1
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Kim BS, Kim MR, Kim YW, Baek MJ, Suh TK, Kim SY. Risk factors for sialocele after parotidectomy: Does tumor size really matter? Auris Nasus Larynx 2023; 50:935-941. [PMID: 36922283 DOI: 10.1016/j.anl.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 02/06/2023] [Accepted: 02/28/2023] [Indexed: 03/16/2023]
Abstract
OBJECTIVE Sialocele that develops after parotid surgery often prolongs the treatment period and stresses both the surgeon and patient. The extent of surgery and tumor size are known to be associated with sialocele occurrence. We investigated the incidence of post-parotidectomy sialocele and the associated risk factors, with a focus on tumor size. METHODS We retrospectively reviewed the medical records of 172 patients who underwent parotidectomy between January 2013 and May 2020 at Haeundae Paik Hospital, Inje University of Korea. We stratified patients into those with and without sialocele (fluid collection in the operative bed). We compared clinical data, patient demographics, and surgical details; we identified risk factors for sialocele development after parotid surgery. RESULTS Seventeen patients were diagnosed with post-parotidectomy sialocele (9.88%; 17/172). Univariate logistic regression revealed that the male sex, deep lobe tumor location, and large tumor size were significantly associated with postoperative sialocele (p = 0.015, 0.009, and 0.016, respectively). We subjected these parameters to multivariate analyses; the odds ratios were 3.70, 3.58, and 2.34, respectively. Receiver operating characteristic curve analyses showed that a tumor size > 2.50 cm was the optimal cutoff in terms of predicting post-parotidectomy sialocele. CONCLUSION Male sex, a tumor in the deep lobe, and large tumor size were strongly associated with increased risk for sialocele after parotidectomy. Tumor size > 2.50 cm serves as the cutoff identifying patients likely to experience sialocele after parotid surgery.
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Affiliation(s)
- Bo-Soo Kim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Inje University of Korea, Busan, Republic of Korea
| | - Mi Ra Kim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Inje University of Korea, Busan, Republic of Korea
| | - Yong-Wan Kim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Inje University of Korea, Busan, Republic of Korea
| | - Moo Jin Baek
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Inje University of Korea, Busan, Republic of Korea
| | - Tae-Kyung Suh
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Inje University of Korea, Busan, Republic of Korea
| | - Sang-Yeon Kim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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2
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Hassan CH, Deberge S, Jegoux F. Outpatient parotidectomy: Outcomes, safety and satisfaction. Am J Otolaryngol 2023; 44:103974. [PMID: 37437335 DOI: 10.1016/j.amjoto.2023.103974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 07/04/2023] [Indexed: 07/14/2023]
Abstract
PURPOSE Parotidectomies are rarely performed on an outpatient basis. The specific perioperative outcomes and their management remains insufficiently described to change daily practice. The objectives were to study the outcomes, the complications and the patient satisfaction rate in parotidectomy performed on an outpatient basis. MATERIALS AND METHODS We conducted a retrospective monocentric database study on 85 patients who underwent parotidectomy as a first and sole procedure from 2015 to 2020. We analyzed perioperative outcomes between outpatients and inpatients. RESULTS Among 28 outpatients and 57 inpatients, no significant differences in total perioperative complications (p = .66; OR = 1.25; 95 % confidence interval (CI) [0.47; 3.36]), reoperations (p = .55), readmissions (p = 1), or unplanned visits (p = .52) were shown in multivariate analysis. The conversion rate for surgical reasons was 8.6 %, and the satisfaction rate was high. CONCLUSION Although outpatient parotidectomies should be as safe as for inpatients, the high rate of minor complications requires specific perioperative management, such as a systematic early postoperative visit and optimized preoperative information in order to be carried out with minimal issues.
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Affiliation(s)
| | - Sarah Deberge
- ENT Surgery, CHU Pontchaillou, 2 rue Henri Le Guilloux, 35033 Rennes, France
| | - Franck Jegoux
- ENT Surgery, CHU Pontchaillou, 2 rue Henri Le Guilloux, 35033 Rennes, France
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3
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Deva FAL, Gupta A. Centripetal Versus Centrifugal Facial Nerve Dissection in Superficial Parotidectomy: Comparison of the Two Methods at a Tertiary Care Center. Indian J Otolaryngol Head Neck Surg 2023; 75:1525-1532. [PMID: 37636668 PMCID: PMC10447743 DOI: 10.1007/s12070-023-03476-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 01/09/2023] [Indexed: 03/09/2023] Open
Abstract
OBJECTIVES To compare the intraoperative and postoperative parameters of two techniques of facial nerve dissection: Centripetal vs Centrifugal. STUDY DESIGN Prospective study. SETTING Academic tertiary referral centre. METHODS In our study, cases of superficial parotidectomy were randomly selected from the outpatient departments of ORL & HNS. Of these patients, 30 underwent standard anterograde dissection group (Group A) and 30 underwent retrograde facial nerve dissection (Group B). All the patients were assessed pre-operatively, intra-operatively and post-operatively to compare the various parameters. RESULTS The most common complaint in both groups was parotid swelling. The operative time for A was shorter at 2.1 h as compared to 1.9 h min in group B. The resolution of symptoms was nearly comparable in both groups. Facial nerve palsy was slightly more in group B but the difference was not statistically significant. CONCLUSION The operative time and post-operative complications were both comparable between AFND and RFND, implying both techniques can be used by surgeons depending on the individual cases.
