Superficial Parotidectomy and Extracapsular Dissection as Part of Surgeon's Armamentarium for Benign Parotid Tumors: A Clinical Trial

Background: Superficial Parotidectomy (SP) has been considered the standard treatment for benign parotid tumors. In recent years, extracapsular dissection (ECD) is gaining popularity. Literature addressing the comparison of these techniques is limited. Objective: To compare SP and ECD among patients with single, mobile, benign tumor in superficial lobe of parotid gland. Methodology: This randomized trial conducted in King Edward Medical University, Lahore from 2015 to 2018 included patients with solitary, mobile tumor in superficial parotid lobe using non-probability purposive sampling. FNAC confirmed benign tumor and MRI demarcated tumor extent. The patients were randomized for SP or ECD. Post-operatively, the patients were followed up to detect adverse effects and recurrence. Data was analyzed using SPSS 26.0. T-test and Fischer exact test were used considering p-value <0.05 significant. Results: SP group included 27 and ECD included 19 patients with mean ages 48.76.7 and 47.2 +/- 6.2 years respectively. 95.65% of patients had pleomorphic adenoma while rest had Warthin's tumor. Temporary facial nerve palsy was most common adverse effect in SP group (18.52%) followed by Frey's Syndrome (11.11%). Parotid fistula was most common adverse effect in ECD group (10.53%). No patient in either group experienced permanent facial nerve palsy or had recurrence at 1 year follow up. The overall adverse effect rate was lower in ECD than SP (21.05% vs 29.63%) Return to work was significantly shorter in ECD group (5.6+1.2 vs 15.2 +/- 3.7 days, p-value 0.001). Conclusion: The adverse effect rate and recovery period in ECD for small mobile tumor of superficial lobe were lower but not statistically significant.