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Consensus on current clinical workflow and future use of 3D models in parotid gland tumor surgery: A Delphi study
Manon C M Moll1, Luc H E Karssemakers2, Loes M M Braun3
1Department of Head and Neck Surgery and Oncology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek, Plesmanlaan 121, Amsterdam, 1066 CX, the Netherlands; Department of Head and Neck Surgery and Oncology, Verwelius 3D Lab, The Netherlands Cancer Institute, Antoni van Leeuwenhoek, Amsterdam, the Netherlands; Academic Centre of Dentistry Amsterdam, Vrije Universiteit, Gustav Mahlerlaan 3004, Amsterdam, 1081 LA, the Netherlands.
Objective:
MRI-based 3D models provide patient-specific spatial information on the relationship between parotid gland tumors and the facial nerve. However, their potential role in clinical practice and the level of support for their implementation remain unclear. This study aimed to assess the level of consensus among surgeons on the current clinical workflows in parotid gland surgery and the future role of 3D models.
Study Design:
We used a three-round Delphi study to explore consensus among surgeons performing more than five parotid surgeries annually. Round 1 consisted of semi-structured interviews about parotid surgery, innovations, and the use of 3D models. Inductive analysis was used to formulate statements and questions for round 2. In rounds 2 and 3, participants rated the questions and statements on a 7-point adjective scale.
Results:
A panel of 15 surgeons, including 9 otolaryngologists and 6 oral and maxillofacial surgeons from nine Dutch hospitals, completed all study rounds. Partial consensus was observed for 10% of statements in round 3. Trends toward greater importance of both MRI scanning and 3D model use were identified in cases involving malignancy, facial nerve dysfunction, deep lobe tumors, fixed tumors, non-palpable tumors, and indications for a mastoidectomy. Stronger trends toward importance were observed for using 3D models in preoperative planning and patient counseling than in their use during surgery.
Conclusion:
Although consensus was limited, this study identified indications for MRI use and highlighted the perceived value of 3D models in parotid gland tumor surgery.
