Extracapsular dissection with a transparotid facial nerve dissection approach versus partial superficial parotidectomy for benign tumours in the tail of the parotid gland: a single-centre retrospective study of 89 patients

Int J Oral Maxillofac Surg. 2023 Jun;52(6):656-662. doi: 10.1016/j.ijom.2022.09.003. Epub 2022 Sep 17.

Abstract

The aims of this study were (1) to evaluate the transparotid facial nerve dissection approach (TFND), in which the intraparotid cervicofacial or temporofacial division is identified first through a superficial lobe incision; and (2) to compare extracapsular dissection with a TFND (ECD-TFND) with partial superficial parotidectomy with a retrograde approach (PSP) for benign tumours in the tail of the parotid gland with respect to surgical outcomes. Eighty-nine patients underwent PSP or ECD-TFND for benign tumours in the tail of the parotid gland: 49 were treated surgically with PSP and 40 with ECD-TFND. The mean ( ± standard deviation) surgical time did not differ significantly between the groups: 64 ± 22.4 min for PSP and 59 ± 19.8 min for ECD-TFND (P = 0.302). There was a significant difference in sialocele: 18 (36.7%) patients in the PSP group and four (10%) in the ECD-TFND group (P = 0.002). There was also a significant difference in facial nerve injuries: temporary paralysis was observed in 13 (26.5%) patients in the PSP group and two (5%) in the ECD-TFND group (P = 0.007). It appears that TFND is a viable and safe approach when performing ECD for benign tumours in the tail of the parotid gland. ECD-TFND should be preferred over PSP for benign tumours in the tail of the parotid gland.

Keywords: Facial nerve; Facial nerve injuries; Facial palsy; Parotid gland; Parotid neoplasms.

MeSH terms

  • Adenoma, Pleomorphic* / pathology
  • Facial Nerve / pathology
  • Facial Nerve / surgery
  • Humans
  • Neoplasm Recurrence, Local / pathology
  • Parotid Gland / pathology
  • Parotid Gland / surgery
  • Parotid Neoplasms* / pathology
  • Parotid Neoplasms* / surgery
  • Postoperative Complications / pathology
  • Retrospective Studies