PRISMA-Extracapsular Dissection Versus Superficial Parotidectomy in Treatment of Benign Parotid Tumors: Evidence From 3194 Patients. 2015

Shang Xie, and Kan Wang, and Hui Xu, and Rui-Xi Hua, and Tian-Zhu Li, and Xiao-Feng Shan, and Zhi-Gang Cai
From the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China (SX, KW, HX, T-ZL, X-FS, Z-GC) and Department of Oncology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China (R-XH).

Benign parotid tumor is one of the most common neoplasms in head and neck region. Its therapeutic methods have been debatable topics over the past 100 years. Recently, some surgeons suggest that extracapsular dissection (ECD) instead of superficial parotidectomy (SP) for treatment of benign parotid tumor. This study aimed to compare ECD with SP in the treatment of benign parotid tumors by a meta-analysis.We searched Cochrane Library, PubMed, Embase, Ovid, and Web of Science databases on February 14, 2015 for studies that assessed clinical outcomes of SP and ECD as surgical techniques for the management of benign parotid tumors. Outcome data were evaluated by pooled risk ratio (RR) and corresponding 95% confidence interval (CI).After serious scrutiny, a total of 14 cohort studies with 3194 patients were included in this meta-analysis. The pooled RR revealed that there were no significant difference in tumor recurrence rate between ECD and SP (fixed-effect model: RR = 0.71, 95% CI = 0.40-1.27, P = 0.249; random-effect model: RR = 0.67, 95% CI = 0.38-1.23, P = 0.197). However, there were significantly lower incidences of transient facial nerve dysfunction (FND), permanent FND, and Frey's syndrome in patients of ECD group compared with SP group.ECD might be a good choice in treatment of the benign parotid tumor that were mobile, small, located in superficial lobe and without adhesion to facial nerve; ECD should be performed by the experienced surgeons with ability of dissection facial nerve, who should perform SP if tumor is found adhere to facial nerve during an operation; and a multicenter randomized control trial study is necessary to decide the optimal treatment of benign parotid tumor.

UI MeSH Term Description Entries
D009364 Neoplasm Recurrence, Local The local recurrence of a neoplasm following treatment. It arises from microscopic cells of the original neoplasm that have escaped therapeutic intervention and later become clinically visible at the original site. Local Neoplasm Recurrence,Local Neoplasm Recurrences,Locoregional Neoplasm Recurrence,Neoplasm Recurrence, Locoregional,Neoplasm Recurrences, Local,Recurrence, Local Neoplasm,Recurrence, Locoregional Neoplasm,Recurrences, Local Neoplasm,Locoregional Neoplasm Recurrences,Neoplasm Recurrences, Locoregional,Recurrences, Locoregional Neoplasm
D010306 Parotid Gland The largest of the three pairs of SALIVARY GLANDS. They lie on the sides of the FACE immediately below and in front of the EAR. Gland, Parotid,Glands, Parotid,Parotid Glands
D010307 Parotid Neoplasms Tumors or cancer of the PAROTID GLAND. Cancer of Parotid,Parotid Cancer,Cancer of the Parotid,Neoplasms, Parotid,Cancer, Parotid,Cancers, Parotid,Neoplasm, Parotid,Parotid Cancers,Parotid Neoplasm
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D004210 Dissection The separation and isolation of tissues for surgical purposes, or for the analysis or study of their structures. Dissections
D005155 Facial Nerve Diseases Diseases of the facial nerve or nuclei. Pontine disorders may affect the facial nuclei or nerve fascicle. The nerve may be involved intracranially, along its course through the petrous portion of the temporal bone, or along its extracranial course. Clinical manifestations include facial muscle weakness, loss of taste from the anterior tongue, hyperacusis, and decreased lacrimation. Acquired Facial Neuropathy,Cranial Nerve VII Diseases,Facial Myokymia,Facial Neuropathy,Geniculate Ganglionitis,Cranial Nerve VII Disorders,Facial Nerve Disorders,Facial Nerve Motor Disorders,Facial Nerve Sensory Disorders,Facial Neuritis,Familial Facial Neuropathy,Motor Disorders, Facial Nerve,Sensory Disorders, Facial Nerve,Seventh Cranial Nerve Diseases,Acquired Facial Neuropathies,Disease, Facial Nerve,Diseases, Facial Nerve,Disorder, Facial Nerve,Disorders, Facial Nerve,Facial Myokymias,Facial Nerve Disease,Facial Nerve Disorder,Facial Neuritides,Facial Neuropathies,Facial Neuropathies, Acquired,Facial Neuropathies, Familial,Facial Neuropathy, Acquired,Facial Neuropathy, Familial,Familial Facial Neuropathies,Ganglionitides, Geniculate,Ganglionitis, Geniculate,Geniculate Ganglionitides,Myokymia, Facial,Myokymias, Facial,Neuritides, Facial,Neuritis, Facial,Neuropathies, Facial,Neuropathies, Familial Facial,Neuropathy, Facial,Neuropathy, Familial Facial
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013547 Sweating, Gustatory An autonomic disorder characterized by excessive sweating of the forehead, upper lip, perioral region, or sternum subsequent to gustatory stimuli. The auriculotemporal syndrome features facial flushing or sweating limited to the distribution of the auriculotemporal nerve and may develop after trauma to the parotid gland, in association with PAROTID NEOPLASMS, or following their surgical removal. (From Ann Neurol 1997 Dec;42(6):973-5) Auriculotemporal Syndrome,Baillarger Syndrome,Frey Syndrome,Hyperhidrosis, Gustatory,Auriculotemporal Nerve Syndrome,Frey's Syndrome,Gustatory Sweating,Salivosudoriparous Syndrome,von Frey Syndrome,von Frey's Syndrome,Gustatory Hyperhidroses,Gustatory Hyperhidrosis,Hyperhidroses, Gustatory,Salivosudoriparous Syndromes,Syndrome, Auriculotemporal,Syndrome, Baillarger,Syndrome, Frey,Syndrome, Frey's,Syndrome, Salivosudoriparous,Syndrome, von Frey,Syndrome, von Frey's,Syndromes, Salivosudoriparous,von Freys Syndrome
D015994 Incidence The number of new cases of a given disease during a given period in a specified population. It also is used for the rate at which new events occur in a defined population. It is differentiated from PREVALENCE, which refers to all cases in the population at a given time. Attack Rate,Cumulative Incidence,Incidence Proportion,Incidence Rate,Person-time Rate,Secondary Attack Rate,Attack Rate, Secondary,Attack Rates,Cumulative Incidences,Incidence Proportions,Incidence Rates,Incidence, Cumulative,Incidences,Person time Rate,Person-time Rates,Proportion, Incidence,Rate, Attack,Rate, Incidence,Rate, Person-time,Rate, Secondary Attack,Secondary Attack Rates
D017063 Outcome Assessment, Health Care Research aimed at assessing the quality and effectiveness of health care as measured by the attainment of a specified end result or outcome. Measures include parameters such as improved health, lowered morbidity or mortality, and improvement of abnormal states (such as elevated blood pressure). Assessment, Outcome,Outcome Assessment,Outcome Assessment (Health Care),Outcomes Research,Assessment, Outcomes,Outcome Measures,Outcome Studies,Outcomes Assessment,Assessment, Outcome (Health Care),Assessments, Outcome,Assessments, Outcome (Health Care),Assessments, Outcomes,Measure, Outcome,Measures, Outcome,Outcome Assessments,Outcome Assessments (Health Care),Outcome Measure,Outcome Study,Outcomes Assessments,Research, Outcomes,Studies, Outcome,Study, Outcome

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