Bipolar dissection technique in parotid gland surgery

Abstract

Background: Parotid gland surgery (PGS) has to manage the balancing act between sufficient radicality and preservation of functional structures. While many studies evaluate post-therapeutic complication due to different extent of surgery, the current study introduces bipolar dissection (BP) being a fast and safe preparation technique.

Methods: Analysis of clinical parameters (age, sex, tumour entity, treatment modalities, facial nerve palsy, bleeding, saliva fistula and Frey’s syndrome) of 319 consecutively included patients who underwent extracapsular dissection and superficial/total/radical parotidectomy. Subgroup analysis was done according to the preparation technique (cold vs BP).

Results: Facial nerve palsy rate increased with the extent of PGS (p < .0001). There were no differences in the risk of post-operative bleeding, salivary fistula and Frey’s syndrome. BP resulted in a significant reduction of operation time (p = .04), postoperative bleeding (p = .001) and salivary fistula (p = .045) when compared with cold preparation.

Conclusions: Ubiquitous available BP allows fast and safe PGS regardless its extent.

Chinese abstract

背景：腮腺手术（PGS）必须尽量保持在足够大效果和功能结构保存之间的平衡。虽然许多研究探讨由于不同程度的手术导致的治疗后并发症, 但该研究介绍双极解剖（BP）, 它是一种快速安全的制备技术。

方法：接受囊外解剖和浅表/全/腮腺切除术的319例患者被纳入研究, 他们的临床参数（年龄、性别、肿瘤实体、治疗方式、面神经麻痹、出血、唾液瘘管和弗雷综合征）得以分析。根据制备技术（冷相对于BP）进行亚组分析。

结果：面神经麻痹率随PGS程度的变化而增加（p <0.0001）。术后出血、唾液瘘管和弗雷综合征的风险之间无差异。与冷制剂相比, BP导致手术时间（p = 0.04）、术后出血（p = 0.001）和唾液瘘（p = 0.045）的发生率显着降低。

结论：常见的BP导致快速安全的腮腺手术, 无论其程度如何。

Keywords:

• Bipolar dissection
• parotid gland
• parotidectomy
• facial nerve palsy
• outcome

Disclosure statement

All authors disclose any financial or intellectual conflict of interest.