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  • Extra-capsular Dissection Versus Superficial Parotidectomy for Clinically Benign Parotid Tumors
    Shaban .M. Abdelmageed and Shawki Sharouda
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  • Extra-capsular Dissection Versus Superficial Parotidectomy for Clinically Benign Parotid Tumors

    Shaban .M. Abdelmageed and Shawki Sharouda
    Assistant Professor of General Surgery, Faculty of Medicine, Ain Shams University

    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.