Abstract：
OBJECTIVE: The primary objective of this study was to explore the potential disparity in postoperative fistula occurrence rates between patients who undergo (partial) lateral parotidectomy and those who undergo the extracapsular dissection technique for the management of benign parotid gland tumours.
METHODS: A consecutive series of 363 patients treated with (partial) lateral parotidectomy and extracapsular dissection technique for benign parotid gland tumours at one tertiary centre between 2018 and 2022 were included. To evaluate the impact of the surgical technique and possible other risk factors (tumour location, tumour size, Body Mass Index, age, smoking, diabetes mellitus, arterial hypertension) for the development of fistulas, multivariate logistic regression analyses using backward lection were applied to estimate odds ratios (ORs) and 95%-confidence intervals (CIs).
RESULTS: In 363 patients, 21 patients (5.8%) developed a fistula. Patients who underwent (partial) lateral parotidectomy had three times higher chance of developing a fistula compared to patients who were operated using the extracapsular dissection technique (ORadjusted = 2.6, 4.1% vs. 12.5%, p = 0.044). In the multivariate analyses, no other risk factors for the development of fistulas were statistically significant in this cohort. The incidence of facial nerve paralysis was not significantly different between the extracapsular dissection and lateral parotidectomy group (5/73 = 6.8% vs. 11/290 = 3.8%, p = 0.333).
CONCLUSIONS: Fistulas occur more often in patients treated by means of a (partial) lateral parotidectomy approach compared to patients treated using the extracapsular dissection technique. Therefore, surgeons should be vigilant about postoperative fistula risks in lateral parotidectomy and consider preventive measures.
METHODS: A consecutive series of 363 patients treated with (partial) lateral parotidectomy and extracapsular dissection technique for benign parotid gland tumours at one tertiary centre between 2018 and 2022 were included. To evaluate the impact of the surgical technique and possible other risk factors (tumour location, tumour size, Body Mass Index, age, smoking, diabetes mellitus, arterial hypertension) for the development of fistulas, multivariate logistic regression analyses using backward lection were applied to estimate odds ratios (ORs) and 95%-confidence intervals (CIs).
RESULTS: In 363 patients, 21 patients (5.8%) developed a fistula. Patients who underwent (partial) lateral parotidectomy had three times higher chance of developing a fistula compared to patients who were operated using the extracapsular dissection technique (ORadjusted = 2.6, 4.1% vs. 12.5%, p = 0.044). In the multivariate analyses, no other risk factors for the development of fistulas were statistically significant in this cohort. The incidence of facial nerve paralysis was not significantly different between the extracapsular dissection and lateral parotidectomy group (5/73 = 6.8% vs. 11/290 = 3.8%, p = 0.333).
CONCLUSIONS: Fistulas occur more often in patients treated by means of a (partial) lateral parotidectomy approach compared to patients treated using the extracapsular dissection technique. Therefore, surgeons should be vigilant about postoperative fistula risks in lateral parotidectomy and consider preventive measures.
摘要：
目的：本研究的主要目的是探讨接受（部分）腮腺外侧切除术的患者和接受囊外切除术治疗腮腺良性肿瘤的患者术后瘘发生率的潜在差异。
方法：纳入了2018年至2022年在一个三级中心接受（部分）腮腺外侧切除术和囊外解剖技术治疗腮腺良性肿瘤的连续363例患者。评估手术技术的影响和可能的其他风险因素(肿瘤位置，肿瘤大小，身体质量指数,年龄,吸烟,糖尿病,动脉高血压)用于瘘管的发展，使用反向选择的多变量逻辑回归分析用于估计比值比（OR）和95％置信区间（CI）。
结果：在363名患者中，21例患者（5.8％）发生瘘管。与使用囊外解剖技术进行手术的患者相比，接受（部分）腮腺外侧切除术的患者发生瘘管的机会高三倍（ORadjusted=2.6，4.1％vs.12.5%,p=0.044)。在多变量分析中，在该队列中,没有其他发生瘘管的危险因素有统计学意义.面神经麻痹的发生率在囊外解剖和腮腺外侧切除术组之间没有显着差异（5/73=6.8％vs.11/290=3.8%，p=0.333）。
结论：与使用囊外解剖技术治疗的患者相比，使用（部分）腮腺外侧切除术治疗的患者更容易发生瘘。因此,外科医生应警惕腮腺外侧切除术后瘘的风险，并考虑预防措施。
方法：纳入了2018年至2022年在一个三级中心接受（部分）腮腺外侧切除术和囊外解剖技术治疗腮腺良性肿瘤的连续363例患者。评估手术技术的影响和可能的其他风险因素(肿瘤位置，肿瘤大小，身体质量指数,年龄,吸烟,糖尿病,动脉高血压)用于瘘管的发展，使用反向选择的多变量逻辑回归分析用于估计比值比（OR）和95％置信区间（CI）。
结果：在363名患者中，21例患者（5.8％）发生瘘管。与使用囊外解剖技术进行手术的患者相比，接受（部分）腮腺外侧切除术的患者发生瘘管的机会高三倍（ORadjusted=2.6，4.1％vs.12.5%,p=0.044)。在多变量分析中，在该队列中,没有其他发生瘘管的危险因素有统计学意义.面神经麻痹的发生率在囊外解剖和腮腺外侧切除术组之间没有显着差异（5/73=6.8％vs.11/290=3.8%，p=0.333）。
结论：与使用囊外解剖技术治疗的患者相比，使用（部分）腮腺外侧切除术治疗的患者更容易发生瘘。因此,外科医生应警惕腮腺外侧切除术后瘘的风险，并考虑预防措施。
