Comparative Analysis of Fistula Development After Parotid Gland Surgery: Lateral Parotidectomy Versus Extracapsular Dissection Technique

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Clinical Otolaryngology Pub Date : 2024-08-15 DOI:10.1111/coa.14213

Nadia Sadok, Tobias Bastian, Noemi Voss, Kerstin Stähr, Diana Arweiler-Harbeck, Stephan Lang, Moritz Meyer

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引用次数: 0

Abstract

Purpose

The primary objective of this study was to explore the potential disparity in postoperative fistula occurrence rates between patients who undergo (partial) lateral parotidectomy and those who undergo the extracapsular dissection technique for the management of benign parotid gland tumours.

Methods

A consecutive series of 363 patients treated with (partial) lateral parotidectomy and extracapsular dissection technique for benign parotid gland tumours at one tertiary centre between 2018 and 2022 were included. To evaluate the impact of the surgical technique and possible other risk factors (tumour location, tumour size, Body Mass Index, age, smoking, diabetes mellitus, arterial hypertension) for the development of fistulas, multivariate logistic regression analyses using backward lection were applied to estimate odds ratios (ORs) and 95%-confidence intervals (CIs).

Results

In 363 patients, 21 patients (5.8%) developed a fistula. Patients who underwent (partial) lateral parotidectomy had three times higher chance of developing a fistula compared to patients who were operated using the extracapsular dissection technique (OR_adjusted = 2.6, 4.1% vs. 12.5%, p = 0.044). In the multivariate analyses, no other risk factors for the development of fistulas were statistically significant in this cohort. The incidence of facial nerve paralysis was not significantly different between the extracapsular dissection and lateral parotidectomy group (5/73 = 6.8% vs. 11/290 = 3.8%, p = 0.333).

Conclusion

Fistulas occur more often in patients treated by means of a (partial) lateral parotidectomy approach compared to patients treated using the extracapsular dissection technique. Therefore, surgeons should be vigilant about postoperative fistula risks in lateral parotidectomy and consider preventive measures.

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腮腺手术后瘘管发展的比较分析：腮腺外侧切除术与腮腺囊外切除术技术的对比分析

目的：本研究的主要目的是探讨接受（部分）侧腮腺切除术和接受囊外剥离术治疗良性腮腺肿瘤的患者之间术后瘘管发生率的潜在差异：纳入2018年至2022年间在一家三级中心接受（部分）侧腮腺切除术和囊外剥离技术治疗腮腺良性肿瘤的363例连续系列患者。为评估手术技术和其他可能的风险因素（肿瘤位置、肿瘤大小、体重指数、年龄、吸烟、糖尿病、动脉高血压）对瘘管发生的影响，采用倒推法进行多变量逻辑回归分析，以估计几率比（ORs）和95%置信区间（CIs）：在363名患者中，21名患者（5.8%）出现了瘘管。与采用囊外剥离技术的患者相比，接受（部分）侧腮腺切除术的患者出现瘘管的几率高出三倍（OR调整后=2.6，4.1% vs. 12.5%，p=0.044）。在多变量分析中，该队列中发生瘘管的其他风险因素均无统计学意义。面神经麻痹的发生率在囊外切除术组和侧腮腺切除术组之间没有明显差异（5/73 = 6.8% vs. 11/290 = 3.8%，p = 0.333）：结论：与采用囊外剥离技术治疗的患者相比，采用（部分）外侧腮腺切除术治疗的患者更容易发生瘘管。因此，外科医生应警惕侧腮切除术的术后瘘管风险，并考虑采取预防措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Otolaryngology 医学-耳鼻喉科学

CiteScore

4.00

自引率

4.80%

发文量

106

审稿时长

>12 weeks

期刊介绍： Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with: current otorhinolaryngological practice audiology, otology, balance, rhinology, larynx, voice and paediatric ORL head and neck oncology head and neck plastic and reconstructive surgery continuing medical education and ORL training The emphasis is on high quality new work in the clinical field and on fresh, original research. Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject. • Negative/null results In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.