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Affiliation(s)
| | - Anchal Gupta
- Department of ORL & HNS, ASCOMS Medical College and Hospital, Jammu, India
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4
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Masoudi M, Wiseman J, Wiseman SM. A contemporary systematic review of the complications associated with SURGICEL. Expert Rev Med Devices 2023; 20:741-752. [PMID: 37526076 DOI: 10.1080/17434440.2023.2242776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 07/27/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND This review aims to summarize the findings from recent literature (2010-2022) reporting on complications that resulted from the surgical use of SURGICEL for intraoperative hemostasis. METHODS A literature search was conducted using the MEDLINE (OVID), Embase, and Cochrane Central Register of Controlled Trials - CENTRAL (OVID) databases. The studies were sorted into case reports and other study types for data extraction. Covidence was used for data extraction and statistics were descriptive. RESULTS Of the total 560 articles screened, 73 papers were selected for a full-text review and 70 studies were included in this review. A total of 7,242 participants were included in the studies (case studies n = 93, others n = 7149). 67/70 of the included studies reported complications when SURGICEL was used intraoperatively. Reported complications included: SURGICEL induced masses (granulomas, abscesses, hematomas, cysts) (n = 25), hemorrhagic complications (n = 12), masses misdiagnosed as tumors, cardiovascular, nervous system, and hepatobiliary complications, pain, and infections. Other complications included: fistulas, erectile dysfunction, chorioamnionitis, swelling, urinary leak, renal failure, and anaphylaxis. CONCLUSIONS Publications reporting on complications associated with the use of SURGICEL intraoperatively have continued to emerge. Future studies should compare how the types and rates of complications compare between SURGICEL and alternative hemostatic agents.
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Affiliation(s)
- Matthew Masoudi
- Department of Surgery, St. Paul's Hospital & University of British Columbia, Vancouver, British Columbia, Canada
| | - Jacob Wiseman
- Department of Surgery, St. Paul's Hospital & University of British Columbia, Vancouver, British Columbia, Canada
| | - Sam M Wiseman
- Department of Surgery, St. Paul's Hospital & University of British Columbia, Vancouver, British Columbia, Canada
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5
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Yang X, Ge S, Tao Y, Li J, Shang W, Song K. Assessment of the observation management of sialocele after partial superficial parotidectomy. Oral Dis 2023; 29:996-1004. [PMID: 34773330 DOI: 10.1111/odi.14079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/05/2021] [Accepted: 11/10/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE This study aimed to investigate the usefulness of management of sialocele formation and to evaluate the quality of life of patients under elective management post-parotidectomy. MATERIALS AND METHODS A prospective study was performed including patients who underwent postoperative management with either compression therapy or observation. The self-filled questionnaire method was used to assess the quality of life of participants who changed from compression therapy to observation. Demographic and operative data, variables regarding wound complications and scores for quality of life were documented and analysed. RESULTS A total of 86 patients met the eligibility criteria. The respective rates of sialocele formation within 1 month were 5.3% in the compression therapy group (2/38) and 16.0% in the observation group (4/25), but no significant difference was observed (p = 0.204). Meanwhile, both groups displayed comparable times of needle aspiration and time for sialocele resolution (p > 0.05). Based on 23 valid paired questionnaires, scores for physical and social-emotional function before changing from compression therapy to observation were significantly lower than scores after the change (p < 0.001). CONCLUSION The application of observation after partial superficial parotidectomy appears to have acceptable clinical outcomes and considerable improvements in quality of life.
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Affiliation(s)
- Xiaochen Yang
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Shandong, China
- School of Stomatology, Qingdao University, Shandong, China
| | - Shengyou Ge
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Shandong, China
- School of Stomatology, Qingdao University, Shandong, China
| | - Yueqin Tao
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Shandong, China
| | - Jieying Li
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Shandong, China
- School of Stomatology, Qingdao University, Shandong, China
| | - Wei Shang
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Shandong, China
- School of Stomatology, Qingdao University, Shandong, China
| | - Kai Song
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Shandong, China
- School of Stomatology, Qingdao University, Shandong, China
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6
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Roh JL. Sialocele formation after partial parotidectomy: Dependent on remnant parotid exposure. Head Neck 2023; 45:1299-1304. [PMID: 36939294 DOI: 10.1002/hed.27348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 02/15/2023] [Accepted: 03/06/2023] [Indexed: 03/21/2023] Open
Abstract
BACKGROUND This study compared the complete closure versus the exposure of remnant parotid parenchyma in sialocele formation. METHODS This study included 151 patients with benign parotid lesions who underwent partial parotidectomy plus the complete closure or exposure of remnant parotid parenchyma. Two surgical methods of closed or exposed parenchyma were alternatively allocated to consecutive patients without randomization and blinding processes. RESULTS Complete closure and exposure of the remnant parotid parenchyma were performed in 81 and 70 patients. Early postoperative complications occurred with temporary events: transient facial weakness, 24 (16%); hematoma, 9 (6%); wound infection, 1 (0.7%) without statistical difference between the two groups (p > 0.1). Postoperative sialocele was more frequently found in the exposure group (n = 15) than the closure group (n = 4; p = 0.003). CONCLUSIONS The complete closure of remnant parotid parenchyma is preferred over the exposure of injured parenchymal parenchyma to prevent postparotidectomy sialocele.
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Affiliation(s)
- Jong-Lyel Roh
- Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.,Department of Biomedical Science, General Graduate School, CHA University, Seongnam, Republic of Korea
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7
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Lan L, Wang D, Ma R, Wang W. Extracapsular dissection by the sternocleidomastoid muscle-parotid space approach reduces the risks of postparotidectomy sialocele and salivary fistula. Head Neck 2022; 44:2522-2527. [PMID: 35912938 DOI: 10.1002/hed.27159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 07/07/2022] [Accepted: 07/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Postoperative sialoceles and fistulas are frequent surgical complications of parotid tumor resection. Extracapsular dissection by the sternocleidomastoid muscle-parotid space approach (ECD-SMPSA) is a minimally invasive technique. To our knowledge, the characteristics of sialoceles and fistulas secondary to ECD-SMPSA have not been reported. METHODS This prospective study enrolled 52 patients who underwent ECD-SMPSA without sialocele/fistula prevention measures. Postoperative sialoceles and fistulas were evaluated during 2 months of follow-up. RESULTS Among the 52 patients, only one male patient developed a mild sialocele. No salivary fistulas occurred. The overall rate of sialocele/fistula formation was 1.92%. CONCLUSIONS When treating clinically benign tumors that involve the sternocleidomastoid muscle-parotid space, ECD-SMPSA may prevent postoperative formation of sialoceles and salivary fistulas.
