The prevention and management of complications in parotid and other
major salivary gland surgeries.
Panagiota Koutsonikola, Lampros Zouloumis
Department of Oral and Maxillofacial Surgery, School of Dentistry of the Aristotle University of Thessaloniki Greece
DOI: 10.54936/haoms2425770
SUMMARY:The prevention and management of complications that appear after the application of the classical techniques of traditional surgery of the major salivary glands, during the intra-operative or post-operative period, are not a common subject in the international literature and the number of scientific articles is relatively small. The most frequently occurring and most serious postoperative complications, early or late, are the partial or complete transection of the facial nerve or its branches, the development of neuroma on the transection of the greater auricular nerve, Frey’s syndrome, the
deformed scars on the face, the numbness of the cheek and auricle, salivary fistula, sialocele, seroma, parotid removal skin intrusion and facial asymmetry, surgical incision keloid, and surgical wound inflammation-infiltration,which have been studied and adequately documented (30, 35). The increasingly frequently applied modern,advanced and minimally invasive-endoscopic surgical procedures which tend to replace traditional surgical techniques, are distinguished by their rapid recovery and significantly lower rate of complications. Endoscopic operations of the major salivary glands and the complica-
tions associated with them are minor and usually belong to the general postoperative complications such as local inflammation, hematoma, injury, rupture and stricture of the excretory duct.
KEY WORDS: Salivary gland tumors, parotid gland, post surgery complications of salivary glands operation. Prevention and management post parotidectomy complications.
REFERENCES
1 Athavale SM, Phillips S, Mangus B, Datta J, Sinard RJ, Netterville JL, et al. Complications of AlloDerm and dermamatrix for parotidectomy reconstruction. Head Neck. 2012;34:88–93. [PubMed] [Google Scholar]
2. Bailey BJ. Head and Neck Surgery-Otolaryngology. 3rd Edn. Philadelphia, PA: Lippincott Williams & Wilkins; 2001. [Google Scholar]
3. Bjerkhoel A, Trobbe O. Frey’s syndrome: treatment with botulinum toxin. J Laryngol Otol 1997;111:839-44. [PubMed] [Google Scholar]
4. Casler JD, Conley J. Sternocleidomastoid muscle transfer and superficial musculoaponeurotic system plication in the prevention of Frey’s syndrome. Laryngoscope 1991;101:95-100. [PubMed] [Google Scholar]
5. Cavanaugh K, Park A. Postparotidectomy fistula: a different treatment for an old problem. Int J Pediatr Otorhinolaryngol 1999;47:265-8. [PubMed] [Google Scholar]
6. Chan LS, Barakate MS, Havas TE. Free fat grafting in superficial parotid surgery to prevent Frey’s syndrome and improve aesthetic outcome. J Laryngol Otol. 2014;128 Suppl 1:S44–9. [PubMed] [Google Scholar]
7. Chatziavramidis A, Stefanidis A, Kinigou m., Tanasidis M., Triaridis A., Thomaidis I., Sidiras Th. Frey syndrome after parotidectomy. Symptomatic treatment with botulinum toxin (early results). “Theageneio”, Otorhinolaryngology - Head & Neck Surgery: issue 34, Thessaloniki October - November - December 2008, p.24-30.
8. Chia –Hui Shao, Chia Chun Chiang, Tsai wei Huang . Systematic Review Exercise therapy for cancer treatment-induced trismus in patients with head and neck cancer: A systematic review and meta-analysis of randomized controlled trialsRadiotherapy and Oncology Volume 151, October 2020, Pages 249-255https://doi.org/10.1016/j.radonc.2020.08.024
9. Flávia Aparecida de Oliveira 1 , Eliza Carla Barroso Duarte, Cláudia Teixeira Taveira, Aline Abreu Máximo, Erica Carvalho de Aquino, Rita de Cássia Alencar, Eneida Franco Vencio Salivary gland tumor: a review of 599 cases in a Brazilian population Head Neck Pathol . 2009 Dec;3(4):271-5. doi: 10.1007/s12105-009-0139-9. Epub 2009 Sep 16.
