Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jul 1;23(4):e485-e492.
doi: 10.4317/medoral.22386.

Complications after superficial parotidectomy for pleomorphic adenoma

P Infante-Cossio  1 , E Gonzalez-Cardero, A Garcia-Perla-Garcia, E Montes-Latorre, J-L Gutierrez-Perez, V-E Prats-Golczer
Affiliations

Complications after superficial parotidectomy for pleomorphic adenoma

P Infante-Cossio et al. Med Oral Patol Oral Cir Bucal. .

Abstract

Background: The significance of complications after superficial parotidectomy remains unclear, since prospective studies are lacking. The aim of this study was to evaluate facial nerve dysfunction and other postoperative complications after superficial parotidectomy for pleomorphic adenoma of the superficial lobe and to identify the associated risk factors.

Material and methods: Prospective and descriptive clinical study on 79 patients undergoing formal superficial parotidectomy with the modified facelift incision, dissection of the facial nerve and reconstruction with the superficial musculoaponeurotic system flap. Function of the facial nerve using the House-Brackmann scale and the intra- and postoperative complications were recorded at 1 week and 1, 3, 6 and 12 months. A descriptive, inferential and binary logistic regression analysis were performed for the variables facial nerve dysfunction, tumor size and location, clinical presentation and duration of surgery.

Results: 77.2% of the patients presented facial paresis at 1 week, with the marginal-mandibular branch being the most commonly affected (64.5%). 94.9% recovered the facial function at 6 months and 100% at 12 months. A statistically significant relationship was found between the appearance of facial paresis and tumor location in the superior lateral area of the superficial lobe, size >2 cm and prolonged operative time. None of the remaining variables showed significant differences at any study timepoint. At 12 months, 57% of patients had recovered tactile sensitivity in the earlobe. The clinical occurrence of Frey's syndrome was 11.4%.

Conclusions: Despite the high incidence of postoperative facial paresis at 1 week, its magnitude was low and the recovery time was short. Tumor location in the parotid superficial lobe upper area, size and prolonged operative time are risk factors that can worsen facial paresis at different study timepoints. The knowledge of these complications is relevant for patient´s counseling and to achieve better long-term outcomes.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest statement: The authors declare not to have any conflict of interest.

Figures

Figure 1
Figure 1
Intraoperative view of areas I and II after dissection of the facial nerve (FN). Detail of the facial nerve and GAN dissection, while the superficial lobe remains attached by the Stensen duct (SD).
Figure 2
Figure 2
Scar appearance at 1 year. Ideal (left), moderate (central) or hypertrophic (right).
Figure 3
Figure 3
Depression of the facial contour at 1 year. None (left), moderate (central) or major (right).
See this image and copyright information in PMC

References

    1. Marchese-Ragona R, De Filippis C, Marioni G, Staffieri A. Treatment of complications of parotid gland surgery. Acta Otorhinolaryngol Ital. 2005;25:174–8. - PMC - PubMed
    1. Gaillard C, Perie S, Susini B, St Guily JL. Facial nerve dysfunction after parotidectomy: the role of local factors. Laryngoscope. 2005;115:287–91. - PubMed
    1. Gonzalez-Cardero E, Infante-Cossio P, Cayuela A, Acosta-Feria M, Gutierrez-Perez JL. Facial disability index (FDI): adaptation to Spanish, reliability and validity. Med Oral Patol Oral Cir Bucal. 2012;17:e1006–12. - PMC - PubMed
    1. Sethi N, Tay PH, Scally A, Sood S. Stratifying the risk of facial nerve palsy after benign parotid surgery. J Laryngol Otol. 2014;128:159–62. - PubMed
    1. Prats-Golczer VE, Gonzalez-Cardero E, Exposito-Tirado JA, Montes-Latorre E, Gonzalez-Perez LM, Infante-Cossio P. Impact of dysfunction of the facial nerve after superficial parotidectomy: a prospective study. Br J Oral Maxillofac Surg. 2017;55:798–802. - PubMed

Publication types