The Role of Extracapsular Dissection for Benign Parotid Tumors

Robert L. Witt; Heinrich Iro; Mark McGurk

doi:10.1007/s40136-014-0045-x

The Role of Extracapsular Dissection for Benign Parotid Tumors

Robert L. Witt^*, Heinrich Iro, Mark McGurk

^*Corresponding author for this work

Research output: Contribution to journal › Review article › peer-review

12 Citations (Scopus)

Abstract

Surgical treatment of benign parotid tumors has been debated for decades. Extracapsular dissection (ECD) differs markedly from classic surgical approaches to the parotid neoplasm because facial nerve dissection is not performed. ECD, its advantages, disadvantages, indications, and contra-indications for benign tumors with an emphasis on benign mixed tumor will be comprehensively explored in this chapter. 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 neuro-monitoring play a heightened role in ECD. Recurrence and permanent facial nerve dysfunction with ECD are not higher in high volume centers performed by experienced surgeons. Transient facial nerve dysfunction, Frey’s syndrome, sensory deficits, and sialocele are lower with ECD. Devastating adverse outcomes of permanent facial nerve dysfunction and recurrence should be considered by the occasional and inexperienced parotid surgeon.

Original language	English
Pages (from-to)	55-63
Number of pages	9
Journal	Current Otorhinolaryngology Reports
Volume	2
Issue number	2
DOIs	https://doi.org/10.1007/s40136-014-0045-x
Publication status	Published - Jun 2014

Keywords

ECD: benign mixed tumor
Extracapsular dissection
Partial superficial parotidectomy
Pleomorphic adenoma
Superficial parotidectomy

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10.1007/s40136-014-0045-x

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title = "The Role of Extracapsular Dissection for Benign Parotid Tumors",

abstract = "Surgical treatment of benign parotid tumors has been debated for decades. Extracapsular dissection (ECD) differs markedly from classic surgical approaches to the parotid neoplasm because facial nerve dissection is not performed. ECD, its advantages, disadvantages, indications, and contra-indications for benign tumors with an emphasis on benign mixed tumor will be comprehensively explored in this chapter. 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 neuro-monitoring play a heightened role in ECD. Recurrence and permanent facial nerve dysfunction with ECD are not higher in high volume centers performed by experienced surgeons. Transient facial nerve dysfunction, Frey{\textquoteright}s syndrome, sensory deficits, and sialocele are lower with ECD. Devastating adverse outcomes of permanent facial nerve dysfunction and recurrence should be considered by the occasional and inexperienced parotid surgeon.",

keywords = "ECD: benign mixed tumor, Extracapsular dissection, Partial superficial parotidectomy, Pleomorphic adenoma, Superficial parotidectomy",

author = "Witt, {Robert L.} and Heinrich Iro and Mark McGurk",

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doi = "10.1007/s40136-014-0045-x",

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AU - Witt, Robert L.

AU - Iro, Heinrich

AU - McGurk, Mark

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N2 - Surgical treatment of benign parotid tumors has been debated for decades. Extracapsular dissection (ECD) differs markedly from classic surgical approaches to the parotid neoplasm because facial nerve dissection is not performed. ECD, its advantages, disadvantages, indications, and contra-indications for benign tumors with an emphasis on benign mixed tumor will be comprehensively explored in this chapter. 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 neuro-monitoring play a heightened role in ECD. Recurrence and permanent facial nerve dysfunction with ECD are not higher in high volume centers performed by experienced surgeons. Transient facial nerve dysfunction, Frey’s syndrome, sensory deficits, and sialocele are lower with ECD. Devastating adverse outcomes of permanent facial nerve dysfunction and recurrence should be considered by the occasional and inexperienced parotid surgeon.

AB - Surgical treatment of benign parotid tumors has been debated for decades. Extracapsular dissection (ECD) differs markedly from classic surgical approaches to the parotid neoplasm because facial nerve dissection is not performed. ECD, its advantages, disadvantages, indications, and contra-indications for benign tumors with an emphasis on benign mixed tumor will be comprehensively explored in this chapter. 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 neuro-monitoring play a heightened role in ECD. Recurrence and permanent facial nerve dysfunction with ECD are not higher in high volume centers performed by experienced surgeons. Transient facial nerve dysfunction, Frey’s syndrome, sensory deficits, and sialocele are lower with ECD. Devastating adverse outcomes of permanent facial nerve dysfunction and recurrence should be considered by the occasional and inexperienced parotid surgeon.

KW - ECD: benign mixed tumor

KW - Extracapsular dissection

KW - Partial superficial parotidectomy

KW - Pleomorphic adenoma

KW - Superficial parotidectomy

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JO - Current Otorhinolaryngology Reports

JF - Current Otorhinolaryngology Reports

IS - 2

ER -

The Role of Extracapsular Dissection for Benign Parotid Tumors

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Keywords

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