10. Frey L. Le syndrome du nerf auriculo-temporal. Rev Neurol. 1923;2:97–104. [Google Scholar]
11. Gao, M. et al. Salivary gland tumours in a Northern Chinese population: a 50-year retrospective study of 7190 cases. Int. J. Oral Maxillofac. Surg. 46, 343–349 (2017).
12 Grosheva Μaria, Horstmann L., G.Fabian Volk, Hollen C,L Ludwing, V Weib at all Frey’s syndrome after superficial parotidectomy: role of the sternocleidomastoid muscle flap: a prospective nonrandomized controlled trial.The American journal of surgery Oct. 2016 p 740-747.
13. Guntinas-Lichius O, Sittel C. Treatment of postparotidectomy salivary fistula with botulinum toxin. Ann Otol Rhinol Laryngol 2001;110:1162-4. [PubMed] [Google Scholar]
14. Harada T, Inoue T, Harashina T, Hatoko M, Ueda K. Dermisfat graft after parotidectomy to prevent Frey’s syndrome and the concave deformity. Ann Plast Surg. 1993;31:450–2. [PubMed] [Google Scholar]
15. Hui Y, Wong DSY, Wong LY, Ho WK, Wei WI. A prospective controlled double-blind trial of great auricular nerve preservation at parotidectomy. Am J Surg 2003;185:574-9. [PubMed] [Google Scholar]
16. Jangyoun Choi,1 Song I Park,1 Eun Young Rha,2 Bommie Florence Seo,1 Ho Kwon,1 and Sung-No Jung1 Acellular dermal matrix (Insuregraf) in the prevention of Frey’s syndrome and surgical site depression after parotidectomyArch Craniofac Surg. 2019 Jun; 20(3): 176–186.Published online 2019 Jun20. doi: 10.7181/acfs.2019.00248 PMCID: PMC6615418 PMID: 31256554
17. Kenneth J. Welch , M.D. F.AC.S Complications of Pediatric Surgery Prevention and managment W.B.Saumders Co. Philadelphia/London/Toronto 1982.
18. Kierner A. C.MD, Zelenka I. MD, Gstoettner W. MD, PhD. The Sternocleidomastoid Flap—Its Indications and
Limitations. First published: 02 January 2009 Laryngoscope https://doi.org/10.1097/00005537-200112000-00025 Citations: 5618.
19. Laccourreye O, Akl E, Gutierrez-Fonseca R, Garcia D, Brasnu D, Bonan B. Recurrent gustatory sweating (Frey syndrome) after intracutaneous injection of botulinum toxin type A: incidence, management, and outcome. Arch Otolaryngol Head Neck Surg 1999;125:283-6. [PubMed] [Google Scholar]
20. Laccourreye O, Cauchois R, Jouffre V, Menard M, Brasnu D. Total conservative parotidectomy for primary benign pleomorphic adenoma of the parotid gland: a 25-year experience with 229 patients. Laryngoscope 1994;104:1487-94. [PubMed] [Google Scholar]
21. Ladeinde A L, Adeyemo W L, Ogunlewe M O, Ajayi O F, Omitola O G. Salivary gland tumours: a 15-year review at the Dental Centre Lagos University Teaching Hospital Afr J Med Med Sci . 2007 Dec;36(4):299-304.
22. Lambiel Silvia, MD; Dulguerov Nicolas, MD;. Courvoisier Delphine S, PhD; Dulguerov Pavel, MD Minor Parotidectomy Complications: A Systematic Review The Laryngoscope © 2020 The American Laryngological, Rhinological and Otological Society, Inc.
