Bipolar dissection technique in parotid gland surgery

Acta Otolaryngol. 2017 Nov;137(11):1210-1214. doi: 10.1080/00016489.2017.1354396. Epub 2017 Jul 25.

Abstract

Background: Parotid gland surgery (PGS) has to manage the balancing act between sufficient radicality and preservation of functional structures. While many studies evaluate post-therapeutic complication due to different extent of surgery, the current study introduces bipolar dissection (BP) being a fast and safe preparation technique.

Methods: Analysis of clinical parameters (age, sex, tumour entity, treatment modalities, facial nerve palsy, bleeding, saliva fistula and Frey's syndrome) of 319 consecutively included patients who underwent extracapsular dissection and superficial/total/radical parotidectomy. Subgroup analysis was done according to the preparation technique (cold vs BP).

Results: Facial nerve palsy rate increased with the extent of PGS (p < .0001). There were no differences in the risk of post-operative bleeding, salivary fistula and Frey's syndrome. BP resulted in a significant reduction of operation time (p = .04), postoperative bleeding (p = .001) and salivary fistula (p = .045) when compared with cold preparation.

Conclusions: Ubiquitous available BP allows fast and safe PGS regardless its extent.

Keywords: Bipolar dissection; facial nerve palsy; outcome; parotid gland; parotidectomy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Dissection / methods
  • Humans
  • Middle Aged
  • Otorhinolaryngologic Surgical Procedures / adverse effects
  • Otorhinolaryngologic Surgical Procedures / methods*
  • Parotid Gland / surgery*
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control
  • Retrospective Studies