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Affiliation(s)
- Lin Lan
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China.,Beijing Key Laboratory of Digital Stomatology, Beijing, China.,National Clinical Research Center for Oral Diseases, Beijing, China
| | - Diancan Wang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China.,Beijing Key Laboratory of Digital Stomatology, Beijing, China.,National Clinical Research Center for Oral Diseases, Beijing, China
| | - Ruohan Ma
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China.,Beijing Key Laboratory of Digital Stomatology, Beijing, China.,National Clinical Research Center for Oral Diseases, Beijing, China.,Department of oral and maxillofacial radiology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Wei Wang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China.,Beijing Key Laboratory of Digital Stomatology, Beijing, China.,National Clinical Research Center for Oral Diseases, Beijing, China
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8
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Chen SWT, Hsin LJ, Lin WN, Tsai YT, Tsai MS, Lee YC. LigaSure versus Conventional Parotidectomy: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2022; 10:healthcare10040706. [PMID: 35455883 PMCID: PMC9027715 DOI: 10.3390/healthcare10040706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/04/2022] [Accepted: 04/07/2022] [Indexed: 11/16/2022] Open
Abstract
Surgery with parotidectomy is the preferable treatment for most parotid tumors. Our meta-analysis compared the differences between the use of the LigaSure (LS) device and the conventional suture ligation technique (CT) in parotidectomies. A literature search in databases including EMBASE, MEDLINE, and the Cochrane Library was carried out. Studies including parotidectomy using LS and CT were included with the intraoperative and postoperative parameters collected. Continuous operative time data were measured by mean differences (MDs). Discrete data on postoperative complications, including facial palsy, postoperative bleeding, and salivary complications, were evaluated with risk differences (RDs). All values were reported with 95% confidence intervals (CIs). Five studies were included in our meta-analysis. The pooled analysis demonstrated a significant reduction in operative time in the LS group (MD: −21.92; 95% CI, −30.18 to −13.66). In addition, the analysis indicated that the incidence of postoperative complications, including permanent facial palsy (RD, −0.01; 95% CI, −0.06 to 0.05), temporary facial palsy (RD, 0.00; 95% CI, −0.03 to 0.04), salivary complications (RD, −0.01; 95% CI, −0.08 to 0.06), and postoperative bleeding (RD, −0.02; 95% CI, −0.07 to 0.04), were all similar between the LS group and the CT group. According to the results, the LS device appears to be a safe and useful tool and could shorten the operative time in patients needing parotidectomy.
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Affiliation(s)
- Sonia Wei-Ting Chen
- Department of Otolaryngology—Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung 20401, Taiwan;
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (L.-J.H.); (W.-N.L.); (Y.-T.T.); (M.-S.T.)
| | - Li-Jen Hsin
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (L.-J.H.); (W.-N.L.); (Y.-T.T.); (M.-S.T.)
- Department of Otolaryngology—Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan
| | - Wan-Ni Lin
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (L.-J.H.); (W.-N.L.); (Y.-T.T.); (M.-S.T.)
- Department of Otolaryngology—Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan
| | - Yao-Te Tsai
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (L.-J.H.); (W.-N.L.); (Y.-T.T.); (M.-S.T.)
- Department of Otolaryngology—Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan
| | - Ming-Shao Tsai
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (L.-J.H.); (W.-N.L.); (Y.-T.T.); (M.-S.T.)
- Department of Otolaryngology—Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan
| | - Yi-Chan Lee
- Department of Otolaryngology—Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung 20401, Taiwan;
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (L.-J.H.); (W.-N.L.); (Y.-T.T.); (M.-S.T.)
- Correspondence: ; Tel.: +886-2-2431-3131 (ext. 6255); Fax: +886-2-2431-1190
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9
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Kinberg EC, Garneau JC, Eljazzar R, Genden EM, Teng MS, Miles BA, Rosenberg J, Lawson W, Yao M. Postparotidectomy sialocele: A 6-year review of underlying factors. Head Neck 2021; 44:745-748. [PMID: 34957635 DOI: 10.1002/hed.26969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/22/2021] [Accepted: 12/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Postparotidectomy sialocele is a frustrating challenge. Published rates of postparotidectomy fluid collections range from 6% to 39%. We report our experience of 398 parotidectomies performed over a 6-year period. METHODS A retrospective chart review of parotidectomies performed over a 6-year period was completed. Drain placement, smoking status, tumor size, and postoperative utilization of scopolamine were analyzed. Binary logistical regression and odds ratio calculations were performed. RESULTS Postparotidectomy sialocele occurred in 25% of patients. Neither suction drain placement nor usage of immediate postoperative scopolamine (in a 22-patient subset) prevented sialocele formation. Smoking status also did not correlate. Increasing resection size was linearly correlated with the risk of sialocele. CONCLUSION Drain placement and smoking status do not correlate with sialocele prevention after parotidectomy. Sialocele formation directly correlates with the resection size. These data may guide preoperative counseling; however, additional work is necessary to identify effective prevention mechanisms for postparotidectomy sialocele.
