Surgical treatment of chronic parotid sialadenitis.

Abstract

OBJECTIVE:

To review the results of surgical management of chronic parotid sialadenitis refractory to medical therapy, with particular respect to long-term symptom resolution and development of post-operative complications.

METHODS:

A retrospective review of parotidectomies performed for chronic intractable parotid sialadenitis. Information was collected about presentation, pre-operative investigations, surgical treatment, post-operative complications and outcome.

RESULTS:

36 parotidectomies were performed for chronic sialadenitis between 1991 and 2002. Age at presentation was 56+/-9.6 years, with median symptom duration of 2.3 years. For patients with non-specific presentations, magnetic resonance imaging (MRI) was the most useful pre-operative investigation. Superficial parotidectomy with duct preservation was the main treatment with a 94 per cent success rate, and near-total parotidectomy was reserved for patients with extensive deep-lobe involvement. Duct ligation significantly increased the risk of transient facial palsy. There was a 56 per cent and 22 per cent incidence of temporary facial paresis and Frey's syndrome, respectively.

CONCLUSIONS:

Controversies exist regarding the optimal pre-operative investigation and surgical treatment of chronic parotid sialadenitis. We advocate magnetic resonance image (MRI) scanning for patients with non-specific symptoms of sialadenitis, and sialography in the presence of reasonable clinical suspicion. We propose superficial parotidectomy without parotid duct ligation as the standard of care, with near-total parotidectomy reserved for extensive deep-lobe disease.

• Authors: S A R Nouraei, Y Ismail, N R McLean, P J Thomson, R H Milner, A R Welch
• Journal: The Journal of laryngology and otology (J Laryngol Otol) Vol. 121 Issue 9 Pg. 880-4 (Sep 2007) ISSN: 1748-5460 [Electronic] England
• PMID: 17166325 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Child
• Child, Preschool
• Chronic Disease
• Female
• Humans
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Otorhinolaryngologic Surgical Procedures (methods)
• Parotid Diseases (surgery)
• Postoperative Complications
• Retrospective Studies
• Sialadenitis (surgery)
• Sialography
• Treatment Outcome
• United Kingdom