Resection of parotid benign tumors (a report of 143 cases)

Objective To analyze the surgical treatment of parotid benign tumors.Methods Clinical data of 143 patients with parotid gland benign tumors hospitalized from August 1995 to December 2009 was studied retrospectively.Of all the 143 cases,28 tumors were located in deep-lobe,115 in superficial lobe;5 were bilateral.As for the pathological diagnosis,Warthin tumor was confirmed in 69 cases(48.28%) and mixed tumor in 63 cases(44.06%).As for the surgery,parotid partial superficial lobectomy was performed in 73 cases,parotid superficial lobectomy in 44 cases,parotid partial superficial lobectomy and deep-lobe tumor resection in 13 cases,total parotidectomy in 12 cases and deep-lobe tumor parotidectomy with preservation of the superficial lobe in 3 cases.During operation,the facial nerve was surgically anatomized and protected in all cases.The parotid duct was reserved in 89 cases.Results The postoperative followed-up time ranged from six months to 2 years.Intraoperative facial nerve injury ocurred in 18 cases and got recovered within six months except incomplete recovery in 2.Incomplete paralysis of facial nerve in 28 cases which got complete restored with in 2 months.Salivary fistula in 11 cases recovered within six months.Frey syndrome ocurred in 6 cases.Tumor recurrence occurred in 2 cases.Conclusion For the benign tumor in the superficial lobe of parotid gland,regional surgical resection is preferred with superficial lobectomy as supplement.As for the deep-lobe tumor,the facial nerve can be partially anatomized and the superficial lobe should be approciately retained to satisfy both patients and surgeons in the parotid function preservation and cosmetic appearance.Absolute clearance of the facial nerve branch is not excessively demanded.Rational use of electric knife can reduce blood loss,facial nerve injury,and postoperative salivary fistula formation.