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Affiliation(s)
- Eliezer C Kinberg
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jonathan C Garneau
- Department of Otolaryngology - Head and Neck Surgery, University of Virginia, Charlottesville, Virginia, USA
| | - Rachelle Eljazzar
- Department of Otolaryngology, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Eric M Genden
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Marita S Teng
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Brett A Miles
- Department of Otolaryngology - Head and Neck Surgery, Northwell Health, New Hyde Park, New York, USA
| | - Joshua Rosenberg
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - William Lawson
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Mike Yao
- Department of Otolaryngology - Head and Neck Surgery, Westchester Medical Center, Valhalla, New York, USA
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10
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Lee E, Magge H, Thakkar PG, Joshi A. A novel treatment of sialocele with sodium tetradecyl sclerotherapy. Am J Otolaryngol 2021; 42:103031. [PMID: 33873047 DOI: 10.1016/j.amjoto.2021.103031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 03/31/2021] [Indexed: 10/21/2022]
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11
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Lee DJ, Lee YM, Park HJ, Lee JW, Cha W. Intraoperative botulinum toxin injection for superficial partial parotidectomy: A prospective pilot study. Clin Otolaryngol 2021; 46:998-1004. [PMID: 33754477 DOI: 10.1111/coa.13767] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 12/04/2020] [Accepted: 03/14/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Sialocele and salivary fistula are not serious but troublesome complications after parotidectomy. Various modalities have been introduced to prevent postoperative saliva-related complications. However, clinical trials assessing the prophylactic use of botulinum toxin (BTX) for parotidectomy have not been conducted yet. Herein, we report a pilot study investigating the safety and efficacy of intraoperative BTX (iBTX) injection in partial superficial parotidectomy (PSP). PARTICIPANTS Patients with benign parotid tumour were prospectively recruited for this clinical trial from 2017 to 2019. The study participants underwent PSP with iBTX injection. We retrospectively reviewed the clinical information of all the consecutive patients who underwent PSP without iBTX from 2013 to 2019. These patients were divided into two groups: the iBTX group (n = 36) and the control group (n = 54). RESULTS Permanent facial palsy was not observed in either group. Two patients (3.7%) had transient marginal palsy in the control group but none had it in the iBTX group. The incidence of sialocele was significantly lower in the iBTX group than in the control group (2.8% vs. 20.4%, P < .05). Although the incidence of salivary fistula was lower in the iBTX group than in the control group (0% vs. 7.4%), no significant difference was determined between the two groups (P = .147). Total drainage volume was significantly lower in the iBTX group than in the control group (55.0 mL vs. 116.6 mL, P < .001). CONCLUSIONS iBTX injection may be safe and effective in reducing sialocele and postoperative drainage in PSP. It might be a useful option to prevent saliva-related complications after PSP.
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Affiliation(s)
- Dong-Joo Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University Hospital, Busan, South Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Yu-Mi Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University Hospital, Busan, South Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Hye-Jin Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University Hospital, Busan, South Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Jung Woo Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University Hospital, Busan, South Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Wonjae Cha
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
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12
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Cohen O, Gabay S, Khafif A. Insertion of a vacuum based drain for post-parotidectomy non-resolving seroma in an outpatient setting. Br J Oral Maxillofac Surg 2020; 59:197-201. [PMID: 33349493 DOI: 10.1016/j.bjoms.2020.08.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 08/10/2020] [Indexed: 02/06/2023]
Abstract
We describe a novel technique for the insertion of a vacuum drain, in an outpatient setting, for persistent seroma post-parotidectomy. This is a retrospective case series of a single academic centre. The complete medical records of all patients who underwent parotidectomy between 2014 and 2019 were reviewed. Data regarding demographics, comorbidities, and intraoperative and postoperative courses were extracted for patients for whom a vacuum drain was inserted due to persistent seroma. A size 8 Fr drain was inserted using a novel approach through the parotidectomy incision using 'Biovac' (Biometrix) 50ml, Trocar kit, that had been adjusted and modified for this purpose. Two hundred and eighteen patients had had parotidectomy during the study period. Eight patients (3.6%) underwent insertion of the drain due to persistent seroma. In three patients (37.5%) no drain was inserted during the initial surgery. The mean (SD) time between surgery and insertion of the outpatient vacuum drain was 10 (5) days. All drain insertions were uneventful and no complications were noted. The mean (SD) time for outpatient vacuum drain removal was 12.75 (4.3) days. A single patient (12.5%) underwent additional needle aspiration of 5cc few days following removal of the drain. Persistent seromas may be managed in an outpatient clinic with good results and a high safety profile.
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Affiliation(s)
- O Cohen
- A.R.M. Center for Otolaryngology Head and Neck Surgery, Assuta Medical Center, Tel Aviv, Israel.
| | - S Gabay
- A.R.M. Center for Otolaryngology Head and Neck Surgery, Assuta Medical Center, Tel Aviv, Israel
| | - A Khafif
- A.R.M. Center for Otolaryngology Head and Neck Surgery, Assuta Medical Center, Tel Aviv, Israel
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13
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Lambiel S, Dulguerov N, Courvoisier DS, Dulguerov P. Minor Parotidectomy Complications: A Systematic Review. Laryngoscope 2020; 131:571-579. [PMID: 32678921 DOI: 10.1002/lary.28912] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 05/12/2020] [Accepted: 05/26/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To report descriptive statistics for minor parotidectomy complications. METHODS A systematic review was performed, selecting 235 studies for analysis. The incidence of complications was tabulated, and descriptive statistics calculated. Outlier studies, 1 standard deviation above the mean, were reexamined to determine potential causal factors for each complication. All studies were examined for statistically significant differences for any potential causal factor. RESULTS The pooled incidence of minor complications reported were hematoma 2.9% (95% confidence interval [CI]: 2.4-3.5), wound infection 2.3% (95% CI: 1.8-2.9), sialocele 4.5% (95% CI: 3.5-5.7), salivary fistula 3.1% (95% CI: 2.6-3.7), flap necrosis 1.7% (95% CI: 1.1-2.5), scar issues 3.6% (95% CI: 2.4-5.4), numbness 33.9% (95% CI: 25.6-43.4), and deformity 11.8 (95% CI: 6.9-19.5). Implants result in more wound complications, such as hematoma, sialocele, or salivary fistula. Sialocele and salivary fistula appear more frequently after less extensive parotid surgery, whereas hematoma, wound infections, flap necrosis, and aesthetic considerations are worse with more extensive resections. CONCLUSIONS Minor parotidectomy complications are more frequent than generally assumed and related to certain factors that should be investigated. Laryngoscope, 131:571-579, 2021.