23. Laskawi R, Schott T, Mirzaie-Petri M, Schroeder M. Surgical management of pleomorphic adenomas of the parotid gland: a follow-up study of three methods. J Oral Maxillofac Surg 1996;54:1176-9. [PubMed] [Google Scholar]
24. Laskawi R, Drobik C, Schonebeck C. Up-to-date report of botulinum toxin type A treatment in patients with gustatory sweating (Frey syndrome). Laryngoscope 1998;108:381-4. [PubMed] [Google Scholar]
25. Leverstein1 H., Tiwari1 R. M., Snow1 G. B., van der Wal2 J. E. at all. The surgical management of recurrent or residual pleomorphic adenomas of the parotid gland. Analysis and results in 40 patients. European Archives of Oto-Rhino-Laryngology volume 254, pages 313–317 (1997)
26. Louise Kent M., Brennan M.T., Noll J.L., Fox P.C., Burri S.H., Hunter J.C., Lockhart P.B. Radiation-induced trismus in head and neck cancer patients. Support. Care Cancer. 2008;16:305–309. doi: 10.1007/s00520-007-0345-5. [PubMed] [CrossRef] [Google Scholar]
27. Luo W, Zheng X, Chen L, Jing W, Tang W. at all.The use of human acellular dermal matrix in the prevention of infra-auricular depressed deformities and Frey’s syndrome following total parotidectomy Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology Volume 114, Issue 2, August 2012, Pages e9-e13
28. Maier H. Therapie nichttumoroeser Speicheldruesen erkrankungen und postoperativer Komplikationen. LaryngoRhino-Otol 2001; 80 Supplement 1: 89-114.
29. Mandour MA, El-Sheikh MM, El-Garem F. Tympanic neurectomy for parotid fistula. Arch Otolaryngol 1976;102:327-9. [PubMed] [Google Scholar]
30. Marchese-Ragona R, De Filippis C, Marioni G, and Staffieri A. Treatment of complications of parotid gland surgery prevention and managment of complication of salivary gland operations Acta Otorhinolaryngol Ital. 2005 Jun; 25(3): 174–178.
31. Marchese Ragona R, de Filippis C, Staffieri A, Tugnoli V, Restivo DA. Parotid fistula: treatment with botulinum toxin. Plastic Reconst Surg 2001;107:886-7. [PubMed] [Google Scholar]
32. Marchese Ragona R, Tugnoli V, Panzuto N, Aimoni C, Pastore A. L’utilizzo della tossina botulinica nel trattamento della sindrome di Frey. Proceedings of 85° Congresso Nazionale S.I.O. Rome, 27-30 May, 1998. [Google Scholar]
33. Moss C E, C J Johnston, N M Whear. Amputation neuroma of the great auricular nerve after operations on the parotid gland. British Journal of Oral and Maxillofacial Surgery 38(5):537-8 November 2000 DOI: 10.1054/bjom.2000.0466 Source Pub Med
34. Natvig K, Soberg R. Relationship of intraoperative rupture of pleomorphic adenomas to recurrence: an 11-25 year follow-up study. Head Neck 1994;16:213-7. [PubMed] [Google Scholar]
35. Nitzan D, Kronenberg J, Horowitz Z, Wolf M, Bedrin L, Chaushu G, et al. Quality of life following parotidectomy for malignant and benign disease. Plast Reconstr Surg. 2004;114:1060–7. [PubMed] [Google Scholar]
36. Nosan DK, Ochi JW, Davidson TM. Preservation of facial contour during parotidectomy. Otolaryngol Head Neck Surg. 1991;104:293–8. [PubMed] [Google Scholar]
37. Olsen KD. Superficial parotidectomy. Oper Techn Gen Surg 2004;6:102-14. [Google Scholar]
38. Piekarski J, Nejc D, Szymczak W, Wronski K, Jeziorski A. Results of extracapsular dissection of pleomorphic adenoma of parotid gland. J Oral Maxillofac Surg 2004;62:1198-202. [PubMed] [Google Scholar]
39. Reilly J, Myssiorek D. Facial nerve stimulation and postparotidectomy facial paresis. Otolaryngol Head Neck Surg 2003;128:530-3. [PubMed] [Google Scholar]
40. Rhee JS, Davis RE, Goodwin WJ Jr. Minimizing deformity from parotid gland surgery. Curr Opin Otolaryngol Head Neck Surg 1999;7:90-8. [Google Scholar]
41. Roh, J. L. & Park, C. I. Gland-preserving surgery for pleomorphic adenoma in the submandibular gland. Br. J. Surg. 95, 1252–1256 (2008).
