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Minimal Margin Extracapsular Dissection: A Viable Alternative Technique for Benign Parotid Lesions?
Caitlin P McMullen1, Richard V Smith2, Thomas J Ow2
1Department of Otolaryngology-Head & Neck Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
The Annals of Otology, Rhinology, and Laryngology
|July 27, 2016
Summary
Minimal margin extracapsular dissection (MECD) for benign parotid tumors shows promise. This technique resulted in low complication rates, including no Frey syndrome and minimal facial nerve weakness, with no recurrences observed.
Area of Science:
- Otolaryngology
- Head and Neck Surgery
- Surgical Oncology
Background:
- Extracapsular dissection (ECD) is a less invasive approach for benign parotid lesions.
- Minimal margin extracapsular dissection (MECD) offers a potentially safer alternative by dissecting closer to the tumor capsule.
Purpose of the Study:
- To evaluate the safety and complication rates of the MECD technique for benign parotid lesions at a single institution.
Main Methods:
- Retrospective review of medical records for 40 patients who underwent MECD.
- Outcomes assessed included intraoperative findings, complications (e.g., facial nerve weakness, Frey syndrome), and tumor recurrence.
Main Results:
- MECD was performed on 40 patients with benign parotid lesions (average size 2.2 cm).
- Two cases (5%) of low-intermediate grade mucoepidermoid carcinoma were identified intraoperatively, requiring completion superficial parotidectomy.
- One case of temporary facial nerve weakness and no cases of Frey syndrome were reported. No tumor recurrences were observed during an average follow-up of 3.5 years.
Conclusions:
- MECD may be a viable alternative to superficial parotidectomy for select benign parotid lesions when performed by experienced surgeons.
- The technique demonstrated low rates of nerve weakness and Frey syndrome.
- Long-term follow-up is needed to fully ascertain recurrence risks.
