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Comparative Analysis of Fistula Development After Parotid Gland Surgery: Lateral Parotidectomy Versus Extracapsular
Nadia Sadok1, Tobias Bastian1, Noemi Voss1
1Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, Essen, Germany.
Summary
Lateral parotidectomy increases fistula risk threefold compared to extracapsular dissection for benign parotid tumors. Surgeons should consider preventive measures for parotidectomy patients due to higher fistula occurrence.
Area of Science:
- Otolaryngology
- Surgical Oncology
- Head and Neck Surgery
Background:
- Benign parotid gland tumors are common, requiring surgical management.
- Postoperative complications, such as fistulas, can impact patient outcomes.
- Surgical technique choice may influence complication rates.
Purpose of the Study:
- To compare postoperative fistula rates between lateral parotidectomy and extracapsular dissection for benign parotid tumors.
- To identify risk factors associated with fistula development after parotid surgery.
Main Methods:
- A retrospective study of 363 patients undergoing surgery for benign parotid tumors.
- Comparison of fistula rates between (partial) lateral parotidectomy and extracapsular dissection techniques.
- Multivariate logistic regression analysis to assess surgical technique and other risk factors.
Main Results:
- Fistulas occurred in 5.8% of patients (21/363).
- Lateral parotidectomy was associated with a significantly higher fistula rate (12.5% vs. 4.1%, ORadj=2.6, p=0.044).
- No other tested risk factors were significant; facial nerve paralysis rates did not differ between groups.
Conclusions:
- Fistulas are more frequent following (partial) lateral parotidectomy compared to extracapsular dissection.
- Surgeons should be aware of increased fistula risk with lateral parotidectomy and consider preventative strategies.
- Extracapsular dissection may offer a lower fistula risk profile for benign parotid tumors.