42. Sachsman SM, Rice DH. Use of AlloDerm implant to improve cosmesis after parotidectomy. Ear Nose Throat J. 2007;86:512–3. [PubMed] [Google Scholar]
43. Scott B. D’Souza J. Perinparajah N. Lowe D. Rogers S.N.Longitudinal evaluation of restricted mouth opening (trismus) in patients following primary surgery for oral and oropharyngeal squamous cell carcinoma Research Article| Volume 49, ISSUE 2, P106-111, March 2011 Published:March 17, 2010 DOI:https://doi.org/10.1016/j.bjoms.2010.02.008 44.Skandalakis John E. Slandalakis Panagiotis N., Skandalakis Lee J. Surgical anatomy and technique 2ND Edition Spinger Verlag New York Inc. 2000.
45. Staffieri A, Marchese Ragona R, de Filippis C, Tugnoli V. Management of parotid fistulae and sialoceles with botulinum toxin. Otolaryngol Head Neck Surg 1999;121:P240-1. [Google Scholar]
46. Teive HA, Troiano AR, Robert F, Iwamoto FM, Maniglia JJ, Mocellin M, Werneck LC. Botulinum toxin for treatment of Frey’s syndrome: report of two cases. Arq Neuropsiquiatr. 2003 Jun; 61 (2A): 256-8. Epub 2003 Jun 9.
47. Tugnoli V, Marchese-Ragona R, Eleopra R, Quatrale R, Capone JG, Pastore A, et al. The role of gustatory flushing in Frey’s syndrome and its treatment with botulinum toxin A. Clin Auton Res 2002;12:174-8. [PubMed] [Google Scholar]
48. Wax M, Tarshis L. Post-parotidectomy fistula. J Otolaryngol 1991;20:10-3. [PubMed] [Google Scholar]
49. Wen-Chieh Liao, Chuang Chih-Chao 1, Hsu Ma 1, Chih-Yi Hsu 2 Salivary Gland Tumors: A Clinicopathologic Analysis From Taipei Veterans General Hospital. Ann Plast Surg 2020 Jan;84(1S Suppl 1):S26-S33.doi: 10.1097/SAP.0000000000002178.
50. Wolber, P., Volk, G.F., Horstmann, L., Finkensieper, M., Shabli, S., Wittekindt, C., Klussmann, J.P., Guntinas-Lichius, O.,Beutner, D. and Grosheva, M. (2018) Patient’s Perspective on Long-Term Complications after Superficial Parotidectomy for Benign Lesions: Prospective Analysis of a 2-Year Follow-up. Clinical Otolaryngology,43,1073-1079. https://doi.org/10.1111/coa.13104.
51. Ye WM, Zhu HG, Zheng JW, Wang XD, Zhao W, Zhong LP, et al. Use of allogenic acellular dermal matrix in preventionof Frey’s syndrome after parotidectomy. Br J Oral Maxillofac Surg. 2008;46:649–52. [PubMed] [Google Scholar]
52. Zedan Ali, Rezk Khalid, Anwar A. Elshenawy, Nabih Ola, Atta Haisam. Complications of Parotid Surgery—10 Years’ Experience Journal of Cancer Therapy 2020, 11, 306-323 https://www.scirp.org/journal/jct ISSN Online: 2151-1942 ISSN Print: 2151-1934.
