Ahmed A. Noreldin*; MD, Rama A. Ali*; MD, Ahmed M. Kenawy*; MD, LobnaY.Ghanem**; MD, Abeya A. Lotfy** ;MD, Ahmed S. Ismail***; Msc.
Tamer A Wafa, PhD, MRCS, Abdelrahman Elshafey, PhD, Mostafa El-Ayoty, PhD, Mohamed Elzohiri, PhD
Tamer A Wafa, PhD, MRCS, Abdelrahman Elshafey, PhD, Sherif Abdelmaksoud, PhD, Hesham Sheir, PhD, MRCS, Mohamed El-Ghazaly, PhD
Shaban .M. Abdelmageed and Shawki Sharouda
1Adel A. Sied, 2Mohammed A. Rizk, 2Sherif M. Abdel Aziz
Reda Saad Mohamed Ezz, Mohamed Abd El Monem Rizk, Medhat Mohamed Helmy Khalil, Ahmed Heshmat Soliman Ahmed
Tamer M. Nabil1 M.D, Ahmed H. Khalil2 M.D, MRCS, Mohamed M. Elbarbary3 M.D
Mohamed Abd El-Monem Abd El-Salam Rizk, MD, Mohamed Ismail Mohamed Ismail, MD, Ramez Mounir Wahba , MD
Mohamed Abd El-Monem Abd El-Salam Rizk1, MD, Mohamed Ismail mohamed Ismail1, Ramez Mounir Wahba1,Waleed Anwar Abd El-Mohsen2
Ahmed Sobhy Abbass Ahmed Elsobky
1Yasser M. Salama M.Sc. MRCS, 2Mostafa S. Mahmoud MD
Tarek Ahmed Abd El- Azim, Mostafa Soliman Mahmoud, Mohamed Ismail Mohamed,Ahmad Refaat ELGendi*
Ahmed Serag Emara, Gad Mohamed Behairy, Amr H Afifi
Extra-capsular Dissection Versus Superficial Parotidectomy for Clinically Benign Parotid Tumors
Introduction: Surgical techniques for parotid gland tumor removal have been shaped over the years by the
importance of the gland's relationship with the facial nerve, recurrence rates with specific techniques and ,
histologic behavior of parotid tumors. Parotidectomy with facial nerve dissection has become the
procedure of choice in removal of parotid gland tumors because of the associated low recurrence rate.
However, the extensive dissections associated with this procedure can cause significant postoperative
complications and cosmetic disfigurement. In order to avoid these complications, extracapsular dissection
technique can be used in the management of benign lesions of the parotid gland. Objective: The aim of this
study is to compare exra-capsular dissection(ECD) with superficial parotidectomy(SP) in a group of
patients suffering from clinically benign parotid tumors, and to see whether ECD may represent an
alternative option to SP or it can be rather, its evolution. Patients and methods: 36 patients with clinically
benign parotid tumors were included in this prospective study. their ages ranged from 32 years to 63 years.
These patients were managed over a period of 5years. They were managed between November 2012 and
December 2016, at Ain Shams university hospitals in Egypt. The patients were divided into two groups:
the superficial parotidectomy group (SP) involved 19 patients while the extra-capsular dissection group
(ECD) involved 17 patients. All patients were assessed clinically and investigated by ultrasonography,
computerized tomography (C T) and fine needle aspiration cytology ((FNAC). Results: thirty six patients
with benign parotid tumor were included. nineteen cases underwent superficial parotidectomy and 17 cases
underwent extracapsular dissection. twenty one patients were male and 15 patients were females. The
histopathological results included 26 cases of pleomorphic adenoma, 8 cases of Warthin’s tumor, and 2
cases of simple cyst. There was no post-operative permanent facial nerve injury, Frey’s syndrome or
salivary leak within the extracapsular dissection group. however within the superficial parotidectomy
group there were 2 cases of Frey’s syndrome, 1 case of salivary fistula and 5 cases of cosmetic deformity
in the form of depressions in the parotid region . No recurrence was detected in either group. Conclusion:
Extracapsular dissection for benign parotid tumors has low postoperatvemorbidity and good cosmetic
results, compared to superficial parotidectomy.