partial superficial parotidectomy in parotid benign tumor. ipras

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PARTIAL SUPERFICIAL PAROTIDECTOMY IN PAROTID BENIGN TUMOR Ricardo Yáñez MD, Francisco J. Loyola MD, Jorge Cornejo MD, Mariana Valenzuela MD, Raúl Martínez MD and Grace Tapia MD. Dr. Sotero del Río Hospital Chile IPRAS 2013

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Page 1: PARTIAL SUPERFICIAL PAROTIDECTOMY IN PAROTID BENIGN TUMOR. IPRAS

PARTIAL SUPERFICIAL

PAROTIDECTOMY IN PAROTID

BENIGN TUMOR

Ricardo Yáñez MD, Francisco J. Loyola MD, Jorge Cornejo MD, Mariana Valenzuela MD, Raúl Martínez MD and Grace Tapia MD.

Dr. Sotero del Río HospitalChile

IPRAS 2013

Page 2: PARTIAL SUPERFICIAL PAROTIDECTOMY IN PAROTID BENIGN TUMOR. IPRAS

Background

•Neoplasms of the parotid glands account for about 2-3% of head and neck tumors.

•Most tumors are benign and treatment is suprafacial parotidectomy

Lin et al. / American Journal of Otolaryngology–Head and Neck Medicine and Surgery 29 (2008) 94–100

IPRAS 2013

Page 3: PARTIAL SUPERFICIAL PAROTIDECTOMY IN PAROTID BENIGN TUMOR. IPRAS

Background

•The surgical technique of

superficial parotidectomy via a

facelift incision is described.

Lohuis PJ et al .Ann Otol Rhinol Laryngol. 2009 Apr;118(4):276-80.

IPRAS 2013

Page 4: PARTIAL SUPERFICIAL PAROTIDECTOMY IN PAROTID BENIGN TUMOR. IPRAS

Aim

•To present the results of treatment, histology, complications and recurrence.

•To compare classic superficial parotidectomy with partial superficial parotidectomy.

IPRAS 2013

Page 5: PARTIAL SUPERFICIAL PAROTIDECTOMY IN PAROTID BENIGN TUMOR. IPRAS

Method

•Retrospective analysis of all patients

with benign parotid tumors who

underwent parotidectomy at our

center between 2001 and 2010.

•The patients with malignant tumor

was excluded.

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Page 6: PARTIAL SUPERFICIAL PAROTIDECTOMY IN PAROTID BENIGN TUMOR. IPRAS

Method

•Medical record review

•Clinical evaluation

•t-student (SPSS 16.0)

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Page 7: PARTIAL SUPERFICIAL PAROTIDECTOMY IN PAROTID BENIGN TUMOR. IPRAS

MethodSurgical

Technique

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Page 8: PARTIAL SUPERFICIAL PAROTIDECTOMY IN PAROTID BENIGN TUMOR. IPRAS

MethodSurgical Technique for partial

suprafacial parotidectomy via a facelift incision

IPRAS 2013

• Incision is made behind the tragus.

• Then extended distally around the origin of the earlobe to the retroauricular fold.

• At the level of the tragus the retroauricular incision is extended posteriorly and then curved in occipital direction into o just below the hairline.

Page 9: PARTIAL SUPERFICIAL PAROTIDECTOMY IN PAROTID BENIGN TUMOR. IPRAS

Results

•The series consisted of 75 patients, 49 women.

•The average age was 46 years (range 17-77 years).

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Page 10: PARTIAL SUPERFICIAL PAROTIDECTOMY IN PAROTID BENIGN TUMOR. IPRAS

Results

Distribution by surgical technique

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Page 11: PARTIAL SUPERFICIAL PAROTIDECTOMY IN PAROTID BENIGN TUMOR. IPRAS

Results

Distribution by histology

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Page 12: PARTIAL SUPERFICIAL PAROTIDECTOMY IN PAROTID BENIGN TUMOR. IPRAS

Results

n %Temporary facial nerve

palsy35 46.7

Depression of the surgical bed

12 16

Periauricular dysesthesia

14 18.7

Frey syndrome 2 2.6

Dissatisfied with his scar

0 0

Pain or periauricular discomfort

0 0

Tumor recurrence 0 0

Postoperative complications

IPRAS 2013

Page 13: PARTIAL SUPERFICIAL PAROTIDECTOMY IN PAROTID BENIGN TUMOR. IPRAS

Resultsn=75

Total parotidectomy

(n=3)

Suprafacial(n=53)

Parcial(n=19)

Temporary facial nerve palsy

35 (46.7%) 3 (100%) 28 (52.8%) 4 (21%)

Depression of the surgical bed

12 (16%) 3 (100%) 9 (17%) 0

Periauricular dysesthesia

14 (18.7%) 2 (66.7%) 10 (18.8%) 2 (10.5%)

Frey syndrome 2 (2.6%) 2 (66.7%) 0 0

Dissatisfied with scar

0 0 0 0

Pain or periauricular discomfort

0 0 0 0

Tumor recurrence 0 0 0 0

Postoperative complications by surgical technique

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Page 14: PARTIAL SUPERFICIAL PAROTIDECTOMY IN PAROTID BENIGN TUMOR. IPRAS

ResultsSuprafacial

(n=53)Parcial(n=19)

p

Temporary facial nerve

palsy28 (52.8%) 4 (21%) <0,05

Depression of the

surgical bed9 (17%) 0 <0,05

Periauricular dysesthesia

10 (18.8%) 2 (10.5%) N.S

Frey syndrome

0 0 N.S

Dissatisfied with scar

0 0 N.S

Pain or periauricular discomfort

0 0 N.S

Tumor recurrence

0 0 N.S

Comparative analysis: Suprafacial vs parcial

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Page 15: PARTIAL SUPERFICIAL PAROTIDECTOMY IN PAROTID BENIGN TUMOR. IPRAS

Discussion

•The application of techniques based on the anatomy of the facial nerve and less invasive surgeries such as partial suprafacial parotidectomy allow low morbidity rates and no difference in recurrence rate.

•The results obtained were similar to those described in the literature.

IPRAS 2013

Page 16: PARTIAL SUPERFICIAL PAROTIDECTOMY IN PAROTID BENIGN TUMOR. IPRAS

PARTIAL SUPERFICIAL

PAROTIDECTOMY IN PAROTID

BENIGN TUMOR

Ricardo Yáñez MD, Francisco J. Loyola MD, Jorge Cornejo MD, Mariana Valenzuela MD, Raúl Martínez MD and Grace Tapia MD.

Dr. Sotero del Río HospitalChile

IPRAS 2013