Surgical management of benign tumors of the parotid gland: extracapsular dissection versus superficial parotidectomy--our experience in 232 cases

Abstract

Purpose: The purpose of this study was to retrospectively analyze all cases of benign parotid tumors treated at our institution from 2002 to 2009.

Materials and methods: We carried out a retrospective review of 232 patients with benign primary parotid tumors. Extracapsular dissection or superficial parotidectomy was performed. Clinical and histopathologic data were analyzed, and management was described. The statistical difference between the 2 techniques as concerns evaluated recurrence rate and complications was measured with the log-rank (Cox-Mantel) test. The chosen level of statistical significance was P < .05.

Results: A total of 232 patients were enrolled, 107 women and 125 men, whose mean age was 53.2 ± 11.3 years. Extracapsular dissection was performed in 176 cases (76%) (mean age, 52.82 ± 11.55 years), and superficial parotidectomy was performed in 56 cases (24%) (mean age, 54.59 ± 10.56 years). The mean lesion size was 1.89 ± 0.52 cm for extracapsular dissection and 3.49 ± 0.43 cm for superficial parotidectomy (P < .001). Mean follow-up was 52.6 ± 4.5 months for the group of patients treated with superficial parotidectomy and 46 ± 5.2 months for the group treated with extracapsular dissection. No significant differences as concerns capsular rupture and recurrence were observed after extracapsular dissection and superficial parotidectomy (3.4% vs 1.8% [P = .1] and 4.5% vs 3.6% [P = .1], respectively). Transient facial nerve injury, facial paralysis, and Frey syndrome were significantly more frequent after superficial parotidectomy than after extracapsular dissection (26.8% vs 3.9% [P = .001], 8.9% vs 0% [P < .001], and 5.3% vs 0% [P < .001], respectively).

Conclusions: Extracapsular dissection showed similar effectiveness and fewer side effects than superficial parotidectomy and could be considered as the treatment of choice for tumors located in the superficial portion of the parotid gland.