title: Minimal Margin Extracapsular Dissection: A Viable Alternative Technique for Benign Parotid Lesions?
abstract: OBJECTIVE
  Extracapsular dissection (ECD) has become an accepted, less invasive alternative for the removal of select benign parotid lesions that may reduce complications. Minimal margin extracapsular dissection (MECD) with dissection on or closer to the tumor capsule may be a reasonable alternative to ECD. The objective of this study is to review the complications and safety of the MECD technique at a single institution.
  
  
  METHODS
  Medical records for patients who underwent MECD for suspected benign parotid lesions were reviewed. Outcome measurements included intraoperative findings, complications, and recurrences.
  
  
  RESULTS
  Forty patients underwent a MECD for suspected benign parotid lesions. The average tumor size was 2.2 cm. Frozen section revealed low-intermediate grade mucoepidermoid carcinoma in 2 (5%) cases, requiring completion of a superficial parotidectomy at the same setting. There was 1 case of temporary facial nerve weakness and no cases of Frey syndrome. No tumor recurrences were observed within the follow-up period (average 3.5 years.) CONCLUSION: In the hands of an experienced surgeon, MECD may be a viable alternative to formal superficial parotidectomy. This study reports low rates of nerve weakness and Frey syndrome. Long-term follow-up is necessary to determine the ultimate risk of recurrence.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: Caitlin P
authors.initials: CP
authors.lastname: McMullen
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA Department of Pathology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: Richard V
authors.initials: RV
authors.lastname: Smith
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA Department of Pathology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Ow
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Tassler
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA bschiff@montefiore.org.
authors.forename: Bradley A
authors.initials: BA
authors.lastname: Schiff
mesh_terms: D000235:Adenolymphoma / Q000473:pathology / Q000601:surgery*; D008949:Adenoma, Pleomorphic / Q000473:pathology / Q000601:surgery*; D004210:Dissection / Q000379:methods*; D005158:Facial Paralysis / Q000453:epidemiology; D006801:Humans; D000072662:Margins of Excision; D008875:Middle Aged; D010307:Parotid Neoplasms / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013547:Sweating, Gustatory / Q000453:epidemiology; D047368:Tumor Burden
keywords: adenoma; benign neoplasms; mixed salivary gland tumor; parotid gland; parotid neoplasms; pleomorphic