Department of Oral and Maxillofacial Surgery, School of Dentistry of the Aristotle University of Thessaloniki Greece
DOI: 10.54936/haoms2425770
SUMMARY:The prevention and management of complications that appear after the application of the classical techniques of traditional surgery of the major salivary glands, during the intra-operative or post-operative period, are not a common subject in the international literature and the number of scientific articles is relatively small. The most frequently occurring and most serious postoperative complications, early or late, are the partial or complete transection of the facial nerve or its branches, the development of neuroma on the transection of the greater auricular nerve, Frey’s syndrome, the
deformed scars on the face, the numbness of the cheek and auricle, salivary fistula, sialocele, seroma, parotid removal skin intrusion and facial asymmetry, surgical incision keloid, and surgical wound inflammation-infiltration,which have been studied and adequately documented (30, 35). The increasingly frequently applied modern,advanced and minimally invasive-endoscopic surgical procedures which tend to replace traditional surgical techniques, are distinguished by their rapid recovery and significantly lower rate of complications. Endoscopic operations of the major salivary glands and the complica-
tions associated with them are minor and usually belong to the general postoperative complications such as local inflammation, hematoma, injury, rupture and stricture of the excretory duct.
KEY WORDS: Salivary gland tumors, parotid gland, post surgery complications of salivary glands operation. Prevention and management post parotidectomy complications.
REFERENCES
1 Athavale SM, Phillips S, Mangus B, Datta J, Sinard RJ, Netterville JL, et al. Complications of AlloDerm and dermamatrix for parotidectomy reconstruction. Head Neck. 2012;34:88–93. [PubMed] [Google Scholar]
2. Bailey BJ. Head and Neck Surgery-Otolaryngology. 3rd Edn. Philadelphia, PA: Lippincott Williams & Wilkins; 2001. [Google Scholar]
3. Bjerkhoel A, Trobbe O. Frey’s syndrome: treatment with botulinum toxin. J Laryngol Otol 1997;111:839-44. [PubMed] [Google Scholar]
4. Casler JD, Conley J. Sternocleidomastoid muscle transfer and superficial musculoaponeurotic system plication in the prevention of Frey’s syndrome. Laryngoscope 1991;101:95-100. [PubMed] [Google Scholar]
5. Cavanaugh K, Park A. Postparotidectomy fistula: a different treatment for an old problem. Int J Pediatr Otorhinolaryngol 1999;47:265-8. [PubMed] [Google Scholar]
6. Chan LS, Barakate MS, Havas TE. Free fat grafting in superficial parotid surgery to prevent Frey’s syndrome and improve aesthetic outcome. J Laryngol Otol. 2014;128 Suppl 1:S44–9. [PubMed] [Google Scholar]
7. Chatziavramidis A, Stefanidis A, Kinigou m., Tanasidis M., Triaridis A., Thomaidis I., Sidiras Th. Frey syndrome after parotidectomy. Symptomatic treatment with botulinum toxin (early results). “Theageneio”, Otorhinolaryngology - Head & Neck Surgery: issue 34, Thessaloniki October - November - December 2008, p.24-30.
8. Chia –Hui Shao, Chia Chun Chiang, Tsai wei Huang . Systematic Review Exercise therapy for cancer treatment-induced trismus in patients with head and neck cancer: A systematic review and meta-analysis of randomized controlled trialsRadiotherapy and Oncology Volume 151, October 2020, Pages 249-255https://doi.org/10.1016/j.radonc.2020.08.024
9. Flávia Aparecida de Oliveira 1 , Eliza Carla Barroso Duarte, Cláudia Teixeira Taveira, Aline Abreu Máximo, Erica Carvalho de Aquino, Rita de Cássia Alencar, Eneida Franco Vencio Salivary gland tumor: a review of 599 cases in a Brazilian population Head Neck Pathol . 2009 Dec;3(4):271-5. doi: 10.1007/s12105-009-0139-9. Epub 2009 Sep 16.
