The use of bipolar coagulation forceps prevented salivary fistula in patients with parotidectomy: a retrospective study

Background Salivary fistula is a relatively common complication in patients who have undergone a parotidectomy. The purpose of this study was to investigate the effects of bipolar coagulation forceps use on salivary fistulas. Methods From March 2015 to June 2020, 177 patients who underwent a parotidectomy in the Department of Oral and Maxillofacial Surgery at the Second Xiangya Hospital of Central South University were recruited. The patients were divided into an experimental group and a control group based on whether bipolar coagulation forceps or sutures were used, respectively. Results The drainage output of the experimental group was significantly lower than that of the control group (p = 0.04). The duration of dressing pressure applied in the experimental group was significantly shorter than that in the control group (p = 0.0003). Moreover, the incidence of salivary fistula in the experimental group (9.8%, 8/82) was notably lower than that in the control group (34.7%, 33/95) (p < 0.0001). In the logistic regression model for salivary fistula development, both the use of bipolar coagulation forceps (p = 0.0021) and drainage output (p = 0.0237) were associated with the presence of salivary fistulas. Conclusions Our findings indicate that the use of bipolar coagulation forceps decreases the incidence of salivary fistula in patients who have undergone a parotidectomy. The use of bipolar coagulation forceps is a safe, effective, and convenient method to prevent salivary fistulas in patients who undergo a parotidectomy. Trial registration: Current Controlled Trials ChiCTR2100044722, Date: 26/03/2021, Retrospectively registered.

The Bipolar Coagulation Forceps Prevented Salivary Fistula in Patients with Parotidectomy

Background: Salivary fistula is a relatively common complication in patients with parotidectomy. The purpose of this study was to investigate the effect of bipolar coagulation forceps in salivary fistulas.Method and Material: From March 2015 to June 2020, 177 patients for management of parotidectomy were recruit from the Department of Oral and Maxillofacial Surgery at the Second Xiangya Hospital, Central South University. The patients were divided into experimental group and control group according to application of bipolar coagulation forceps or suture, respectively.Results: The draining output of experimental group was dramatically decreased compared to control group (p = 0.04). The duration of pressure dressing application in experimental group was significantly increased compared to control group (p = 0.0003). Moreover, the incidence of salivary fistula in experimental group (9.8%, 8/82) was notably lower than that in control group (34.7%, 33/95) (p < 0.0001). In logistic regression model for salivary fistula development, both of bipolar coagulation forceps (p = 0.0026) and draining output (p = 0.0186) associated with salivary fistula.Conclusion: Our findings indicated that bipolar coagulation forceps decreased the incidence of salivary fistula in parotidectomy patients. The bipolar coagulation forceps is a safe, effective, and convenient method to prevent salivary fistulas in parotidectomy patients.

Management of Benign Parotid Lesions: An Overview of Complications and Extent of Surgical Resection

Background The surgical management of benign lesions of the parotid gland is focused on the complete removal of the lesion, minimizing the chances of recurrence and to preserve facial nerve function. There is a relative paucity of literature regarding the post-operative complications of the surgical procedures for benign parotid lesions. The aim of this study is to evaluate the post- operative complications of a limited surgical procedure, namely partial superficial parotidectomy. Material and Method This retrospective cohort study included all parotid surgeries performed for benign parotid pathology from January 2008 to December 2018. The patient’s demographic data, presenting symptoms, type of surgery performed, complications, presence of post operative facial nerve paralysis and grade, histopathology type and follow up period were collected from hospital records of Al Shifa system. The mean follow-up time was 12.5 months. Results The study yielded a total of 125 partial superficial parotidectomies performed on 123 patients with a mean age of 44.5 years (range 8-87 years). Pleomorphic adenoma (n= 68, 54.4%) and Warthins tumor (n=32, 25.6%), were the most common neoplastic lesions. Non-neoplastic lesions were 18 (14.4%). Temporary facial nerve weakness occurred in 11 patients (8.8%). All cases of facial nerve weakness improved within three months post-operatively. The rate of salivary fistula and sialocele were 5.5% and 1.5% respectively. One patient who had histologically proven pleomorphic adenoma had recurrence of tumor (0.8%). Conclusion Partial superficial parotidectomy was associated with low incidence of facial nerve dysfunction which was mostly transient, and no permanent facial nerve dysfunction was reported. Other complications like sialocele, salivary fistula and Frey’s syndrome were reported at lower rates than the reported rates in the literature for the conventional superficial parotidectomy. The findings support partial superficial parotidectomy approach for the treatment of benign parotid pathology, which entails less extensive resection of parotid parenchyma and less extensive dissection of facial nerve branches thereby minimizing the risk of post-operative complications.

Open Treatment of Mandibular Condyle by Direct Transparotid Approach: Our Experience

The fractures of the mandibular condyle are commonly encountered in maxillofacial surgical practice. The controversies to open or not to open are still ongoing. We have used both techniques, to successfully manage our patients. Open treatment of condyle fracture with or without dislocation is technically challenging. We used a “Direct Transparotid” approach in treating 13 condyle fractures over a period of 4 years. The patients were evaluated for facial nerve injury, salivary fistula, scar, function, and occlusion over a period of 12 months. There were no major complications with acceptable scar, both intraoperatively and postoperatively. The script aims at presenting our experience of direct transparotid approach surgical technique.