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Affiliation(s)
- Silvia Lambiel
- Department of Otorhinolaryngology-Head and Neck Surgery, Geneva University Hospital, Geneva, Switzerland
| | - Nicolas Dulguerov
- Department of Otorhinolaryngology-Head and Neck Surgery, Geneva University Hospital, Geneva, Switzerland
| | | | - Pavel Dulguerov
- Department of Otorhinolaryngology-Head and Neck Surgery, Geneva University Hospital, Geneva, Switzerland.,Center for Otorhinolaryngology-Maxillofacial and Head and Neck Surgery, La Tour Hospital, La Tour Medical Group, Meyrin, Switzerland
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Bird J, Mirza AH, King E. Caution in the use of TissuePatchDS-P ™ in drainless benign superficial parotidectomy, a pilot study: Our experience in three patients. Clin Otolaryngol 2020; 45:837-840. [PMID: 32506702 DOI: 10.1111/coa.13594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 05/16/2020] [Accepted: 05/25/2020] [Indexed: 11/27/2022]
Affiliation(s)
| | | | - Emma King
- Poole NHS Foundation Trust, Poole, UK
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15
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Chiesa-Estomba CM, Larruscain-Sarasola E, González-García JA, Sistiaga-Suarez JA, Altuna-Mariezcurrena X. Cold Knife Dissection and Bipolar Diathermy Vs Harmonic Scalpel in Parotid Gland Surgery for Benign Tumours. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2020. [DOI: 10.1016/j.otoeng.2019.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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16
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Chiesa-Estomba CM, Larruscain-Sarasola E, González-García JA, Sistiaga-Suarez JA, Altuna-Mariezcurrena X. Cold knife dissection and bipolar diathermy Vs harmonic scalpel in parotid gland surgery for benign tumours. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2019; 71:93-98. [PMID: 31594557 DOI: 10.1016/j.otorri.2019.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 03/22/2019] [Accepted: 04/10/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Surgical techniques for extirpation of tumours of the parotid gland have evolved significantly in recent years. Previous data suggest the use of Harmonic Scalpel reduced operative time, intraoperative blood loss, postoperative drain production, and incidence of facial nerve injury, in comparison to cold scalpel dissection MATERIAL AND METHODS: retrospective analysis of 2group of patients operated using harmonic scalpel versus cold knife dissection and bipolar diathermy and compare operative time and post-surgical complication rate:, facial nerve injury, sialocele or salivary fístula formation, after parotidectomy for benign parotid tumours. RESULTS 108 patients were included. Regarding surgical time, the mean time to using Harmonic Scalpel was 114±39 (Min: 60/Max: 240), and the mean time using bipolar diathermy was 135±38 (Min: 90/Max: 285) and this was the only significant difference between the 2techniques (p=.049). CONCLUSIONS Harmonic scalpel is a safe and effective tool to perform parotid surgery in benign tumours. However, a shorter surgical time was the only advantage found over the traditional cold dissection and bipolar dissection method.
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Affiliation(s)
- Carlos Miguel Chiesa-Estomba
- Servicio de Otorrinolaringología, Cirugía de Cabeza y Cuello, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España.
| | - Ekhiñe Larruscain-Sarasola
- Servicio de Otorrinolaringología, Cirugía de Cabeza y Cuello, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España
| | - Jose Angel González-García
- Servicio de Otorrinolaringología, Cirugía de Cabeza y Cuello, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España
| | - Jon Alexander Sistiaga-Suarez
- Servicio de Otorrinolaringología, Cirugía de Cabeza y Cuello, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España
| | - Xabier Altuna-Mariezcurrena
- Servicio de Otorrinolaringología, Cirugía de Cabeza y Cuello, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España
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17
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Fibrin sealant and parotidectomy wound complications in 100 patients. Eur Arch Otorhinolaryngol 2019; 276:2621-2624. [DOI: 10.1007/s00405-019-05540-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Accepted: 07/01/2019] [Indexed: 12/31/2022]
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18
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Ricci E, Riva G, Dagna F, Cavalot AL. The use of platelet-rich plasma gel in superficial parotidectomy. ACTA ACUST UNITED AC 2019; 39:363-366. [PMID: 30933175 PMCID: PMC6966782 DOI: 10.14639/0392-100x-2093] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 05/17/2018] [Indexed: 11/23/2022]
Abstract
Platelet-rich plasma (PRP) gel has been used in several conditions to enhance wound healing processes. The aim of this retrospective study was to evaluate clinical outcomes in patients who underwent superficial parotidectomy with and without the use of PRP gel at the surgical field. Fifty-nine patients underwent superficial parotidectomy with preservation of the facial nerve for benign tumours. In 21 cases, PRP gel was added on the remaining parotid gland and facial nerve branches. Clinical characteristics, complications, length of hospitalisation and duration of the drainage tube maintenance were recorded. The median duration of drainage tube maintenance was 2 and 3 days, and median hospital stay was 3 and 4 days in the PRP-group and non-PRP-group, respectively. Facial palsy and salivary complications (sialocele and salivary fistula) were more frequent in the non-PRP-group. The use of PRP gel seems to have positive effects on clinical outcomes in superficial parotidectomy for benign tumours. It represents an efficient and low-cost adjunct that can lower complications.
