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| |  Endoscopic Parotidectomy Is Safer, Less Costly, and Offers Improved Cosmetic Outcome Over Conventional Parotidectomies: Presented at AAO-HNSF By Mary Beth Nierengarten CHICAGO -- September 29, 2008 -- For patients with benign lesions in the parotid tail, minimally-invasive endoscopic surgery offers a safer and less costly treatment with improved cosmetic outcome over conventional parotid approaches, researchers reported here at the American Academy of Otolaryngology - Head and Neck Surgery Foundation (AAO-HNSF) 2008 Annual Meeting & OTO EXPO. Although endoscopic surgery is gaining in popularity and is used more frequently in many surgical disciplines, it is less often in head and neck surgery because of the anatomical complexity of the region, according to the study investigators. To evaluate the benefits of endoscopic parotidectomy and to compare this procedure to conventional parotid surgeries, Shiou-yu Yeh, MD, Department of Otorhinolaryngology - Head and Neck Surgery, Changhua Christian Hospital, Changhua, Taiwan, and colleagues conducted a retrospective comparison of the 2 procedures in patients treated in Changhua Christian Hospital from January 2002 to August 2007. The study's findings were presented in a poster session on September 21. The researchers assessed outcomes in 198 patients with benign parotid tumours treated by conventional parotid surgery and 32 patients with benign parotid tail disease treated by endoscopic parotid surgery. Conventional surgeries included parotid tumour excision, superficial parotidectomy, or total parotidectomy. Variables examined included patient age, gender, wound size, operation time, complications, medical cost, and admission length. Patients were not included in the study if they had parotid tumours, had undergone revision surgery, or had preoperative nerve dysfunction. The study found no difference between the 2 procedures in patient age and gender. Patients treated with endoscopic parotidectomy had a shorter wound size than the conventionally treated group, with a mean wound size of 3.0 cm (range, 2.2-3.5 cm), which, according to the researchers, was nearly invisible. Complication rates were lower in patients treated with endoscopic parotidectomy compared with conventional parotid surgery in terms of transient facial nerve weakness after surgery (12.5% vs 23.7%, respectively), as well as permanent facial nerve weakness (0 vs 5 patients, respectively). Complications among patients treated by conventional surgery were wound infection (n = 5), wound dehiscence (n = 4), postoperative seroma (n = 2), Frey syndrome (n = 1), and pneumonia (n = 1). The duration of surgery was significantly reduced with endoscopic parotidectomy versus conventional parotidectomy (114.8 vs 165.50 minutes, P < .05). Endoscopic parotidectomy also was associated with shorter hospital length of stay and medical cost, but neither comparison was statistically significant. Based on these results the investigators concluded that "the advantages of [endoscopic parotidectomies] include smaller operative scar with cosmetic results, shorter operation time and hospital stay, and less complication rates and medical costs."
[Presentation title: Comparison of Endoscopic and Conventional Parotid Surgeries. Poster S164]
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