Selective deep lobe parotidectomy: a systematic review and meta-analysis of outcomes.
I Burridge, M Marwat, V Manoharan et al.
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In 30 seconds
This PRISMA-based systematic review and random-effects meta-analysis assessed outcomes after selective deep lobe parotidectomy, which preserves the superficial lobe, for deep lobe parotid tumours. Eight studies comprising 299 patients were included; all tumours were benign, and no malignancies were reported. Temporary facial weakness occurred in 24.2%, while permanent weakness occurred in 3.0%; recurrence was 0.8%. The authors concluded that the procedure is a safe option for benign deep lobe tumours, while noting the need for larger prospective comparative studies with long-term follow-up.
Key findings
- Across 299 patients, temporary facial weakness occurred in 24.2% and permanent weakness in 3.0%.
- Recurrence was 0.8%; reported complications also included auricular numbness in 36.7% and contour deformity in 11.8%.
- All tumours in the included studies were benign; pleomorphic adenoma accounted for 225 cases (75.3%).
Why it matters
Deep lobe parotid surgery is challenging because of the tumour location and proximity to the facial nerve. These pooled outcomes provide a summary of reported morbidity and recurrence for an approach that preserves the superficial lobe. The findings may help frame discussions of surgical options for benign deep lobe tumours, while the evidence base remains limited to the included studies.
What to keep in mind
The review included eight studies and 299 patients, all with benign tumours. The authors call for larger prospective comparative studies with long-term follow-up.