10. Frey L. Le syndrome du nerf auriculo-temporal. Rev Neurol. 1923;2:97–104. [Google Scholar]
11. Gao, M. et al. Salivary gland tumours in a Northern Chinese population: a 50-year retrospective study of 7190 cases. Int. J. Oral Maxillofac. Surg. 46, 343–349 (2017).
12 Grosheva Μaria, Horstmann L., G.Fabian Volk, Hollen C,L Ludwing, V Weib at all Frey’s syndrome after superficial parotidectomy: role of the sternocleidomastoid muscle flap: a prospective nonrandomized controlled trial.The American journal of surgery Oct. 2016 p 740-747.
13. Guntinas-Lichius O, Sittel C. Treatment of postparotidectomy salivary fistula with botulinum toxin. Ann Otol Rhinol Laryngol 2001;110:1162-4. [PubMed] [Google Scholar]
14. Harada T, Inoue T, Harashina T, Hatoko M, Ueda K. Dermisfat graft after parotidectomy to prevent Frey’s syndrome and the concave deformity. Ann Plast Surg. 1993;31:450–2. [PubMed] [Google Scholar]
15. Hui Y, Wong DSY, Wong LY, Ho WK, Wei WI. A prospective controlled double-blind trial of great auricular nerve preservation at parotidectomy. Am J Surg 2003;185:574-9. [PubMed] [Google Scholar]
16. Jangyoun Choi,1 Song I Park,1 Eun Young Rha,2 Bommie Florence Seo,1 Ho Kwon,1 and Sung-No Jung1 Acellular dermal matrix (Insuregraf) in the prevention of Frey’s syndrome and surgical site depression after parotidectomyArch Craniofac Surg. 2019 Jun; 20(3): 176–186.Published online 2019 Jun20. doi: 10.7181/acfs.2019.00248 PMCID: PMC6615418 PMID: 31256554
17. Kenneth J. Welch , M.D. F.AC.S Complications of Pediatric Surgery Prevention and managment W.B.Saumders Co. Philadelphia/London/Toronto 1982.
18. Kierner A. C.MD, Zelenka I. MD, Gstoettner W. MD, PhD. The Sternocleidomastoid Flap—Its Indications and
Limitations. First published: 02 January 2009 Laryngoscope https://doi.org/10.1097/00005537-200112000-00025 Citations: 5618.
19. Laccourreye O, Akl E, Gutierrez-Fonseca R, Garcia D, Brasnu D, Bonan B. Recurrent gustatory sweating (Frey syndrome) after intracutaneous injection of botulinum toxin type A: incidence, management, and outcome. Arch Otolaryngol Head Neck Surg 1999;125:283-6. [PubMed] [Google Scholar]
20. Laccourreye O, Cauchois R, Jouffre V, Menard M, Brasnu D. Total conservative parotidectomy for primary benign pleomorphic adenoma of the parotid gland: a 25-year experience with 229 patients. Laryngoscope 1994;104:1487-94. [PubMed] [Google Scholar]
21. Ladeinde A L, Adeyemo W L, Ogunlewe M O, Ajayi O F, Omitola O G. Salivary gland tumours: a 15-year review at the Dental Centre Lagos University Teaching Hospital Afr J Med Med Sci . 2007 Dec;36(4):299-304.
22. Lambiel Silvia, MD; Dulguerov Nicolas, MD;. Courvoisier Delphine S, PhD; Dulguerov Pavel, MD Minor Parotidectomy Complications: A Systematic Review The Laryngoscope © 2020 The American Laryngological, Rhinological and Otological Society, Inc.
