Advertisement
Original Article|Articles in Press

Risk factors for sialocele after parotidectomy: Does tumor size really matter?

Published:March 14, 2023DOI:https://doi.org/10.1016/j.anl.2023.02.006

      Abstract

      Objective

      Sialocele that develops after parotid surgery often prolongs the treatment period and stresses both the surgeon and patient. The extent of surgery and tumor size are known to be associated with sialocele occurrence. We investigated the incidence of post-parotidectomy sialocele and the associated risk factors, with a focus on tumor size.

      Methods

      We retrospectively reviewed the medical records of 172 patients who underwent parotidectomy between January 2013 and May 2020 at Haeundae Paik Hospital, Inje University of Korea. We stratified patients into those with and without sialocele (fluid collection in the operative bed). We compared clinical data, patient demographics, and surgical details; we identified risk factors for sialocele development after parotid surgery.

      Results

      Seventeen patients were diagnosed with post-parotidectomy sialocele (9.88%; 17/172). Univariate logistic regression revealed that the male sex, deep lobe tumor location, and large tumor size were significantly associated with postoperative sialocele (p = 0.015, 0.009, and 0.016, respectively). We subjected these parameters to multivariate analyses; the odds ratios were 3.70, 3.58, and 2.34, respectively. Receiver operating characteristic curve analyses showed that a tumor size > 2.50 cm was the optimal cutoff in terms of predicting post-parotidectomy sialocele.

