gms | German Medical Science

76th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

04.05. - 08.05.2005, Erfurt

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Extracapsular dissection of benign parotid-gland tumors - requirements and indications

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  • corresponding author Heinrich Iro - ENT, Erlangen
  • Alessandro Bozzato - ENT, Erlangen
  • Frank Gottwald - ENT, Erlangen
  • Johannes Zenk - ENT, Erlangen

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 76. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V.. Erfurt, 04.-08.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05hno397

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hno2005/05hno216.shtml

Published: September 22, 2005

© 2005 Iro et al.
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Extracapsular dissection of benign parotid-gland tumors is repeatedly discussed controversially. We report our postsurgical results in an retrospective analysis.

From 2000 to 2004, 103 Partients (61m, 42f, range 15-90, mean age 53,5) underwent extracapsular dissection of a parotid gland tumor. Before surgery high resolution ultrasound was performed in all cases, classifying the mass as being singular, appearing benign and being situated in the superficial part of the gland. Also, electromyography (EMG) reported in all patients a regulary facial nerve function. Extracapsular dissection under neuromonitoring was carried out without contact to the facial nerve, nor opening of the cover of the tumor. The main trunk of the facial nerve had not to be exposed.

Directly after surgery 11 (11%) of our patients suffered from saliva fistula, any of them closed without further surgical treatment within four weeks. Facial palsy House grade II was seen postoperativly in 6 cases, House grade III in three cases. Within 10 weeks in three patients a residual facial palsy House grade II was seen, the EMG predicting a complete restitution in all cases. A symptomatic Frey-Syndrom was not observed.

Subtle presurgical asessment, excluding multiple adenomas, as well as neuromonitoring of facial nerve function are obligat requirements for extracapsular dissection. We emphasise that this surgical approach has to be reserved for the experienced head and neck surgeon, being familiar with complications and the possible ad hoc extension of the procedure.