Surgical Treatment of Chronic Parotitis

Superficial Parotidectomy for Juvenile Recurrent Parotitis

OBJECTIVES

To investigate long-term outcomes, imaging, and pathologic findings in pediatric patients who underwent superficial parotidectomy for recalcitrant juvenile recurrent parotitis (JRP).

METHODS

Records for 20 children (23 parotidectomies; 9 females, 11 males; age at surgery of 8.6 ± 3.7 years) collected over a 10-year period (2012-2021) were reviewed. Parents were contacted via telephone to obtain extended follow-up. A simplified scoring system was used to assess imaging findings and an additional pathologic review was conducted to further clarify the underlying disease process.

RESULTS

All but one patient experienced resolution of their recurrent symptoms after superficial parotidectomy. Three of the patients studied required surgery on the contralateral side, and this could be predicted based on their imaging at the time of the initial surgery. Pathologic findings included ductal fibrosis, metaplasia, and dilatation as well as parenchymal atrophy and fatty deposition. There were no major surgical complications, however, the incidence of Frey's syndrome in this sample was 43.5% of surgical sites.

CONCLUSION

For patients with frequent recalcitrant symptoms or significant quality of life impairment related to JRP, superficial parotidectomy represents a potential treatment option with the noted reduction in symptom burden following surgery. Further longitudinal studies are needed.

LEVEL OF EVIDENCE

4 Laryngoscope, 133:1495-1500, 2023.

Superficial parotidectomy for chronic parotid sialadenitis: a case series and review of the literature

OBJECTIVES

To report the clinical outcomes of patients with chronic parotid sialadenitis treated with superficial parotidectomy, and to review the literature.

METHODS

A retrospective case series was conducted of all patients undergoing parotidectomy for chronic parotid sialadenitis at our institution between 2009 and 2018.

RESULTS

Eighteen superficial parotidectomies were performed, resulting in complete symptom resolution in 17 patients. There was only one recurrence, of a milder form of the disease, requiring no specific treatment. Eight temporary post-operative facial nerve palsies and one permanent palsy occurred. Further complications included post-operative wound haematoma, seroma, Frey's syndrome, neuropathic pain and wound infection.

CONCLUSION

Superficial parotidectomy is sufficient to control patient symptoms, avoiding the increased morbidity associated with near-total parotidectomy. The literature does not point to a clear difference in either the incidence of recurrence or the risk of a facial nerve palsy between the two procedures. Furthermore, the symptoms attributed to recurrence are often not severe enough to warrant salvage near-total parotidectomy.