Effective surgical management of anterior tumors of the parotid gland: Main trunk method vs. peripheral Smethod

Am J Otolaryngol. 2021 Jul-Aug;42(4):102964. doi: 10.1016/j.amjoto.2021.102964. Epub 2021 Feb 16.

Abstract

Objective: Several surgical procedures have been proposed for tumors in the anterior parotid gland. Although the standard approach to other parotid tumors is generally also used for anterior tumors, handling of the facial nerve has not been addressed in any previous reports.

Methods: A total of 654 patients with benign parotid tumors who underwent surgery in our department were classified into anterior (AT), middle (MT), and posterior tumor (PT) groups according to tumor location. Clinical characteristics, histopathological types, and frequency of postoperative transient facial palsy were examined. In the AT group, two surgical methods were compared, which were the main trunk method (MTM) and the peripheral method (PM).

Results: 172 patients were included in the AT group, 175 in the MT group, and 307 in the PT group. The AT group showed significant female predominance and a higher percentage of deep lobe tumors than the PT group. There was no significant difference in the rate of postoperative transient facial palsy among the AT (MTM), MT, and PT groups. The PM had a significantly shorter operating time and lower rate of transient facial palsy than the MTM.

Conclusion: The PM for AT was considered a useful surgical method from the standpoints of postoperative complications and operating time. In the PM, a wide operating field made identification of the facial nerve easier.

Keywords: Anterior tumor; Facial nerve; Parotid tumor; Surgical management.

MeSH terms

  • Adult
  • Aged
  • Facial Nerve / surgery
  • Facial Paralysis / epidemiology
  • Facial Paralysis / etiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Operative Time
  • Otorhinolaryngologic Surgical Procedures / adverse effects
  • Otorhinolaryngologic Surgical Procedures / methods*
  • Parotid Gland / pathology
  • Parotid Gland / surgery*
  • Parotid Neoplasms / pathology
  • Parotid Neoplasms / surgery*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Treatment Outcome