Facial paralysis after superficial parotidectomy: analysis of possible predictors of this complication

ABSTRACT INTRODUCTION: Salivary gland tumors represent 3-10% of all head and neck neoplasms. These tumors occur predominantly in major salivary glands. The parotid gland is affected most often, ranging from 36.6% to 83%. The pleomorphic adenoma comprises 45-60% of all salivary gland tumors. Several surgical approaches have been described to treat this tumor. Lesion of the facial nerve is one of the most serious complications that can occur after parotid gland surgery. OBJECTIVES: To determine possible predictive factors related to the occurrence of peripheral facial paralysis (PFP) after superficial parotidectomy in the surgical treatment of the pleomorphic adenomas of the parotid gland. METHODS: This was a primary, observational, case-control study performed through the revision of patients' charts and histopathological reports. Data was obtained from 1995 to 2014. The analyzed events were: tumor's length and depth; duration of the disease referred by the patient (more than 1, 5 or 10 years); primary or secondary surgical approach. RESULTS: The analysis showed that tumor lengths equal or superior to 3.0 cm were a risk factor of PFP with an odds ratio of 3.98 (p = 0.0310). Tumor depths equal or superior to 2.0 cm were also a risk factor with an odds ratio of 9.5556 (p = 0.0049). When the tested event was secondary surgery to recurrent tumors we have found an odds ratio of 6.7778 (p = 0.0029). CONCLUSION: Tumors with 3.0 cm or more in length and/or 2.0 cm or more in depth have a significant higher risk of facial nerve injury. Secondary surgery to recurrent tumors also has a much higher risk of evolving with facial palsy after superficial parotidectomy.

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Main Authors: Bittar,Renato Fortes, Ferraro,Homero Penha, Ribas,Marcelo Haddad, Lehn,Carlos Neutzling
Format: Digital revista
Language:English
Published: Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. 2016
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1808-86942016000400447
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spelling oai:scielo:S1808-869420160004004472016-09-09Facial paralysis after superficial parotidectomy: analysis of possible predictors of this complicationBittar,Renato FortesFerraro,Homero PenhaRibas,Marcelo HaddadLehn,Carlos Neutzling Salivary gland neoplasms Parotidectomy Superficial parotidectomy Facial nerve Facial paralysis ABSTRACT INTRODUCTION: Salivary gland tumors represent 3-10% of all head and neck neoplasms. These tumors occur predominantly in major salivary glands. The parotid gland is affected most often, ranging from 36.6% to 83%. The pleomorphic adenoma comprises 45-60% of all salivary gland tumors. Several surgical approaches have been described to treat this tumor. Lesion of the facial nerve is one of the most serious complications that can occur after parotid gland surgery. OBJECTIVES: To determine possible predictive factors related to the occurrence of peripheral facial paralysis (PFP) after superficial parotidectomy in the surgical treatment of the pleomorphic adenomas of the parotid gland. METHODS: This was a primary, observational, case-control study performed through the revision of patients' charts and histopathological reports. Data was obtained from 1995 to 2014. The analyzed events were: tumor's length and depth; duration of the disease referred by the patient (more than 1, 5 or 10 years); primary or secondary surgical approach. RESULTS: The analysis showed that tumor lengths equal or superior to 3.0 cm were a risk factor of PFP with an odds ratio of 3.98 (p = 0.0310). Tumor depths equal or superior to 2.0 cm were also a risk factor with an odds ratio of 9.5556 (p = 0.0049). When the tested event was secondary surgery to recurrent tumors we have found an odds ratio of 6.7778 (p = 0.0029). CONCLUSION: Tumors with 3.0 cm or more in length and/or 2.0 cm or more in depth have a significant higher risk of facial nerve injury. Secondary surgery to recurrent tumors also has a much higher risk of evolving with facial palsy after superficial parotidectomy.info:eu-repo/semantics/openAccessAssociação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial.Brazilian Journal of Otorhinolaryngology v.82 n.4 20162016-08-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1808-86942016000400447en10.1016/j.bjorl.2015.08.024
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libraryname SciELO
language English
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author Bittar,Renato Fortes
Ferraro,Homero Penha
Ribas,Marcelo Haddad
Lehn,Carlos Neutzling
spellingShingle Bittar,Renato Fortes
Ferraro,Homero Penha
Ribas,Marcelo Haddad
Lehn,Carlos Neutzling
Facial paralysis after superficial parotidectomy: analysis of possible predictors of this complication
author_facet Bittar,Renato Fortes
Ferraro,Homero Penha
Ribas,Marcelo Haddad
Lehn,Carlos Neutzling
author_sort Bittar,Renato Fortes
title Facial paralysis after superficial parotidectomy: analysis of possible predictors of this complication
title_short Facial paralysis after superficial parotidectomy: analysis of possible predictors of this complication
title_full Facial paralysis after superficial parotidectomy: analysis of possible predictors of this complication
title_fullStr Facial paralysis after superficial parotidectomy: analysis of possible predictors of this complication
title_full_unstemmed Facial paralysis after superficial parotidectomy: analysis of possible predictors of this complication
title_sort facial paralysis after superficial parotidectomy: analysis of possible predictors of this complication
description ABSTRACT INTRODUCTION: Salivary gland tumors represent 3-10% of all head and neck neoplasms. These tumors occur predominantly in major salivary glands. The parotid gland is affected most often, ranging from 36.6% to 83%. The pleomorphic adenoma comprises 45-60% of all salivary gland tumors. Several surgical approaches have been described to treat this tumor. Lesion of the facial nerve is one of the most serious complications that can occur after parotid gland surgery. OBJECTIVES: To determine possible predictive factors related to the occurrence of peripheral facial paralysis (PFP) after superficial parotidectomy in the surgical treatment of the pleomorphic adenomas of the parotid gland. METHODS: This was a primary, observational, case-control study performed through the revision of patients' charts and histopathological reports. Data was obtained from 1995 to 2014. The analyzed events were: tumor's length and depth; duration of the disease referred by the patient (more than 1, 5 or 10 years); primary or secondary surgical approach. RESULTS: The analysis showed that tumor lengths equal or superior to 3.0 cm were a risk factor of PFP with an odds ratio of 3.98 (p = 0.0310). Tumor depths equal or superior to 2.0 cm were also a risk factor with an odds ratio of 9.5556 (p = 0.0049). When the tested event was secondary surgery to recurrent tumors we have found an odds ratio of 6.7778 (p = 0.0029). CONCLUSION: Tumors with 3.0 cm or more in length and/or 2.0 cm or more in depth have a significant higher risk of facial nerve injury. Secondary surgery to recurrent tumors also has a much higher risk of evolving with facial palsy after superficial parotidectomy.
publisher Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial.
publishDate 2016
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1808-86942016000400447
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