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Surgical treatment of chronic parotid sialadenitis

Published online by Cambridge University Press:  14 December 2006

S A R Nouraei ,
Y Ismail ,
N R McLean ,
P J Thomson ,
R H Milner  and
AR Welch
S A R Nouraei
Affiliation:
Department of Otolaryngology, Charing Cross Hospital, London, UK
Y Ismail
Affiliation:
Department of Plastic Surgery, Royal Victoria Infirmary, Newcastle upon Tyne, UK
N R McLean
Affiliation:
Institute of Craniofacial Studies, Adelaide, Australia
P J Thomson
Affiliation:
Department of Oral and Maxillofacial Surgery, Newcastle General Hospital, Newcastle upon Tyne, UK
R H Milner
Affiliation:
Department of Plastic Surgery, Royal Victoria Infirmary, Newcastle upon Tyne, UK
AR Welch
Affiliation:
Department of Otolaryngology, Freeman Hospital, Newcastle upon Tyne, UK.
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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.

Keywords

Parotid GlandSialadenitisParotidectomyMagnetic Resonance Imaging
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 121 , Issue 9 , September 2007 , pp. 880 - 884
Copyright
2006 JLO (1984) Limited

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Footnotes

Presented at the Summer Scientific Meeting of the British Association of Plastic Surgeons, 7 July 2005, Windsor, UK.