Surgical Outcome of Extracapsular Dissection of Benign Parotid Gland Tumor: A Comparative Study to Superficial Parotidectomy

Background/Objectives: Extracapsular dissection has the advantage of reducing complications by minimizing tissue loss of the parotid without intentionally exposing the facial nerve in patients with benign parotid tumor. However, there has been controversy over the surgical results. Thus, the surgical outcomes of extracapsular dissection for benign parotid tumor was compared to those of superficial parotidectomy.Materials & Methods: A retrospective chart review was conducted with 132 patients who received surgery for benign parotid tumor in our center from January 2014 to December 2018 retrospectively.Results: A total of 132 people were enrolled, with 62 people receiving extracapsular dissection, 38 people receiving partial superficial parotidectomy and 32 people receiving superficial parotidectomy. No significant difference was found between the three groups regarding complications such as facial nerve palsy, Frey's syndrome, or first bite syndrome. Operation time and hospital stay was significantly short in extracapsular dissection group.Conclusion: For well-selected cases, extracapsular dissection can be considered as an option for surgery of benign parotid tumor.

Case Series-An Overview of Extracapsular Dissection of Parotid Tumours

Extra Capsular Dissection (ECD) differs markedly from classic surgical approaches to the parotid neoplasm because facial nerve dissection is not performed. Factors noted to favor this approach include mobility of the tumor within the gland, a thin covering of capsule and glandular tissue, and a tumor large enough to allow digital manipulation during dissection. Imaging, fine needle aspiration cytology, and neuron-monitoring play a heightened role in ECD [1]. The AIM of this article is to report case series on surgical management of few types of parotid tumors by extra capsular dissection and to assess longterm results after the treatment of Parotid tumors using surgical technique ECD. This case series includes five different parotid tumors such as Warthin’s tumor, Pleomorphic adenoma, Sialadenoma papilliferum of parotid, chronic sialoadenitis, Parotid cystadenoma, out of 30 cases operated in our hospital. All the patients in this study received appropriate surgical treatment (ECD) and done a follow up evaluation every month. Extra capsular dissection is a safe, reliable and recommended technique to manage the small benign superficial parotid tumors if the case is selected properly.

First branchial arch cyst in an elderly patient: diagnostic dilemma and subsequent management

The branchial system plays a significant role in the embryological development of the many internal and external human body structures. Failure of normal development of these systems may result in branchial system anomalies. Anomalies of the first branchial cleft are rare and account for 1–8% of all branchial anomalies. They have an incidence of 1 per 1 million births, most of which are diagnosed in early childhood. We present an unusual case of a first branchial arch cyst in an elderly gentleman: a 65-year-old man who presented with a persistent swelling in the left pre-auricular region with no associated sinus, fistulae or lymphadenopathy and with an intact facial nerve. Investigations including fine needle aspiration, ultrasound and magnetic resonance imaging led to the diagnosis of a lesion of salivary origin and an extracapsular dissection was undertaken. The histological appearance on excision was, however, in keeping with a first arch branchial cyst. In conclusion, the nonspecific clinical and radiological presentation of first branchial arch anomalies may lead to difficulty and often delay in the diagnosis of these lesions, particularly in elderly patients as it is more often associated with childhood and adolescence. A high level of suspicion is mandatory to prevent inappropriate management in the form of incision and drainage, which further increases the risk of recurrence and facial nerve injury at the time of formal excision due to scarring.

Case series-an overview of extracapsular dissection of parotid tumours

<p>Extra capsular dissection (ECD) differs markedly from classic surgical approaches to the parotid neoplasm because facial nerve dissection is not performed. Factors noted to favor this approach include mobility of the tumor within the gland, a thin covering of capsule and glandular tissue, and a tumor large enough to allow digital manipulation during dissection. Imaging, fine needle aspiration cytology, and neuron-monitoring play a heightened role in ECD. The aim of this article is to report case series on surgical management of few types of parotid tumors by extra capsular dissection and to assess long-term results after the treatment of parotid tumors using surgical technique ECD.This case series includes five different parotid tumors such as Warthin’s tumor, Pleomorphic adenoma, Sialadenoma papilliferum of parotid, chronic sialoadenitis, parotid cystadenoma, out of 30 cases operated in our hospital. All the patients in this study received appropriate surgical treatment (ECD)<strong> </strong>and done a follow up evaluation every month.</p>

Frequency of surgical complications and recurrence rate after extracapsular dissection of benign tumors of the parotid.

Objective: To determine surgical complications and recurrence rate in patients with benign lesions of the parotid undergoing extracapsular dissection. Study Design: Case Series. Setting: Department of Surgery, Rawalpindi Medical University, Rawalpindi. Period: January 2010 and December 2018. Material & Methods: The hospital records of all 50 patients who underwent extracapsular dissection with a diagnosis of either Pleomorphic adenoma or War thin tumor between reviewed retrospectively. Data regarding demographics, tumor, complications and recurrence was collected. Results: Out of 50 patients, 40 were males and 10 were females with age ranging from 26 to 52 years and mean age of 42 years. 44 of 50 parotid lumps were diagnosed as Pleomorphic adenoma and 6 were cases of Warthin tumor. The range of lesion size was 1.5 to 3 cm. 15 (30%) patients suffered from transient facial nerve weakness, whereas only 1 (2%) sustained a facial nerve injury which required repair. There was no case of Frey syndrome, sialocele and hematoma, however, salivary fistula was seen in 1 (2%) patient. Capsule rupture during surgery occurred in 15 (30%) patients and recurrence was seen in only 1 patient (2%). Conclusion: Extracapsular dissection has low recurrence rate, very few complications and is a safe and effective treatment for Pleomorphic adenoma and Warthin tumor.