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Clinical and patient-reported outcomes between full-endoscopic and conventional parotidectomy: a prospective cohort
Su Chen1, Yun-Cong Huang1, Ze-Kang Su2
1State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China.
Objectives:
This study investigates the clinical and patient-reported outcomes of full-endoscopic parotidectomy compared to the conventional approach.
Methods:
Between July 2021 and December 2023, patients who underwent parotidectomy were prospectively enrolled and assigned to either the full-endoscopic parotidectomy group (Group I) or the conventional surgery group (Group II). Clinical outcomes were evaluated, and patient-reported outcomes were assessed using a Visual Analogue Scale and five FACE-Q scales.
Results:
A total of 293 patients were prospectively included, with 146 in the full-endoscopic group and 147 in the conventional group. Blood loss was significantly lower in the full-endoscopic group (regression coefficient, 0.61; 95% CI, 0.15 to 1.07), as was the rate of immediate facial paralysis (0.76; 95% CI, 0.25 to 1.27). The full-endoscopic group also showed superior outcomes on the Visual Analogue Scale (- 0.14; 95% CI, - 0.23 to - 0.05) and FACE-Q scales for Appearance-Related Psychosocial Distress (1.15; 95% CI, 0.59 to 1.71), Social Function (- 0.37; 95% CI, - 0.59 to - 0.15), Satisfaction with Facial Appearance (- 0.44; 95% CI, - 0.64 to - 0.23), Psychological Function (- 0.39; 95% CI, - 0.58 to - 0.20), and Satisfaction With Outcome (- 0.42; 95% CI, - 0.66 to - 0.19).
Conclusions:
Full-endoscopic parotidectomy yields less blood loss and a reduced incidence of immediate facial paralysis compared to conventional surgery. Patients undergoing full-endoscopic parotidectomy reported better aesthetic and psychological outcomes.
Clinical Relevance:
The combined analysis of clinical and patient-reported outcomes is valuable in guiding surgical planning. These findings provide valuable insights for patients considering full-endoscopic parotidectomy and underscore the importance of addressing functional, aesthetic, and psychological aspects for both patients and healthcare providers.
