Superficial and total parotidectomy in parotid neoplasms 10 years of experience in maxillifacial surgery in El Salvador

Abstract

Objective: This study analyzes the prevalence of parotid neoplasms in the region western El Salvador, as well as some cases in San Salvador in the public and private area as a maxillofacial surgeon. Also, he intends to observe the results of the parotidectomy superficial or total with preservation of the facial nerve as definitive treatment. Patients and
Methods: Analytical, retrospective and longitudinal study with 37 patients from the western area from El Salvador; with parotid neoplasms, 31 patients were evaluated regardless of gender and were operated on, performing superficial and total parotidectomy in the period comprised between 2009-2019. There was postoperative follow-up between 9 years and 6 months, evaluating complications surgical procedures, some patients no longer attended their check-ups.
Results: Of all salivary neoplasms, 68.5% were found in the parotid gland. 86.5% of the neoplasms were benign. The most frequent tumor was the pleomorphic adenoma (67.7%), Whartin's tumor (6.4%). Mucoepidermoid carcinomas (8.1%), adenocarcinoma parapharyngeal tumor (2.7%) referred to oncology, with the only malignant tumor operated on a Hodgkin lymphoma (2.7%). The most frequent complications were the paresis of the nerve large earphone (100%), the majority recovered some degree of sensitivity after a year and a half without being quantified, transient mild neuropraxia was observed in 16 patients (51.6%) of whom 15 completely remitted between 2-4 weeks, leaving one patient with weakness of the left eyebrow after 5 years; in addition, there was a total paralysis in Hodgkin's lymphoma where the facial nerve was sacrificed. There were 3 flap necroses and 4 Frey's syndromes. To date, there is no recurrence. Discussion: In this study, the incidence of benign tumors in the parotid gland in agreement with international reports;
being the pleomorphic adenoma followed by the Whartin tumor, the most common tumors that affect more to the feminine gender and the right side. Parotidectomy as a treatment for the management of benign and low-grade malignant parotid neoplasms is effective by not relapse to date without major complications.