Preservation of Salivary Function Following Extracapsular Dissection for Tumors of the Parotid Gland

Publication date: Available online 28 March 2018
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Sung Joon Park, Sungjun Han, Hyo-Jung Lee, Soon-Hyun Ahn, Woo-Jin Jeong
PurposeWe sought to evaluate salivary function following extracapsular dissection (ECD), compared to partial superficial parotidectomy (PSP) and classic superficial parotidectomy (CSP), of benign parotid gland tumors. The investigators hypothesized that ECD would be superior in preserving post-operative salivary function than PSP and CSP.MethodsRetrospective analyses were performed for 43 consecutive patients undergoing parotidectomies, by a single experienced surgeon, of benign parotid tumors. Clinical data and pre- and post- operative whole salivary flow rates were compared between the operative procedures. Pearson's chi-square, Fisher's exact test was used to compare categorical variables. Kruskal-Wallis, Mann-Whitney U, and Wilcoxon signed rank tests were used to compare means. P value under 0.05 was considered as significant throughout the study.ResultsTumor sizes did not differ between the groups. Operative times, amounts of drainage, and hospital days for ECD were significantly less than for CSP, and tended to be less than PSP. Resection margins were exposed in 0, 12.5, and 6.7% of ECD, PSP, and CSP patients, respectively. Post-operative complications occurred less (but not significantly) following ECD. Post-operative basal salivary flow rates in the ECD, PSP, and CSP groups were 0.39, 0.32, and 0.14 mL/min, respectively (P =.05). Stimulated salivary flow rates remained stable for the ECD and PSP groups, but decreased in the CSP group.ConclusionExtracapsular dissection is a safe and time-efficient surgical approach, offering early recovery for parotid tumors and better preservation of salivary function. ECD should be considered as a surgical approach for parotid tumors, especially those in the parotid tail region, such as for Warthin's tumors.



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