Is extracapsular dissection a better option for benign parotid tumors?
Background: While a superficial or total parotidectomy is considered the gold standard surgical intervention for benign parotid tumors, the surgery risks intraoperative damage to the facial nerve. In fact, the rate of temporary paresis of the facial nerve is 15 to 25 percent after superficial parotidectomy and 20 to 50 percent after total parotidectomy, with a 5 to 10 percent rate of permanent facial paresis. Extracapsular dissection without exposure of the facial nerve’s main trunk has recently been favored as an alternative. Data on the incidence of facial nerve lesions and other acute postoperative complications, however, is lacking.
Explore this issue:March 2010
Study Design: Retrospective analysis between 2000 and 2008 of 934 patients operated on for a newly diagnosed benign tumor of the parotid gland. Of these, 377 (40 percent) underwent extracapsular dissection. The authors provided a classification of techniques based on the extent of dissection of the facial nerve, with extracapsular dissection being the cases in which the tumor was removed without exposure of the main trunk of the facial nerve. The function of the facial nerve was assessed pre- and post-surgery using the House-Brackmann grading system.
Setting: University of Erlangen-Nuremberg, Germany