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Pediatric Parotidectomy: Do Surgical Indications Affect Outcomes?

Christopher L Kalmar1, Vijay A Patel2, Jesse A Taylor1

  • 1From the Division of Plastic and Reconstructive Surgery, Children's Hospital of Philadelphia, Philadelphia.

Annals of Plastic Surgery
|December 21, 2020
PubMed
Summary

Pediatric parotidectomy complication risks vary by indication. Malignant neoplasms increase nerve injury risk, while vascular malformations raise bleeding concerns. Lymphatic malformations show the lowest complication rates.

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Area of Science:

  • Pediatric surgery
  • Otolaryngology
  • Surgical quality improvement

Background:

  • Parotid gland resections (parotidectomies) in children are performed for diverse pathologies.
  • The specific indication for parotidectomy may influence the risk of adverse events.
  • Understanding these risks is crucial for optimizing pediatric surgical care.

Purpose of the Study:

  • To analyze and compare complication profiles of pediatric parotidectomy across various underlying pathologies.
  • To identify specific indications associated with increased risks of adverse events following parotidectomy in children.

Main Methods:

  • Utilized the American College of Surgeons National Surgical Quality Improvement Program Pediatric data set (2012-2017).
  • Included 208 pediatric patients undergoing parotidectomy.

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  • Classified indications and analyzed complications, readmissions, and reoperations using statistical methods.

    • Main Results:

    • Neoplasms were the most common indication (47.6%), followed by inflammatory conditions (24.0%).
    • Malignant neoplasms significantly increased risks of nerve injury (OR, 3563) and medical complications (OR, 67.2).
    • Vascular malformations were linked to higher bleeding risk (OR, 14.9), while lymphatic malformations had the lowest complication rates (0%).

    Conclusions:

    • Pediatric parotidectomy for malignant neoplasms carries a substantially higher risk of nerve injury.
    • Vascular malformations are associated with an increased risk of bleeding requiring transfusion.
    • Lymphatic malformations represent the lowest-risk indication for parotidectomy in children.