Patient's perspective on long-term complications after superficial parotidectomy for benign lesions: Prospective analysis of a 2-year follow-up

Objective: Evaluation of patients perspective on long-term complications after superficial parotidectomy for benign lesions. Design: A prospective nonrandomized controlled multicenter study. Setting: Three university-based tertiary referral centers (Departments of Otorhinolaryngology of Cologne, Jena and Giessen; all in Germany). Participants: 130 adult patients, who underwent a primary superficial parotidectomy for benign tumors of the parotid gland, were consecutively included from 09/2010 to 05/2012. 61 patients completed every follow-up examination. Main outcome measures: Complications were evaluated using the validated German-language questionnaire Parotidectomy Outcome Inventory 8 at six, 12 and 24months after surgery. Pain intensity was assessed on a numeric rating scale (NRS) at each follow-up visit. Results: At 6 months after surgery, 90% characterized hypoesthesia as the most disturbing problem, followed by fear of revision surgery (57%) and scar (56%). Facial palsy (14%) posed the minor problem. Hypoesthesia improved significantly during the follow-up period (all P<.05), but still posed a problem for 78% of the patients after 2years. Pain, which initially bothered 53% of the patients, significantly decreased, whereas impairment due to Freys syndrome significantly increased during the follow-up (6 vs 24months; P=.002 and P=.001, respectively). Scar, substance loss, xerostomia, facial palsy, and anxiety affected patients with unvarying severity during the 2years (all P>.05). Conclusions: From patients perspective, sensation loss posed the major subjective problem after superficial parotidectomy. Appearance of the scar, and fear of revision surgery impaired more than 50% of the patients in their daily life without significant improvement during the 2years postoperatively. Although superficial parotidectomy is a highly standardized and safe procedure, limited parotidectomy for proven benign parotid salivary gland neoplasms is more likely to result in patients with minimal or no displeasing complications.