Parotidectomy for benign parotid disease at a university teaching hospital: outcome of 963 operations.
OBJECTIVE
The objective of this study was to analyze the perioperative and long-term complications after standardized lateral and total parotidectomy for benign parotid tumors and chronic parotitis with special regard on the training skill of the surgeons at a university teaching center. All teaching operations were performed under strict microscopic control and supervision of experienced surgeons.


METHODS
The authors conducted a retrospective unicentric study in a tertiary university center.


METHODS
Medical records of 963 lateral and total parotidectomies treated from 1986 to 2004 were analyzed with regard to perioperative and long-term complications. The surgeons' expertise to perform a parotidectomy was classified as beginner (0-20 parotidectomies performed), advanced (21-50), experienced (51-100), or highly experienced (>100).


RESULTS
Eighty-five percent of the cases were primary operations (85%) and 15% revision operations. A lateral parotidectomy was necessary in 61% and total parotidectomy in 39%. The mean operation time was 192 minutes. The incidence of transient facial nerve dysfunction was 25%, and 6% for permanent weakness, respectively. Treatment for Frey's syndrome was performed in 5%. First recurrence for pleomorphic adenoma was observed in 2% and for Warthin's tumor in 3%. Significantly more complications were seen after total parotidectomy and in revision cases. Beginners and advanced surgeons (operated 41% of the cases) needed a longer operation time than experienced and highly experienced surgeon (59% of the cases). The surgeon's expertise had no influence on the incidence of complications.


CONCLUSIONS
Standardized education in lateral and total parotidectomy for treatment of benign parotid disease under precise microscopic control is safe, demonstrates good results, and has low perioperative and long-term morbidity.
Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Koeln, Germany. orlando.guntinas@uni-koeln.de
Orlando
O
Guntinas-Lichius
J Peter
JP
Klussmann
Claus
C
Wittekindt
Eberhard
E
Stennert
D002983:Clinical Competence; D005500:Follow-Up Studies; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006801:Humans; D019647:Oral Surgical Procedures / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data; D010305:Parotid Diseases / Q000601:surgery*; D010306:Parotid Gland / Q000601:surgery*; D011183:Postoperative Complications; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome