Evaluation of the effects of residual parotid tissue on complications and quality of life in patients undergoing parotid surgery

Evaluation of the Effects of Residual Parotid Tissue on Complications and Quality of Life in Patients Undergoing Parotid Surgery Objectives: The aim of this study was to measure the postoperative residual parotid volume in patients undergoing parotidectomy and to evaluate the effect of residual parotid volumes on complications and quality of life. Materials and Methods: Between January 2010 and December 2016, 148 parotid gland surgeries were performed in our clinic. POI-8 was applied to 74 patients, MRI was performed for recurrence and measurement of the bilateral parotid gland volumes. Demographic data such as gender, educational status and body mass index were recorded in the patients. At the same time, aesthetic outcome was evaluated with an ordinal scale. The volumetric averages were compared with questions of the quality of life scale, demographic data and aesthetic scale data. Results: 125 patients underwent parotidectomy for benign pathologies and 23 patients for malignant tumors. 74 of 148 patients were included in the study. Superficial parotidectomy was performed in 47 patients, conservative total parotidectomy in 15 patients, and partial superficial parotidectomy in 12 patients. One patient had permanent facial nerve dysfunction and 33 patients had subjective Frey syndrome. The mean residual volume of the operated parotid glands in the volumetric measurement performed with MRI was 9.5 cm³, while the unoperated side was 28.8 cm³. Extent of surgery and residual parotid tissue volume were inversely correlated. There was a statistically significant differences between the residual parotid gland volume and Frey syndrome frequency, scar pain, depression in the surgical field, incision scar and numbness questioned in the POI-8. The BMI, educational status and age of the patients did not affect postoperative quality of life. As the residual parotid gland volume decreases, the patients' cosmetic conditions related to the surgical field significantly increase and the postoperative quality of life decrease. Conclusions: In order to improve the quality of life of the patients after parotid surgery and to minimize the complications, the disease free tissue of the parotid gland should be preserved maximally. The posterior branch of the facial nerve and auricularis magnus nerve should be protected to improve the postoperative quality of life of the patients. The cosmetic appearance of the surgical field affects the postoperative quality of life of patients and needs to be improved. Key Words: Measurement of the parotid volume, parotidectomy, quality of life