Georgios Psychogios1,2, Christopher Bohr3, Jannis Constantinidis4, Martin Canis5, Vincent Vander Poorten6,7, Jan Plzak8, Andreas Knopf9, Christian Betz10, Orlando Guntinas-Lichius11,7, Johannes Zenk12,7. 1. Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ioannina, Leof. Stavrou Niarchou, 455 00, Ioannina, Greece. gpsychogios@uoi.gr. 2. Multidisciplinary Salivary Gland Society (http://www.msgs.international), Geneva, Switzerland. gpsychogios@uoi.gr. 3. Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany. 4. 1st Department of ORL, Head and Neck Surgery, Aristotle University, AHEPA Hospital, Thessaloniki, Greece. 5. Department of Otorhinolaryngology and Head and Neck Surgery, LMU Klinikum, Marchioninistr. 15, 81377, Munich, Germany. 6. Otorhinolaryngology-Head and Neck Surgery and Department of Oncology, Section Head and Neck Oncology, University Hospitals Leuven, KU Leuven, Louvain, Belgium. 7. Multidisciplinary Salivary Gland Society (http://www.msgs.international), Geneva, Switzerland. 8. Department of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Charles University, Motol University Hospital, V Uvalu 84, 150 06, Prague 5, Czech Republic. 9. Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, University of Freiburg, Freiburg, Germany. 10. Department of Otorhinolaryngology, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany. 11. Department of Otorhinolaryngology-Head and Neck, Surgery, Jena University Hospital, Jena, Germany. 12. Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Augsburg, Sauerbruchstraße 6, 86179, Augsburg, Germany.
Abstract
PURPOSE: Surgical treatment of benign parotid tumors has developed in the direction of less invasive procedures in recent years and has raised great debate about the best surgical approach. Aim of this article is to analyse anatomical and other factors that are important in selection of the appropriate surgical technique in treatment of benign parotid tumors. Furthermore, to discuss the risk of complications and recurrent disease according to selected operation. Finally, to define patient selection criteria to facilitate decision making in parotid surgery and become a guide for younger surgeons. METHODS: Literature review and authors' personal opinions based on their surgical experience. RESULTS: All possible surgical techniques for benign parotid surgery with advantages and disadvantages are being described. An algorithm with anatomical and other criteria influencing decision making in benign parotid surgery is presented. CONCLUSION: Surgeons nowadays have many options to choose from for benign parotid surgery. ECD is one of the many surgical techniques available in parotid surgery and can achieve excellent results with proper training and if used for proper indications. PSP is mainly indicated in large tumors of the caudal part of the PG (ESGS level II). SP represents a universal solution in parotid surgery and should be the first technique young surgeons learn. TP has only few but important indications in benign parotid surgery. Surgeons need to carefully consider the patient and his/her preoperative imaging as well as her or his own special expertise to select the most appropriate surgical technique.
PURPOSE: Surgical treatment of benign parotid tumors has developed in the direction of less invasive procedures in recent years and has raised great debate about the best surgical approach. Aim of this article is to analyse anatomical and other factors that are important in selection of the appropriate surgical technique in treatment of benign parotid tumors. Furthermore, to discuss the risk of complications and recurrent disease according to selected operation. Finally, to define patient selection criteria to facilitate decision making in parotid surgery and become a guide for younger surgeons. METHODS: Literature review and authors' personal opinions based on their surgical experience. RESULTS: All possible surgical techniques for benign parotid surgery with advantages and disadvantages are being described. An algorithm with anatomical and other criteria influencing decision making in benign parotid surgery is presented. CONCLUSION: Surgeons nowadays have many options to choose from for benign parotid surgery. ECD is one of the many surgical techniques available in parotid surgery and can achieve excellent results with proper training and if used for proper indications. PSP is mainly indicated in large tumors of the caudal part of the PG (ESGS level II). SP represents a universal solution in parotid surgery and should be the first technique young surgeons learn. TP has only few but important indications in benign parotid surgery. Surgeons need to carefully consider the patient and his/her preoperative imaging as well as her or his own special expertise to select the most appropriate surgical technique.
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