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Affiliation(s)
- E Ricci
- Otorhinolaryngology Division, Santa Croce Hospital, Moncalieri, Italy
| | - G Riva
- Otorhinolaryngology Division, Santa Croce Hospital, Moncalieri, Italy
| | - F Dagna
- Otorhinolaryngology Division, Santa Croce Hospital, Moncalieri, Italy
| | - A L Cavalot
- Otorhinolaryngology Division, Santa Croce Hospital, Moncalieri, Italy
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19
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Mashrah MA, Al-dhohrah TA, Al-zubeiry FA, Yan L, Al-Hamed FS, Zhao X, Pan C. Antegrade versus retrograde facial nerve dissection in benign parotid surgery: Is there a difference in postoperative outcomes? A meta-analysis. PLoS One 2018; 13:e0206028. [PMID: 30339679 PMCID: PMC6195282 DOI: 10.1371/journal.pone.0206028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Accepted: 10/05/2018] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE The primary aim of this meta-analysis was to test the null hypothesis of no difference in facial nerve dysfunction in studies that compared classical antegrade facial nerve dissection (AFND) versus retrograde facial nerve dissection (RFND) during benign parotid surgery. METHODS A comprehensive search of PubMed, the Cochrane Central Register of Controlled Trials, Scopus, Google Scholar, Science Direct and relevant journals was undertaken up to June 27, 2018. Randomized controlled clinical trials (RCTs), controlled clinical trials (CCTs), and retrospective studies aimed at comparing the effect of AFND vs. RFND during parotidectomy were included. The outcome measures included facial nerve dysfunction, Frey's syndrome, recurrence, silaocele, salivary fistula, operating time length of hospital stay, and estimated blood loss. Pooled risk ratio (RR) and weighted mean differences (MD) with 95% confidence intervals were calculated using either a fixed-effects or random-effects model. RESULTS Ten studies; four RCTs and five retrospective studies were included. There were 570 patients (319 in RFND group and 251 in AFND group). 481 patients in 9 studies reported the incidence rate of facial nerve dysfunction. No statistical significant difference was observed between both groups concerning the occurrence of transient or permanent facial nerve paralysis (p = 0.44 and 0.11 respectively). One out 10 studies reported the incidence rate of sialocele, however no statistical difference was observed between the two techniques. There was reduction in the operative time (19.30 min), amount of blood loss (25.08 ml) and amount of healthy salivary tissues removed (12.20 mm) in RFND compared with AFND. CONCLUSIONS According to the results of the current review there is no evidence demonstrating a significant advantage of one approach over another, therefore, well-designed standardized RCTs are required.
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Affiliation(s)
- Mubarak Ahmed Mashrah
- Department of Oral & Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Department of Oral & Maxillofacial Surgery, Mother and Childhood Hospital, Ministry of Health, Ibb city, Yemen
| | | | - Fahmi Ahmed Al-zubeiry
- Department of Oral & Maxillofacial Surgery, Guanghua Stomatology Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lingjian Yan
- Department of Oral & Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | | | - Xiaopeng Zhao
- Department of Oral & Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chaobin Pan
- Department of Oral & Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
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20
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The extent of surgery for benign parotid pathology and its influence on complications: A prospective cohort analysis. Am J Otolaryngol 2018; 39:162-166. [PMID: 29246390 DOI: 10.1016/j.amjoto.2017.11.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 11/22/2017] [Accepted: 11/28/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND The surgical management of benign parotid tumors is aimed at complete extirpation of the mass with preservation of facial nerve function. There is a relative paucity of literature pertaining to complications after benign parotid surgery and related risk factors. We aim to critically review the outcomes following treatment of benign parotid pathology when surgery entailed either complete superficial parotidectomy (CSP), partial superficial parotidectomy (PSP) or extracapsular dissection (ECD). MATERIAL AND METHODS This is a review of prospectively collected data of all parotidectomies performed between June 2006 to June 2016 for histologically-proven benign pathology of the parotid. Median follow-up time was 31.6weeks. RESULTS A total of 101 parotidectomies were carried out on 97 patients (40 CSP, 56 PSP and 5 ECD). Pleomorphic adenoma (48.4%) and Warthin's tumors (32.7%) were the most common pathologies. Temporary facial weakness occurred after 7 operations (6.9%). Facial weakness was permanent in 4 cases (3.9%). The rates of sialocele and salivary fistula were 4.9% and 0.9%, respectively. Only one patient (0.9%) developed Frey Syndrome postoperatively. No significant associations between extent of parotid surgery and postoperative facial nerve dysfunction (p=0.674) or wound complications (p=0.433) were observed. Univariate analyses for potential contributing factors such as advanced age, smoking status, tumor location or histology did not demonstrate any increased risk with developing postoperative complications. CONCLUSION Partial superficial parotidectomy was associated with low rates of morbidity to the facial nerve and surgical wound. The results were comparable to complete superficial parotidectomy. We recommend offering patient partial superficial parotidectomy where appropriate and this is in line with the current trend of minimising surgical dissection, thereby potentially decreasing the risk of short-term and long-term complications.
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21
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Comparison of Complications in Parotid Surgery With Harmonic Scalpel Versus Cold Instruments. J Craniofac Surg 2017; 28:e342-e344. [DOI: 10.1097/scs.0000000000003581] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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22
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Lewis AG, Tong T, Maghami E. Diagnosis and Management of Malignant Salivary Gland Tumors of the Parotid Gland. Otolaryngol Clin North Am 2017; 49:343-80. [PMID: 27040585 DOI: 10.1016/j.otc.2015.11.001] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Malignant parotid tumors are heterogeneous and diverse. Accurate diagnosis requires a pathologist familiar with the various histologic subtypes, immunohistochemistry stains, and common translocations. Clinical course varies according to tumor subtype, ranging from indolent, slow-growing adenoid cystic carcinoma to rapidly progressive, possibly fatal, salivary ductal carcinoma. Histologic grade is important in prognosis and therapy. Surgery remains the mainstay of treatment when negative margins can be achieved. Radiation improves locoregional control of tumors with high-risk features. Chemotherapy for parotid tumors can be disappointing. Studies of new targeted therapies have not offered significant benefits.
