Evaluation of Salivary Function Post-Partial Superficial Parotidectomy

Document Type : Original

Authors

1 Department of Otorhinolaryngology, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Sinus and Surgical Endoscopic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Department of Forensic Medicine and Toxicology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran.

5 Department of Anesthesiology and Intensive Care, Mashhad University of Medical Sciences, Mashhad, Iran.

6 Ear, Nose, Throat, Head and Neck surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction:
Parotid pleomorphic adenomas necessitate surgical intervention, with a growing emphasis on preserving salivary function post-surgery due to its critical role in maintaining oral health and overall quality of life. This study aims to evaluate a surgical method meticulously designed to preserve salivary function following partial superficial parotidectomy, utilizing Technetium-99m scintigraphy.
Materials and Methods:
This single-center prospective cohort study was conducted in Mashhad, Iran, between 2022 and 2023. The study encompassed 40 patients diagnosed with parotid pleomorphic adenomas, ages 20 to 64, undergoing partial superficial parotidectomy. The salivary function was evaluated using Technetium-99m scintigraphy three weeks post-operation.
Results:
Most participants underwent right parotid surgery (62.5%, n=25) instead of left parotid surgery (37.5%, n=15). The outcomes of the partial superficial parotidectomy indicated no complications during the three-week post-operative period. Saliva secretion rates on the operated side were preserved across the cohort. A significant difference in saliva secretion rates was observed between the operated and contralateral sides (P<0.01) for both right and left parotid surgery groups. No significant correlation was found between the time elapsed post-surgery and saliva secretion rates (P=0.48).
Conclusion:
Our study demonstrated that the superficial parotidectomy technique is notably effective when focused on preserving the salivary function of the deep parotid gland. Not only does it maintain saliva secretion on the operated side, but it also boasts an admirable safety profile. There were no recorded complications, and duct preservation was achieved in most instances.

Keywords

Main Subjects

References

  1. Christensen NR, Charabi S, Sørensen WT, Dethloff T, Balle VH, Tos M. [Benign neoplasms in the parotid gland in the county of Copenhagen 1986-1995]. Ugeskr Laeger. 1998;160(42):6066-9.
  2. Singh A, Handa AC, Sachdev R. Synchronous Parotid and Homolateral Submandibular Gland Pleomorphic Adenoma. Iran J Otorhinolaryngol. 2019; 31(104):185-90.
  3. Dulguerov P, Todic J, Pusztaszeri M, Alotaibi NH. Why Do Parotid Pleomorphic Adenomas Recur? A Systematic Review of Pathological and Surgical Variables. Front Surg. 2017;4:26.
  4. Colella G, Cannavale R, Chiodini P. Meta-analysis of surgical approaches to the treatment of parotid pleomorphic adenomas and recurrence rates. J Craniomaxillofac Surg. 2015;43(6):738-45.
  5. Sergi B, Limongelli A, Scarano E, Fetoni AR, Paludetti G. Giant deep lobe parotid gland pleomorphic adenoma involving the parapharyngeal space. Report of three cases and review of the diagnostic and therapeutic approaches. Acta Otorhinolaryngol Ital. 2008;28(5):261-5.
  6. Fan Y, Li S, Yu S, Zhu X, Shi X, Li W, et al. Use of Propensity Score Matching to Compare Short Outcomes from Transoral and External Surgical Approaches in Patients with Deep-Lobe Parotid Pleomorphic Adenomas. Curr Oncol. 2021; 28(4): 3115-23.

 

 

  1. Chang JW, Leem SS, Choi HJ, Lee JH. Modified Functional Superficial Parotidectomy With Ligation of the Major Branch of the Parotid Duct Extending to the Superficial Lobe. Ann Plast Surg. 2017; 78(5): 507-10.
  2. Mandel ID. The role of saliva in maintaining oral homeostasis. The Journal of the American Dental Association. 1989;119(2):298-304.
  3. Wu CB, Xi H, Zhou Q, Zhang LM. The diagnostic value of technetium 99m pertechnetate salivary gland scintigraphy in patients with certain salivary gland diseases. J Oral Maxillofac Surg. 2015; 73(3):443-50.
  4. Colella G, Giudice A, Rambaldi P, Cuccurullo V. Parotid function after selective deep lobe parotidectomy. British Journal of Oral and Maxillofacial Surgery. 2007;45(2):108-11.
  5. Park SJ, Han S, Lee H-J, Ahn S-H, Jeong W-J. Preservation of Salivary Function Following Extracapsular Dissection for Tumors of the Parotid Gland. Journal of Oral and Maxillofacial Surgery. 2018;76(9):2004-10.
  6. Zhang SS, Ma DQ, Guo CB, Huang MX, Peng X, Yu GY. Conservation of salivary secretion and facial nerve function in partial superficial parotidectomy. Int J Oral Maxillofac Surg. 2013;42(7):868-73.
  7. Li C, Xu Y, Zhang C, Sun C, Chen Y, Zhao H, et al. Modified partial superficial parotidectomy versus conventional superficial parotidectomy improves treatment of pleomorphic adenoma of the parotid gland. The American Journal of Surgery. 2014; 208(1): 112-8.
  8. Cristofaro MG, Allegra E, Giudice A, Colangeli W, Caruso D, Barca I, et al. Pleomorphic adenoma of the parotid: extracapsular dissection compared with superficial parotidectomy—a 10-year retrospective cohort study. The scientific world journal. 2014;2014.
  9. Qin H, Zhang L, Ren F, Yi M. A comparison of the effects of partial superficial parotidectomy and superficial parotidectomy on the postoperative parotid absorption and secretion functions in the treatment of pleomorphic adenoma. International Journal Of Clinical And Experimental Medicine. 2020;13(5):3456-62.
  10. Silvoniemi A, Pulkkinen J, Grénman R. Parotidectomy in the treatment of pleomorphic adenoma–analysis of long-term results. Acta oto-laryngologica. 2010;130(11):1300-5.
  11. Ogreden S, Ruzgar S, Alimoglu Y, Eroglu S, Taskin U, Oktay MF. Comparison of Frey syndrome rates following superficial parotidectomy and partial superficial parotidectomy for pleomorphic adenoma. Journal of Craniofacial Surgery. 2016; 27(5):e469-e71.
Iranian Journal of Otorhinolaryngology
Volume 36, Issue 3
May and June 2024
Pages 483-488

Files

Share

How to cite

Statistics