Extracapsular dissection versus superficial parotidectomy in benign parotid gland tumors: The Vienna Medical School experience

Abstract

Background: The purpose of this study was to evaluate the clinical outcome in patients with benign parotid gland tumors after extracapsular dissection or superficial parotidectomy (SP).

Methods: Eight hundred ninety-four patients with primary pleomorphic adenoma or Warthin's tumor were included from this study. Type and length of surgery, tumor size, resection margins, and complication rates were assessed.

Results: Three hundred ninety-five (44.2%) extracapsular dissections and 499 SPs (55.8%) were performed. The rate of positive margins was significantly higher in the extracapsular dissection compared to the SP group (29.4% vs 10.2%; p < .0001). Recurrent disease (extracapsular dissection = 7.2% vs SP = 2.2%; p = .0003) and permanent facial palsy were significantly more frequent after extracapsular dissection than SP (2.2% vs 0.6%; p = .0396). Significant prolonged surgery time was observed after SP (146 vs 94 minutes; p < .0001).

Conclusion: Because extracapsular dissection led to a significantly higher percentage of permanent facial palsy, recurrent disease, and positive resection margins compared to SP, we recommend SP for treating benign parotid gland tumors. © 2016 Wiley Periodicals, Inc. Head Neck 39: 356-360, 2017.

Keywords: Warthin's tumor; extracapsular dissection; facial palsy; pleomorphic adenoma; postoperative complications; recurrent disease; superficial parotidectomy.