      Conclusion

      Male sex, a tumor in the deep lobe, and large tumor size were strongly associated with increased risk for sialocele after parotidectomy. Tumor size > 2.50 cm serves as the cutoff identifying patients likely to experience sialocele after parotid surgery.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Auris Nasus Larynx
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Herbert HA
        • Morton RP.
        Sialocele after parotid surgery: assessing the risk factors.
        Otolaryngol Head Neck Surg. 2012; 147: 489-492
        • Marchese Ragona R
        • Blotta P
        • Pastore A
        • Tugnoli V
        • Eleopra R
        • De Grandis D.
        Management of parotid sialocele with botulinum toxin.
        Laryngoscope. 1999; 109: 1344-1346
        • Witt RL.
        The incidence and management of siaolocele after parotidectomy.
        Otolaryngol Head Neck Surg. 2009; 140: 871-874
        • Bova R
        • Saylor A
        • Coman WB.
        Parotidectomy: review of treatment and outcomes.
        ANZ J Surg. 2004; 74: 563-568
        • Klintworth N
        • Zenk J
        • Koch M
        • Iro H.
        Postoperative complications after extracapsular dissection of benign parotid lesions with particular reference to facial nerve function.
        Laryngoscope. 2010; 120: 484-490
        • Lee YC
        • Park GC
        • Lee JW
        • Eun YG
        • Kim SW.
        Prevalence and risk factors of sialocele formation after partial superficial parotidectomy: a multi-institutional analysis of 357 consecutive patients.
        Head Neck. 2016; 38 (Suppl): E941-E944
        • SNOW GB
        The surgical approaches to the treatment of parotid pleomorphic adenomas.
        Controversies in the management of salivary gland disease. Oxford University Press, Oxford2001: 57-63
        • Iro H
        • Zenk J.
        Role of extracapsular dissection in surgical management of benign parotid tumors.
        JAMA Otolaryngol Head Neck Surg. 2014; 140: 768-769
        • Lee SY
        • Koh YW
        • Kim BG
        • Hong HJ
        • Jeong JH
        • Choi EC.
        The extended indication of parotidectomy using the modified facelift incision in benign lesions: retrospective analysis of a single institution.
        World J Surg. 2011; 35: 2228-2237
        • Borsetto D
        • Fussey JM
        • Cazzador D
        • Smith J
        • Ciorba A
        • Pelucchi S
        • et al.
        The diagnostic value of cytology in parotid Warthin's tumors: international multicenter series.
        Head Neck. 2020; 42: 522-529
        • Koch M
        • Zenk J
        • Iro H.
        Long-term results of morbidity after parotid gland surgery in benign disease.
        Laryngoscope. 2010; 120: 724-730
        • Mohammed F
        • Asaria J
        • Payne RJ
        • Freeman JL.
        Retrospective review of 242 consecutive patients treated surgically for parotid gland tumours.
        J Otolaryngol Head Neck Surg. 2008; 37: 340-346
        • Ye WM
        • Zhu HG
        • Zheng JW
        • Wang XD
        • Zhao W
        • Zhong LP
        • et al.
        Use of allogenic acellular dermal matrix in prevention of Frey's syndrome after parotidectomy.
        Br J Oral Maxillofac Surg. 2008; 46: 649-652
        • Plaza G
        • Amarillo E
        • Hernández-García E
        • Hernando M
        The role of partial parotidectomy for benign parotid tumors: a case-control study.
        Acta Otolaryngol. 2015; 135: 718-721
        • Aizawa T
        • Kuwabara M
        • Kubo S
        • Aoki S
        • Azuma R
        • Kiyosawa T.
        Polyglycolic acid felt for prevention of frey syndrome after parotidectomy.
        Ann Plast Surg. 2018; 81: 438-440
        • Chandarana S
        • Fung K
        • Franklin JH
        • Kotylak T
        • Matic DB
        • Yoo J.
        Effect of autologous platelet adhesives on dermal fat graft resorption following reconstruction of a superficial parotidectomy defect: a double-blinded prospective trial.
        Head Neck. 2009; 31: 521-530
        • Tuckett J
        • Glynn R
        • Sheahan P.
        Impact of extent of parotid resection on postoperative wound complications: a prospective study.
        Head Neck. 2015; 37: 64-68
        • Romano A
        • Cama A
        • Corvino R
        • Graziano P
        • Friscia M
        • Iaconetta G
        • et al.
        Complications after parotid gland surgery Our experience.
        Ann Ital Chir. 2017; 88: 295-301
        • Scott J.
        Age, sex and contralateral differences in the volumes of human submandibular salivary glands.
        Arch Oral Biol. 1975; 20: 885-887
        • Ericson S.
        The importance of sialography for the determination of the parotid flow. The normal variation in salivary output in relation to the size of the gland at stimulation with citric acid.
        Acta Otolaryngol. 1971; 72: 437-444
        • Ericson S
        • Hedin M
        • Wiberg A.
        Variability of the submandibular flow rate in man with special reference to the size of the gland.
        Odontol Revy. 1972; 23: 411-420
        • Dawes C
        • Cross HG
        • Baker CG
        • Chebib FS.
        The influence of gland size on the flow rate and composition of human parotid saliva.
        Dent J. 1978; 44: 21-25
        • Chow TL
        • Kwok SP.
        Use of botulinum toxin type A in a case of persistent parotid sialocele.
        Hong Kong Med J. 2003; 9: 293-294
        • Rojoa D
        • Raheman F
        • Wright R
        • Ghosh S.
        The use of tissue sealant in parotidectomy – a systematic review and meta-analysis.
        Authorea Preprints, 2020
        • Maharaj M
        • Diamond C
        • Williams D
        • Seikaly H
        • Harris J.
        Tisseel to reduce postparotidectomy wound drainage: randomized, prospective, controlled trial.
        J Otolaryngol. 2006; 35: 36-39
        • Marchese-Ragona R
        • Marioni G
        • Restivo DA
        • Staffieri A.
        The role of botulinum toxin in postparotidectomy fistula treatment. A technical note.
        Am J Otolaryngol. 2006; 27: 221-224
        • Vargas H
        • Galati LT
        • Parnes SM.
        A pilot study evaluating the treatment of postparotidectomy sialoceles with botulinum toxin type A.
        Arch Otolaryngol Head Neck Surg. 2000; 126: 421-424
        • Laskawi R
        • Winterhoff J
        • Köhler S
        • Kottwitz L
        • Matthias C.
        Botulinum toxin treatment of salivary fistulas following parotidectomy: follow-up results.
        Oral Maxillofac Surg. 2013; 17: 281-285
        • Lim YC
        • Choi EC.
        Treatment of an acute salivary fistula after parotid surgery: botulinum toxin type A injection as primary treatment.
        Eur Arch Otorhinolaryngol. 2008; 265: 243-245
        • Ellies M
        • Gottstein U
        • Rohrbach-Volland S
        • Arglebe C
        • Laskawi R.
        Reduction of salivary flow with botulinum toxin: extended report on 33 patients with drooling, salivary fistulas, and sialadenitis.
        Laryngoscope. 2004; 114: 1856-1860
        • Mantsopoulos K
        • Goncalves M
        • Iro H.
        Transdermal scopolamine for the prevention of a salivary fistula after parotidectomy.
        Br J Oral Maxillofac Surg. 2018; 56: 212-215
        • Becelli R
        • Morello R
        • Renzi G
        • Matarazzo G.
        Use of scopolamine patches in patients treated with parotidectomy.
        J Craniofac Surg. 2014; 25: e88-e89
        • Gallo A
        • Manciocco V
        • Pagliuca G
        • Martellucci S
        • de Vincentiis M.
        Transdermal scopolamine in the management of postparotidectomy salivary fistula.
        Ear Nose Throat J. 2013; 92: 516-519