23. Laskawi R, Schott T, Mirzaie-Petri M, Schroeder M. Surgical management of pleomorphic adenomas of the parotid gland: a follow-up study of three methods. J Oral Maxillofac Surg 1996;54:1176-9. [PubMed] [Google Scholar]
24. Laskawi R, Drobik C, Schonebeck C. Up-to-date report of botulinum toxin type A treatment in patients with gustatory sweating (Frey syndrome). Laryngoscope 1998;108:381-4. [PubMed] [Google Scholar]
25. Leverstein1 H., Tiwari1 R. M., Snow1 G. B., van der Wal2 J. E. at all. The surgical management of recurrent or residual pleomorphic adenomas of the parotid gland. Analysis and results in 40 patients. European Archives of Oto-Rhino-Laryngology volume 254, pages 313–317 (1997)
26. Louise Kent M., Brennan M.T., Noll J.L., Fox P.C., Burri S.H., Hunter J.C., Lockhart P.B. Radiation-induced trismus in head and neck cancer patients. Support. Care Cancer. 2008;16:305–309. doi: 10.1007/s00520-007-0345-5. [PubMed] [CrossRef] [Google Scholar]
27. Luo W, Zheng X, Chen L, Jing W, Tang W. at all.The use of human acellular dermal matrix in the prevention of infra-auricular depressed deformities and Frey’s syndrome following total parotidectomy Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology Volume 114, Issue 2, August 2012, Pages e9-e13
28. Maier H. Therapie nichttumoroeser Speicheldruesen erkrankungen und postoperativer Komplikationen. LaryngoRhino-Otol 2001; 80 Supplement 1: 89-114.
29. Mandour MA, El-Sheikh MM, El-Garem F. Tympanic neurectomy for parotid fistula. Arch Otolaryngol 1976;102:327-9. [PubMed] [Google Scholar]
30. Marchese-Ragona R, De Filippis C, Marioni G, and Staffieri A. Treatment of complications of parotid gland surgery prevention and managment of complication of salivary gland operations Acta Otorhinolaryngol Ital. 2005 Jun; 25(3): 174–178.
31. Marchese Ragona R, de Filippis C, Staffieri A, Tugnoli V, Restivo DA. Parotid fistula: treatment with botulinum toxin. Plastic Reconst Surg 2001;107:886-7. [PubMed] [Google Scholar]
32. Marchese Ragona R, Tugnoli V, Panzuto N, Aimoni C, Pastore A. L’utilizzo della tossina botulinica nel trattamento della sindrome di Frey. Proceedings of 85° Congresso Nazionale S.I.O. Rome, 27-30 May, 1998. [Google Scholar]
33. Moss C E, C J Johnston, N M Whear. Amputation neuroma of the great auricular nerve after operations on the parotid gland. British Journal of Oral and Maxillofacial Surgery 38(5):537-8 November 2000 DOI: 10.1054/bjom.2000.0466 Source Pub Med
34. Natvig K, Soberg R. Relationship of intraoperative rupture of pleomorphic adenomas to recurrence: an 11-25 year follow-up study. Head Neck 1994;16:213-7. [PubMed] [Google Scholar]
35. Nitzan D, Kronenberg J, Horowitz Z, Wolf M, Bedrin L, Chaushu G, et al. Quality of life following parotidectomy for malignant and benign disease. Plast Reconstr Surg. 2004;114:1060–7. [PubMed] [Google Scholar]
36. Nosan DK, Ochi JW, Davidson TM. Preservation of facial contour during parotidectomy. Otolaryngol Head Neck Surg. 1991;104:293–8. [PubMed] [Google Scholar]
37. Olsen KD. Superficial parotidectomy. Oper Techn Gen Surg 2004;6:102-14. [Google Scholar]
38. Piekarski J, Nejc D, Szymczak W, Wronski K, Jeziorski A. Results of extracapsular dissection of pleomorphic adenoma of parotid gland. J Oral Maxillofac Surg 2004;62:1198-202. [PubMed] [Google Scholar]
39. Reilly J, Myssiorek D. Facial nerve stimulation and postparotidectomy facial paresis. Otolaryngol Head Neck Surg 2003;128:530-3. [PubMed] [Google Scholar]
40. Rhee JS, Davis RE, Goodwin WJ Jr. Minimizing deformity from parotid gland surgery. Curr Opin Otolaryngol Head Neck Surg 1999;7:90-8. [Google Scholar]
41. Roh, J. L. & Park, C. I. Gland-preserving surgery for pleomorphic adenoma in the submandibular gland. Br. J. Surg. 95, 1252–1256 (2008).
