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Parotidectomy for Benign Parotid Disease at a University Teaching Hospital: Outcome of 963 Operations
Author(s) -
GuntinasLichius Orlando,
Klussmann J Peter,
Wittekindt Claus,
Stennert Eberhard
Publication year - 2006
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/01.mlg.0000200741.37460.ea
Subject(s) - medicine , parotidectomy , perioperative , surgery , pleomorphic adenoma , incidence (geometry) , retrospective cohort study , facial nerve , parotid gland , general surgery , dentistry , salivary gland , physics , pathology , optics
Objective/Hypothesis: The objective of this study was to analyze the perioperative and long‐term complications after standardized lateral and total parotidectomy for benign parotid tumors and chronic parotitis with special regard on the training skill of the surgeons at a university teaching center. All teaching operations were performed under strict microscopic control and supervision of experienced surgeons. Study Design: The authors conducted a retrospective unicentric study in a tertiary university center. Methods: Medical records of 963 lateral and total parotidectomies treated from 1986 to 2004 were analyzed with regard to perioperative and long‐term complications. The surgeons' expertise to perform a parotidectomy was classified as beginner (0–20 parotidectomies performed), advanced (21–50), experienced (51–100), or highly experienced (>100). Results: Eighty‐five percent of the cases were primary operations (85%) and 15% revision operations. A lateral parotidectomy was necessary in 61% and total parotidectomy in 39%. The mean operation time was 192 minutes. The incidence of transient facial nerve dysfunction was 25%, and 6% for permanent weakness, respectively. Treatment for Frey's syndrome was performed in 5%. First recurrence for pleomorphic adenoma was observed in 2% and for Warthin's tumor in 3%. Significantly more complications were seen after total parotidectomy and in revision cases. Beginners and advanced surgeons (operated 41% of the cases) needed a longer operation time than experienced and highly experienced surgeon (59% of the cases). The surgeon's expertise had no influence on the incidence of complications. Conclusions: Standardized education in lateral and total parotidectomy for treatment of benign parotid disease under precise microscopic control is safe, demonstrates good results, and has low perioperative and long‐term morbidity.