[en] Background/Objectives: The aim of our study was to evaluate clinical outcomes in patients with small pleomorphic adenoma (PA) after extracapsular dissection (ED) versus superficial parotidectomy (SP). Methods: Following the PRISMA guidelines, a systematic review covering the years from 1950 to 2025 was conducted using the Pubmed/MEDLINE, Cochrane Library, Scopus, Ovid MEDLINE and Embase databases. A single-arm meta-analysis was performed to evaluate intraoperative capsular rupture, recurrence, transient and permanent facial nerve palsy, Frey's syndrome, salivary fistula, seroma and hematoma of patients who underwent ED vs. those who underwent SP, and funnel plots were constructed to evaluate the robustness of the findings. Results: Of the 1793 identified papers, 21 articles met the inclusion criteria. The meta-analysis (2507 patients) reported the following: (1) the risk of recurrence is similar in patients treated with ED and SP; (2) the transient facial nerve palsy rate is lower after ED (p < 0.05), while the permanent facial nerve palsy rate is similar with ED and SP; (3) post-operative complications, especially Frey's syndrome (p < 0.05), are more common after SP. Conclusions: Given the similar recurrence rate and the lower morbidity compared to SP, ED could be considered the treatment of choice for pleomorphic adenomas of the parotid gland that are up to 3 cm in size, mobile and located in the superficial lobe of the parotid gland.
Disciplines :
Otolaryngology
Author, co-author :
Salzano, Giovanni ; Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Via Pansini 5, 80131 Naples, Italy
Scocca, Veronica ; Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Via Pansini 5, 80131 Naples, Italy
Troise, Stefania ; Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Via Pansini 5, 80131 Naples, Italy
Abbate, Vincenzo ; Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Via Pansini 5, 80131 Naples, Italy
Bonavolontà, Paola ; Maxillofacial Surgery Unit, Department of Clinical and Surgical Medicine, University Federico II of Naples, Via Pansini 5, 80131 Naples, Italy
Vaira, Luigi Angelo ; Maxillofacial Surgery Operative Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07041 Sassari, Italy
Committeri, Umberto ; Maxillofacial Surgery Unit, Santa Maria Hospital, 05100 Terni, Italy
LECHIEN, Jérome ; Université de Mons - UMONS > Faculté de Psychologie et des Sciences de l'Education > Service de Métrologie et Sciences du langage ; Université de Mons - UMONS > Faculté de Médecine, Pharmacie et Sciences Biomédicales > Service de Chirurgie ; Université de Mons - UMONS > Faculté de Médecine et de Pharmacie > Service de Chirurgie
Tramontano, Sara; Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Via Pansini 5, 80131 Naples, Italy
Canterino, Vitanna; Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Via Pansini 5, 80131 Naples, Italy
Dell'Aversana Orabona, Giovanni ; Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Via Pansini 5, 80131 Naples, Italy
Language :
English
Title :
Pleomorphic Adenoma: Extracapsular Dissection vs. Superficial Parotidectomy-An Updated Systematic Review and Meta-Analysis.
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