title: Parotidectomy: a 17-year institutional experience at a rural academic medical center.
abstract: OBJECTIVE
  We describe the parotidectomy experience at a single rural institution over 17 years.
  
  
  METHODS
  We retrieved the records of all patients who underwent parotidectomy for any nontrauma indication (current procedural terminology codes 42410, 42415, 42420, 42425, and 42426) from January 1990 to June 2007 at Dartmouth-Hitchcock Medical Center, a rural medical center that provides both primary and tertiary care to a local population of 14,000, with a catchment area of 600,000 people. Information was collected on initial patient presentation, use of fine-needle aspiration, extent of surgery, final pathologic diagnosis, and complications.
  
  
  RESULTS
  We performed 341 parotidectomy procedures in 334 patients. The largest number of malignancies came from metastatic tumors; squamous cell carcinoma was the most common (37% of malignancies). The most common presenting complaint overall was a painless mass. The most common complication was facial weakness in 17% (57 of 341); 36 of the 57 cases of facial weakness (63%) were associated with surgery for malignancy. The most common benign tumor was pleomorphic adenoma (114 of 186; 61%). Mucoepidermoid carcinoma was the most common primary parotid malignancy (12%).
  
  
  CONCLUSIONS
  In this 17-year rural case series of all parotidectomy procedures done for nontrauma indications, the largest number of malignancies came from metastatic tumors. Although facial nerve paralysis is not a common complication, it occurs most often when surgery is performed for either primary or metastatic malignancy. Surgeons will benefit from this information as they counsel patients who are considering parotidectomy.
authors.affiliation: Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Dartmouth Medical School Hanover, New Hampshire, USA.
authors.forename: Patrick Tate
authors.initials: PT
authors.lastname: Maddox
authors.forename: Joseph Ali
authors.initials: JA
authors.lastname: Paydarfar
authors.forename: Louise
authors.initials: L
authors.lastname: Davies
mesh_terms: D000038:Abscess / Q000209:etiology; D000046:Academic Medical Centers; D008949:Adenoma, Pleomorphic / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000556:secondary / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003560:Cysts / Q000601:surgery; D005152:Facial Muscles; D005260:Female; D006406:Hematoma / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000209:etiology; D010306:Parotid Gland / Q000601:surgery*; D010307:Parotid Neoplasms / Q000556:secondary / Q000601:surgery; D011183:Postoperative Complications; D012042:Registries; D012424:Rural Population; D049291:Seroma / Q000209:etiology; D012793:Sialadenitis / Q000601:surgery; D013547:Sweating, Gustatory / Q000209:etiology; D055815:Young Adult