Between 3-10% of head and neck neoplasms are salivary gland tumors the majority of which (75-85%) occur in the parotid gland. Seventy to eighty percent of these parotid tumours are benign and surgical resection is the treatment of choice.
However, there is controversy over the best surgical procedure. The aim of this review is to investigate the effectiveness and complications of Total conservative parotidectomy (TCP) versus Superficial parotidectomy (SP) for the treatment of primary benign parotid tumors.
Searches were conducted in the PubMed, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), Alt Health Watch, Health Source: Consumer Edition, Health Source: Nursing/Academic Edition, CINAH, Scopus, Wily Online Library, and Electronic Journal Centre databases.
Randomised controlled trials (RCTs), quasi-randomised controlled trials, or retrospective studies conducted in humans investigating primary benign parotid tumors without any metastases were considered. Study quality was assessed based on 5 criteria: random selection in the population, definition of inclusion/exclusion criteria, report of follow-up, validated measurements, and statistical analysis.
- 13 studies involving a total of 2477 patients were included.
- 1317 patients underwent superficial parotidectomy; 391 patients underwent total conservative parotidectomy and 769 patients treated with other surgical techniques were excluded.
- 5 studies were considered to be at high risk of bias and 8 at medium risk.
- A narrative summary was presented.
|Superficial parotidectomy||Total conservative parotidectomy|
|Recurrence incidence||0 – 15% (mean 4.57%)||0 – 16% (mean 2.4%)|
|Facial nerve paresis||0 – 23% (mean 6.75%)||0 – 45% (mean 15%)|
|Facial nerve paralysis||0 – 3% (mean 0.8 %)||0 – 17 % (mean 4.4%)|
The authors concluded:
The results of this review suggest that superficial parotidectomy is superior to total conservative parotidectomy in the management of primary benign tumor in superficial lobes. In addition, superficial parotidectomy showed a minimal recurrence rate for benign tumor in superficial lobes.
A detailed search of the literature has been conducted to identify studies for this review. However, all of the included studies were retrospective and considered to be at medium to high risk of bias. This needs to be taken into consideration when interpreting the findings.
El Fol HA, Beheiri MJ, Zaqri WA. Comparison of the effect of total conservative parotidectomy versus superficial parotidectomy in management of benign parotid gland tumor: A systematic review. J Craniomaxillofac Surg. 2015 Jan 15. pii: S1010-5182(15)00012-8. doi: 10.1016/j.jcms.2015.01.002. [Epub ahead of print] PubMed PMID: 25769678.