Surgical management of benign tumors of the parotid gland: the advantages of extracapsular dissection compared to traditional surgical techniques.

IF 1.6 4区医学 Q2 SURGERY

Frontiers in Surgery Pub Date : 2025-01-15 eCollection Date: 2024-01-01 DOI:10.3389/fsurg.2024.1415485

Antonio Zanghì, Andrea Cavallaro, Martine Marchi, Marcello Marchi, Luigi La Via, Filippo Sanfilippo, Alessandro Cappellani, Simone Di Majo

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引用次数: 0

Abstract

Introduction: Salivary gland tumors represent only 3%-6% of all head and neck neoplasms, and approximately 70% of these tumors are located in the parotid gland. Most of these tumors are found in the more abundant superficial portion of the parotid gland, lateral to the facial nerve (FN). For many years, the location of the facial nerve between the superficial and deep segments of the parotid gland hindered adequate tumor extirpation. Several surgical options are available for the treatment of benign tumors in the parotid gland, but there remains no universal agreement on what the optimal surgical treatment is. In the early twentieth century, tumor enucleation was the standard treatment for parotid tumors to preserve the facial nerve, but high recurrence rates were the main downside of this procedure. To improve the outcome, superficial parotidectomy (SP) was implemented, which involves excision of the entire lateral segment of the parotid gland, superficial to the facial nerve. However, this surgical procedure may lead to severe postoperative complications, including facial nerve paralysis, in a significant number of patients. In recent years, more gland-preserving techniques were developed to reduce complication rates and improve the safety of procedures and patients' satisfaction, without increasing the risk of recurrence.

Materials and method: This study compares our surgical experience with extracapsular dissection gland-sparing surgery (ECD) to traditional superficial parotidectomy in 56 patients who underwent surgery performed by the same surgical team.

Results: The superiority of ECD procedures compared to SP procedures was shown as far as total complication rates are concerned. In this case, Fisher's exact test statistic value was 0.0043 (significant at P < 0.05).

Conclusion: ECD should be applied in properly selected cases and further prospective studies are needed to clarify the optimal indications.

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来源期刊

Frontiers in Surgery Medicine-Surgery

CiteScore

1.90

自引率

11.10%

发文量

1872

审稿时长

12 weeks

期刊介绍： Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles. Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery. Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact. The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.