title: Methylene blue staining in the parotid surgery: Randomized trial, 144 patients.
abstract: OBJECTIVE
  To investigate usefulness of the methylene blue staining for parotid gland surgery.
  
  
  METHODS
  Randomized, prospective controlled trial.
  
  
  METHODS
  The study analyzed 144 surgical operations (2000-2014) for parotidectomy. The cases were randomly divided into two groups: Group 1 (n=70) for surgeries with methylene blue staining, and Group 2 (n=74) for surgeries without staining. Surgical complications like temporary facial weakness, permanent facial nerve injury, and Frey's syndrome were taken for comparison between groups as well as rate of tumor recurrence.
  
  
  RESULTS
  Temporary facial weakness and Frey's syndrome occurred almost evenly in both groups (p=0.34, p=0.68 respectively). Permanent facial nerve injury was significantly lower in the group with staining (p=0.032) and the decline of rate of tumor recurrence was even more significant (p=0.007).
  
  
  CONCLUSIONS
  Intravital staining with methylene blue in parotidectomies simplifies the operation and could assist in better visualization that leads to (1) rapid and precise localization of the tumor, (2) preservation of the facial nerve, and (3) complete removal of the gland tissue in cases with malignancy. This technique reduces the rate of recurrence in cases with malignant tumors.
  
  
  METHODS
  1.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Assaf Harofe Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel. Electronic address: vaimed@yahoo.com.
authors.forename: Michael
authors.initials: M
authors.lastname: Vaiman
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Assaf Harofe Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel.
authors.forename: Basel
authors.initials: B
authors.lastname: Jabarin
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Assaf Harofe Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel.
authors.forename: Rani
authors.initials: R
authors.lastname: Abuita
mesh_terms: D000328:Adult; D004791:Enzyme Inhibitors; D020220:Facial Nerve Injuries / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008751:Methylene Blue; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000517:prevention & control; D010306:Parotid Gland / Q000473:pathology* / Q000601:surgery*; D010307:Parotid Neoplasms / Q000601:surgery; D011183:Postoperative Complications; D011300:Preoperative Care; D011446:Prospective Studies; D013194:Staining and Labeling; D013547:Sweating, Gustatory / Q000209:etiology
chemical_list: D004791:Enzyme Inhibitors; D008751:Methylene Blue