New Parotidectomy Quality of Life Index Poised to Help Improve Clinical Practice

Clinical Question

What is the potential value of a newly developed Parotidectomy Quality of Life Index (PQOL) in addressing the multidimensional nature of patient-centered outcomes from this procedure?

Bottom Line

Demonstrating excellent internal validity and test–retest reliability, an PQOL may provide the opportunity for improvement in clinical practice.

Background: Parotidectomy is the treatment of choice for most tumors of the parotid gland. While such surgical approaches have excellent outcomes per traditional metrics, patient concerns after parotidectomy are not always considered when reporting surgical success. Few tools currently exist to evaluate the impact of parotidectomy on patient quality of life (QOL).

Study design: Survey study

Setting: Department of Otolaryngology–Head and Neck Surgery, Mayo Clinic, Rochester, Minn.

Synopsis: In this two-phase study, researchers developed and validated a new 35-item patient-reported outcome instrument specific to recovery post-parotidectomy. For phase I (content validation), they mapped 61 items across nine domains related to concerns after parotidectomy and constructed a survey of these items. Thirty of 38 participants who enrolled in the study completed the survey. Participants’ responses were then used to narrow the survey down to 35 items across six domains—pain and sensations, facial appearance, facial nerve function, tumor concerns, immediate surgical recovery, and decision-making and surgical satisfaction—and two standalone items for the final QOL instrument. Researchers enrolled 342 participants for phase II (construct validity, convergent validity, and test–retest reliability), of whom 317 (89% female) completed the narrowed-down survey. Cronbach alpha and pair-wise Pearson correlation coefficients were used to measure internal consistency, reliability, and redundancy. Test–retest reliability was evaluated using intraclass correlation coefficients. Results showed that the PQOL demonstrated excellent content, construct, convergent, and test–retest validity. Authors note that as parotidectomy moves into an era of surgical de-escalation, evaluation of new, minimally invasive techniques via instruments such as the PQOL will be imperative. Study limitations included potential selection bias of the validation cohort.

Citation: Yin LX, et al. Patient-reported quality-of-life outcome measure after parotidectomy. JAMA Otolaryngol Head Neck Surg. 2025;151:441-449. doi:10.1001/jamaoto.2024.5253.