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Minor Parotidectomy Complications: A Systematic Review
Silvia Lambiel1, Nicolas Dulguerov1, Delphine S Courvoisier2
1Department of Otorhinolaryngology-Head and Neck Surgery, Geneva University Hospital, Geneva, Switzerland.
Objectives:
To report descriptive statistics for minor parotidectomy complications.
Methods:
A systematic review was performed, selecting 235 studies for analysis. The incidence of complications was tabulated, and descriptive statistics calculated. Outlier studies, 1 standard deviation above the mean, were reexamined to determine potential causal factors for each complication. All studies were examined for statistically significant differences for any potential causal factor.
Results:
The pooled incidence of minor complications reported were hematoma 2.9% (95% confidence interval [CI]: 2.4-3.5), wound infection 2.3% (95% CI: 1.8-2.9), sialocele 4.5% (95% CI: 3.5-5.7), salivary fistula 3.1% (95% CI: 2.6-3.7), flap necrosis 1.7% (95% CI: 1.1-2.5), scar issues 3.6% (95% CI: 2.4-5.4), numbness 33.9% (95% CI: 25.6-43.4), and deformity 11.8 (95% CI: 6.9-19.5). Implants result in more wound complications, such as hematoma, sialocele, or salivary fistula. Sialocele and salivary fistula appear more frequently after less extensive parotid surgery, whereas hematoma, wound infections, flap necrosis, and aesthetic considerations are worse with more extensive resections.
Conclusions:
Minor parotidectomy complications are more frequent than generally assumed and related to certain factors that should be investigated. Laryngoscope, 131:571-579, 2021.
Insights
Minor parotidectomy complications like numbness and sialocele are more common than expected. Factors such as implant use and extent of surgery influence complication rates, requiring further investigation.
Area of Science:
- Otolaryngology
- Surgical Oncology
- Plastic Surgery
Background:
- Parotidectomy is a common surgical procedure.
- Understanding the incidence and risk factors for minor complications is crucial for patient outcomes.
Purpose of the Study:
- To provide descriptive statistics on the incidence of minor complications following parotidectomy.
- To identify potential factors associated with these complications.
Main Methods:
- A systematic review of 235 studies was conducted.
- Incidence rates of complications were tabulated and analyzed.
- Outlier studies and potential causal factors were examined.
Main Results:
- Pooled incidence: hematoma 2.9%, wound infection 2.3%, sialocele 4.5%, salivary fistula 3.1%, flap necrosis 1.7%, scar issues 3.6%, numbness 33.9%, deformity 11.8%.
- Implants correlate with increased wound complications (hematoma, sialocele, salivary fistula).
- Less extensive surgery is linked to higher sialocele/salivary fistula rates; more extensive surgery correlates with hematoma, infection, flap necrosis, and aesthetic issues.
Conclusions:
- Minor complications after parotidectomy occur more frequently than generally assumed.
- Specific factors, including surgical extent and implant use, are associated with increased complication risks.
- Further investigation into these factors is warranted to improve surgical outcomes.