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Affiliation(s)
- Aaron G Lewis
- Department of Surgery, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010, USA
| | - Tommy Tong
- Department of Pathology, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010, USA
| | - Ellie Maghami
- Division of Head and Neck Surgery, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010, USA.
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23
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Britt CJ, Stein AP, Gessert T, Pflum Z, Saha S, Hartig GK. Factors influencing sialocele or salivary fistula formation postparotidectomy. Head Neck 2016; 39:387-391. [PMID: 27550745 DOI: 10.1002/hed.24564] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 06/05/2016] [Accepted: 07/05/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Does the extent of parotidectomy or other patient or tumor characteristics influence the rate of sialocele/salivary fistula formation? METHODS All patients who underwent parotidectomy at the University of Wisconsin from 1994 to 2013 were considered. Patients who developed a sialocele/salivary fistula were identified. Extent of dissection, age, sex, body mass index (BMI), volume of specimen, and rate of malignancy were examined. RESULTS Seventy of 771 patients (9.1%) developed a sialocele/salivary fistula. Sixty-seven fistulae (96%) developed within 1 month and all resolved by 6 months. Age, sex, pathology, and BMI were not increased in the sialocele group. Inferior and middle superficial parotidectomy had a significantly higher rate of sialocele than other extents of dissection. Volume of tissue removed was not significantly different between dissection groups. CONCLUSION Sialocele/salivary fistula is common postparotidectomy and is more likely with inferior and middle superficial parotidectomy. © 2016 Wiley Periodicals, Inc. Head Neck 39: 387-391, 2017.
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Affiliation(s)
- Christopher J Britt
- Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Andrew P Stein
- Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Thomas Gessert
- Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Zach Pflum
- Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Sandeep Saha
- Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Gregory K Hartig
- Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
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24
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Patel DK, Ahmad Z, Morton RP. Partial Superficial Parotidectomy With Retrograde Dissection of the Facial Nerve for Clinically “Benign” Parotid Tumors. Ann Otol Rhinol Laryngol 2016; 125:808-14. [DOI: 10.1177/0003489416655352] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: To review experience with partial superficial parotidectomy (PSP) and retrograde dissection of the facial nerve as a treatment for benign parotid tumors. Methods: Retrospective cohort study of all patients presenting with a suspected benign primary parotid tumor undergoing parotid surgery. Results: There were 214 cases retrieved. Postoperative facial nerve weakness occurred in 33% of patients; all were temporary. Increased extent of surgical resection ( P < .001), deeper tumors ( P = .05), and close tumor proximity to the facial nerve ( P = .007) significantly correlated with postoperative facial weakness. The surgical margin was clear in 54%; 31% had capsule exposed in at least 1 point, and 13.5% had tumor at the margin. Cases with close proximity of tumor to facial nerve were more likely to have tumor at the margin ( P = .034). Conclusion: Partial superficial parotidectomy with retrograde dissection is a suitable method for benign appearing parotid tumors.
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Affiliation(s)
- Depak K. Patel
- Department of Otolaryngology Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand
| | - Zahoor Ahmad
- Department of Otolaryngology Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand
| | - Randall P. Morton
- Department of Otolaryngology Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand
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25
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Jeffe JS, Sulman CG. The use of botulinum toxin B in the treatment of a post-traumatic sialocele in a 4-year-old child: A case report. Int J Pediatr Otorhinolaryngol 2015; 79:2446-9. [PMID: 26471923 DOI: 10.1016/j.ijporl.2015.09.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 09/22/2015] [Accepted: 09/23/2015] [Indexed: 12/26/2022]
Abstract
Parotid sialoceles are bothersome complications of parotidectomy and penetrating injury to the parotid gland. Though typically self-limited and responsive to conservative management, they can be particularly difficult to manage in the pediatric population where even conservative interventions are less well tolerated. We present the case of a 4-year-old child with a post-traumatic parotid sialocele that was successfully managed with a single injection of botulinum toxin B. To our knowledge, this is the first reported case of the use of botulinum toxin for this purpose in the pediatric population.
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Affiliation(s)
- Jill S Jeffe
- Deparment of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, IL, United States.
| | - Cecille G Sulman
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, United States
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26
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Lee YC, Park GC, Lee JW, Eun YG, Kim SW. Prevalence and risk factors of sialocele formation after partial superficial parotidectomy: A multi-institutional analysis of 357 consecutive patients. Head Neck 2015; 38 Suppl 1:E941-4. [DOI: 10.1002/hed.24130] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Revised: 04/13/2015] [Accepted: 05/14/2015] [Indexed: 11/07/2022] Open
Affiliation(s)
- Young Chan Lee
- Department of Otolaryngology-Head and Neck Surgery; School of Medicine, Kyung Hee University; Seoul Korea
| | - Gi Cheol Park
- Department of Otolaryngology; Samsung Changwon Hospital, Sungkyunkwan University School of Medicine; Changwon Korea
| | - Jung-Woo Lee
- Department of Oral and Maxillofacial Surgery; School of Dentistry, Kyung Hee University; Seoul Korea
| | - Young Gyu Eun
- Department of Otolaryngology-Head and Neck Surgery; School of Medicine, Kyung Hee University; Seoul Korea
| | - Seung Woo Kim
- Department of Otolaryngology-Head and Neck Surgery; Veterans Health Service Medical Center; Seoul Korea
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Plaza G, Amarillo E, Hernández-García E, Hernando M. The role of partial parotidectomy for benign parotid tumors: A case-control study. Acta Otolaryngol 2015; 135:718-21. [PMID: 25743619 DOI: 10.3109/00016489.2015.1020394] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To evaluate the results and complications after partial parotidectomy vs superficial parotidectomy, as primary treatment of benign parotid tumors. STUDY DESIGN Case-control study. SETTING University hospital. SUBJECTS AND METHODS A case-control study is presented on parotidectomy, comparing a group of 25 patients treated by partial parotidectomy vs a similar group of 25 patients treated by superficial parotidectomy. All patients had primary benign parotid tumors, were matched by sex and age, and had a minimum follow-up of 4 years. Independent variables included sex, age, medical history, intra-operative variables (surgical time, estimated blood loss, type of drainage, use of collagen), fine-needle aspiration cytology, computed tomography findings, and final histopathological diagnosis. Outcome measures were early and late complications, such as facial nerve paralysis, seroma, sialocele, Frey syndrome, and recurrence. RESULTS Partial parotidectomy resulted in less early and late complications than superficial parotidectomy, with similar recurrence rates. Temporal facial paresis was found in 4% of partial surgeries, vs 12% of superficial parotidectomies, a significant difference. Three months after surgery, only one patient has a persistent marginal nerve paresis. In contrast, sialocele was more common after partial parotidectomy (28% vs 16%), a significant difference. CONCLUSIONS Partial parotidectomy achieves less early and late complications than superficial parotidectomy, with similar recurrence rates.
