl 0000-0001-5906-4488

Utku Aydil 0000-0003-4076-1798

Publication Date
Submission Date December 24, 2024
Acceptance Date March 17, 2025
Published in Issue Year 2025 Volume: 8 Issue: 1

Cite

APA Eker, Ç., Sürmelioğlu, Ö., Dağkıran, M., Tarkan, Ö., et al. (n.d.). Minimally Invasive Approach for the Parotid Gland Neoplasm: A Multicenter Retrospective Analysis. Journal of Cukurova Anesthesia and Surgical Sciences, 8(1), 81-84.

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