Status of the remaining parotid duct and gland following superficial parotidectomy

Predictors of Sialocele or Salivary Fistula After Partial Superficial Parotidectomy for Benign Parotid Tumor: A Retrospective Study

PURPOSE

Partial superficial parotid (PSP) resection is the mainstay of treatment for benign parotid tumor. Unfortunately, the post-surgical formation of sialocele or salivary fistula is a well-recognized complication of parotid surgery. The aim of this study was to determine the predictors of sialocele or salivary fistula after PSP resection for parotid benign tumor.

METHODS

This retrospective cohort study includes patients who underwent PSP resection for benign parotid tumors from January 1, 2015 to December 31, 2019. The predictor variables were demographic data, systemic disease, smoking history, tumor size and type, surgical approach, and area. The outcome variables were the occurrence of sialocele or salivary fistula after PSP resection. Each possible risk factor was then examined using univariate analysis. Variables associated with sialocele or salivary fistula in the univariate analysis were then included in a multiple logistic regression model, and analyzed for possible factors related to the occurrence of sialocele or salivary fistula after partial superficial parotid resection.

RESULTS

The sample was composed of 872 subjects with a mean age of 51.0 ± 8.3, and 59.5% were male. The frequency of sialocele or salivary fistula after partial superficial parotid resection was 10.4% (n = 92). Based on the multiple logistic regression model, hypertension and location of the lesion were associated with sialocoele formation. Hypertension was associated with a decreased risk for the formation of sialocele or salivary fistula (ORs = 0.6, 95% CI = [0.4,1.003], P = .051). When compared the superior lesions, anterior lesions were associated with a decreased risk for the formation of sialocele or salivary fistula (ORs = 0.32, 95% CI = [0.111,0.92], P = .034) and lesions in the middle were associated with an increased risk for sialocele or salivary fistula development (ORs = 2.315,95% CI = [1.199,4.469], P = .012).

CONCLUSIONS

The incidence of sialocele or salivary fistula development was 10.4% in patients undergoing partial superficial parotidectomy in this study. Moreover, middle and anterior tumor location was shown to increase sialocele or salivary fistula risk.

Predictive factors for post-operative drainage after partial superficial parotidectomy: a case-control study

Objectives:

This study aimed to identify the pattern of post-operative drainage following partial superficial parotidectomy with and without the use of a bipolar vessel-sealing device.

Methods:

Of the 49 patients undergoing parotidectomies, a bipolar vessel-sealing device was used for 20. Predictive factors included in the analysis were age, sex, body weight, operating time, tumour pathology, and diabetes mellitus, hypertension and smoking status.

Results:

In multivariate analyses, body weight (p = 0.026) and non-use of a bipolar vessel-sealing device (p = 0.009) were significantly associated with increased post-operative drainage after 24 hours. There was also a trend towards increased drainage in diabetic patients. Operating times were significantly shorter in the bipolar vessel-sealing device group.

Conclusion:

Although 24-hour drainage appears adequate for most patients, in obese and diabetic individuals there is a risk of requiring increased drainage. Therefore, the drain should be left in place for a longer period. The bipolar vessel-sealing device is safe and time-efficient, and decreases the post-operative drainage period.