Patient's perspective on long-term complications after superficial parotidectomy for benign lesions: Prospective analysis of a 2-year follow-up

P Wolber; G F Volk; L Horstmann; M Finkensieper; S Shabli; C Wittekindt; J P Klussmann; O Guntinas-Lichius; D Beutner; M Grosheva

doi:10.1111/coa.13104

Patient's perspective on long-term complications after superficial parotidectomy for benign lesions: Prospective analysis of a 2-year follow-up

Clin Otolaryngol. 2018 Aug;43(4):1073-1079. doi: 10.1111/coa.13104. Epub 2018 Apr 22.

Authors

P Wolber¹, G F Volk², L Horstmann¹, M Finkensieper², S Shabli¹, C Wittekindt³, J P Klussmann¹, O Guntinas-Lichius², D Beutner^{1

4}, M Grosheva¹

Affiliations

¹ Medical Faculty, Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany.
² Department of Otorhinolaryngology, Head and Neck Surgery, Jena University Hospital, Jena, Germany.
³ Department of Otorhinolaryngology, Head and Neck Surgery, University of Giessen, Giessen, Germany.
⁴ Department of Otorhinolaryngology, Head and Neck Surgery, University of Göttingen, Göttingen, Germany.

PMID: 29577637
DOI: 10.1111/coa.13104

Abstract

Objective: Evaluation of patients' perspective on long-term complications after superficial parotidectomy for benign lesions.

Design: A prospective nonrandomized controlled multicenter study.

Setting: Three university-based tertiary referral centers (Departments of Otorhinolaryngology of Cologne, Jena and Giessen; all in Germany).

Participants: 130 adult patients, who underwent a primary superficial parotidectomy for benign tumors of the parotid gland, were consecutively included from 09/2010 to 05/2012. 61 patients completed every follow-up examination.

Main outcome measures: Complications were evaluated using the validated German-language questionnaire Parotidectomy Outcome Inventory 8 at six, 12 and 24 months after surgery. Pain intensity was assessed on a numeric rating scale (NRS) at each follow-up visit.

Results: At 6 months after surgery, 90% characterized hypoesthesia as the most disturbing problem, followed by fear of revision surgery (57%) and scar (56%). Facial palsy (14%) posed the minor problem. Hypoesthesia improved significantly during the follow-up period (all P < .05), but still posed a problem for 78% of the patients after 2 years. Pain, which initially bothered 53% of the patients, significantly decreased, whereas impairment due to Frey's syndrome significantly increased during the follow-up (6 vs 24 months; P = .002 and P = .001, respectively). Scar, substance loss, xerostomia, facial palsy, and anxiety affected patients with unvarying severity during the 2 years (all P > .05).

Conclusions: From patients' perspective, sensation loss posed the major subjective problem after superficial parotidectomy. Appearance of the scar, and fear of revision surgery impaired more than 50% of the patients in their daily life without significant improvement during the 2 years postoperatively. Although superficial parotidectomy is a highly standardized and safe procedure, limited parotidectomy for proven benign parotid salivary gland neoplasms is more likely to result in patients with minimal or no displeasing complications.

Keywords: benign parotid lesions; patient-reported outcome measures; postoperative complications; prospective studies; quality of life.