42. Sachsman SM, Rice DH. Use of AlloDerm implant to improve cosmesis after parotidectomy. Ear Nose Throat J. 2007;86:512–3. [PubMed] [Google Scholar]
43. Scott B. D’Souza J. Perinparajah N. Lowe D. Rogers S.N.Longitudinal evaluation of restricted mouth opening (trismus) in patients following primary surgery for oral and oropharyngeal squamous cell carcinoma Research Article| Volume 49, ISSUE 2, P106-111, March 2011 Published:March 17, 2010 DOI:https://doi.org/10.1016/j.bjoms.2010.02.008 44.Skandalakis John E. Slandalakis Panagiotis N., Skandalakis Lee J. Surgical anatomy and technique 2ND Edition Spinger Verlag New York Inc. 2000.
45. Staffieri A, Marchese Ragona R, de Filippis C, Tugnoli V. Management of parotid fistulae and sialoceles with botulinum toxin. Otolaryngol Head Neck Surg 1999;121:P240-1. [Google Scholar]
46. Teive HA, Troiano AR, Robert F, Iwamoto FM, Maniglia JJ, Mocellin M, Werneck LC. Botulinum toxin for treatment of Frey’s syndrome: report of two cases. Arq Neuropsiquiatr. 2003 Jun; 61 (2A): 256-8. Epub 2003 Jun 9.
47. Tugnoli V, Marchese-Ragona R, Eleopra R, Quatrale R, Capone JG, Pastore A, et al. The role of gustatory flushing in Frey’s syndrome and its treatment with botulinum toxin A. Clin Auton Res 2002;12:174-8. [PubMed] [Google Scholar]
48. Wax M, Tarshis L. Post-parotidectomy fistula. J Otolaryngol 1991;20:10-3. [PubMed] [Google Scholar]
49. Wen-Chieh Liao, Chuang Chih-Chao 1, Hsu Ma 1, Chih-Yi Hsu 2 Salivary Gland Tumors: A Clinicopathologic Analysis From Taipei Veterans General Hospital. Ann Plast Surg 2020 Jan;84(1S Suppl 1):S26-S33.doi: 10.1097/SAP.0000000000002178.
50. Wolber, P., Volk, G.F., Horstmann, L., Finkensieper, M., Shabli, S., Wittekindt, C., Klussmann, J.P., Guntinas-Lichius, O.,Beutner, D. and Grosheva, M. (2018) Patient’s Perspective on Long-Term Complications after Superficial Parotidectomy for Benign Lesions: Prospective Analysis of a 2-Year Follow-up. Clinical Otolaryngology,43,1073-1079. https://doi.org/10.1111/coa.13104.
51. Ye WM, Zhu HG, Zheng JW, Wang XD, Zhao W, Zhong LP, et al. Use of allogenic acellular dermal matrix in preventionof Frey’s syndrome after parotidectomy. Br J Oral Maxillofac Surg. 2008;46:649–52. [PubMed] [Google Scholar]
52. Zedan Ali, Rezk Khalid, Anwar A. Elshenawy, Nabih Ola, Atta Haisam. Complications of Parotid Surgery—10 Years’ Experience Journal of Cancer Therapy 2020, 11, 306-323 https://www.scirp.org/journal/jct ISSN Online: 2151-1942 ISSN Print: 2151-1934.
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