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Indications and Outcomes of Parotidectomy in Saudi Children: Experience From Two Tertiary Centers
Ahmad Albosaily1, Turki Aldrees2, Saleh Aldhahri1
1Department of Otolaryngology, King Saud University, Riyadh, SAU.
Insights
Pediatric parotidectomy is rare, but children with parotid masses face a higher risk of malignancy compared to adults. Tumors in the second decade of life are more often malignant.
Area of Science:
- Pediatric Otolaryngology
- Head and Neck Surgery
- Pediatric Oncology
Background:
- Parotid diseases in children are diverse, with surgery indications differing from adults.
- Most pediatric parotid conditions do not necessitate surgical intervention.
- Understanding parotidectomy outcomes in children is crucial for appropriate management.
Purpose of the Study:
- To review the indications for parotidectomy in a pediatric cohort.
- To evaluate the outcomes of parotidectomy in children.
- To assess the risk of malignancy in pediatric parotid masses.
Main Methods:
- Retrospective review of medical records for patients under 18 who underwent parotid surgery.
- Data collected from two tertiary centers over a 14-year period.
- Analysis included patient demographics, diagnoses, surgical procedures, and complications.
Main Results:
- 18 parotidectomies were performed on pediatric patients (mean age 13.5 years).
- 44.4% of cases were parotid malignancies, with mucoepidermoid carcinoma being most common.
- Temporary facial weakness was the most frequent complication (33.3%), resolving within 2.5 months.
Conclusions:
- Parotidectomy is infrequently performed in the pediatric population.
- Children with solid parotid tumors have an elevated risk of malignancy compared to adults.
- Parotid masses in adolescents (12-17 years) are more likely to be malignant.
Abstract:
Introduction Children can present with a wide variety of parotid diseases. However, most of them do not require surgical treatment. The indications of parotid surgery in children may differ from those in adults. In this study, we aim to review the indications and outcomes of parotidectomy in our pediatric population. Methods Retrospective review of the medical records of patients who underwent parotid surgery at age <18 years in two tertiary centers over a 14-year period. Results A total of 18 parotidectomies were performed on 18 patients with a mean age of 13.5 years. All patients presented with a parotid mass. The most common procedure was superficial parotidectomy followed by total parotidectomy. Ten patients were diagnosed with a benign parotid disease (55.6%). The most common benign disease was pleomorphic adenoma. There were eight cases of parotid malignancy constituting 44.4% of all patients and 57% of patients presenting in the age range of 12-17 years. Mucoepidermoid carcinoma was the most common malignancy (six patients). Fine needle aspiration biopsy was performed in 12 children with a sensitivity, specificity, and overall accuracy of 62.5%, 50%, and 58.6%, respectively. The most common complication was temporary facial weakness (33.3%) which resolved in a mean time of 2.5 months. No disease recurrences were identified. Conclusions Parotidectomy is uncommon in the pediatric age group. Children with a solid parotid tumor have a higher risk of parotid malignancy when compared to adults. A parotid mass presenting in the second decade of life is more likely to be malignant than benign.