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Abstract
The antimuscarinic effect of scopolamine causes a reduction of salivary secretion, so it can be used successfully in postoperative parotid surgery. The aim of this article was to demonstrate the efficiency of postoperative use of scopolamine transdermal patch in reduction of complications due to the presence of saliva in the surgical spaces.
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Tuckett J, Glynn R, Sheahan P. Impact of extent of parotid resection on postoperative wound complications: A prospective study. Head Neck 2014; 37:64-8. [DOI: 10.1002/hed.23558] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2013] [Revised: 09/28/2013] [Accepted: 11/26/2013] [Indexed: 11/08/2022] Open
Affiliation(s)
- Joel Tuckett
- Dept of Otolaryngology - Head and Neck Surgery; South Infirmary Victoria University Hospital; Cork Ireland
| | - Ronan Glynn
- Dept of Otolaryngology - Head and Neck Surgery; South Infirmary Victoria University Hospital; Cork Ireland
| | - Patrick Sheahan
- Dept of Otolaryngology - Head and Neck Surgery; South Infirmary Victoria University Hospital; Cork Ireland
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Nooh N, Abdullah WA, Grawish MEA, Ramalingam S, Javed F, Al-Hezaimi K. The effects of surgicel and bone wax hemostatic agents on bone healing: An experimental study. Indian J Orthop 2014; 48:319-25. [PMID: 24932041 PMCID: PMC4052034 DOI: 10.4103/0019-5413.129451] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND The biological effects of hemostatic agends on the physiological healing process need to be tested. The aim of this study was to assess the effects of oxidized cellulose (surgicel) and bone wax on bone healing in goats' feet. MATERIALS AND METHODS Three congruent circular bone defects were created on the lateral aspects of the right and left metacarpal bones of ten goats. One defect was left unfilled and acted as a control; the remaining two defects were filled with bone wax and surgicel respectively. The 10 animals were divided into two groups of 5 animals each, to be sacrificed at the 3(rd) and 5(th) week postoperatively. Histological analysis assessing quality of bone formed and micro-computed tomography (MCT) measuring the quantities of bone volume (BV) and bone density (BD) were performed. The results of MCT analysis pertaining to BV and BD were statistically analyzed using two-way analysis of variance (ANOVA) and posthoc least significant difference tests. RESULTS Histological analysis at 3 weeks showed granulation tissue with new bone formation in the control defects, active bone formation only at the borders for surgicel filled defects and fibrous encapsulation with foreign body reaction in the bone wax filled defects. At 5 weeks, the control and surgicel filled defects showed greater bone formation; however the control defects had the greatest amount of new bone. Bone wax filled defects showed very little bone formation. The two-way ANOVA for MCT results showed significant differences for BV and BD between the different hemostatic agents during the two examination periods. CONCLUSION Surgicel has superiority over bone wax in terms of osseous healing. Bone wax significantly hinders osteogenesis and induces inflammation.
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Affiliation(s)
- Nasser Nooh
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, Riyadh, Saudi Arabia,Engineer Abdullah Bugshan Research Chair for Growth Factors and Bone Regeneration, 3D Imaging and Biomechanical Lab. College of Biomedical Applied Science, King Saud University, Riyadh, Saudi Arabia,Address for correspondence: Prof. Nasser Nooh, Department of Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, Riyadh, Saudi Arabia. E-mail:
| | - Walid A Abdullah
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, Riyadh, Saudi Arabia,Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Egypt
| | - Mohammed El-Awady Grawish
- Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia,Department of Oral Biology, Faculty of Dentistry, Mansoura University, Egypt
| | - Sundar Ramalingam
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Fawad Javed
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia,Engineer Abdullah Bugshan Research Chair for Growth Factors and Bone Regeneration, 3D Imaging and Biomechanical Lab. College of Biomedical Applied Science, King Saud University, Riyadh, Saudi Arabia
| | - Khalid Al-Hezaimi
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia,Engineer Abdullah Bugshan Research Chair for Growth Factors and Bone Regeneration, 3D Imaging and Biomechanical Lab. College of Biomedical Applied Science, King Saud University, Riyadh, Saudi Arabia
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Chen WL, Zhang LP, Huang ZQ, Zhou B. Percutaneous sclerotherapy of sialoceles after parotidectomy with fibrin glue, OK-432, and bleomycin. Br J Oral Maxillofac Surg 2013; 51:786-8. [DOI: 10.1016/j.bjoms.2013.04.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Accepted: 04/04/2013] [Indexed: 10/26/2022]
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