The Journal of Laryngology & Otology



Main Articles

Surgical treatment of chronic parotid sialadenitis 1


S A R Nouraei a1c1 , Ismail a2 , N R McLean a3 , P J Thomson a4 , R H Milner a2 and AR Welch a5
a1 Department of Otolaryngology, Charing Cross Hospital, London, UK
a2 Department of Plastic Surgery, Royal Victoria Infirmary, Newcastle upon Tyne, UK
a3 Institute of Craniofacial Studies, Adelaide, Australia
a4 Department of Oral and Maxillofacial Surgery, Newcastle General Hospital, Newcastle upon Tyne, UK
a5 Department of Otolaryngology, Freeman Hospital, Newcastle upon Tyne, UK.

Article author query
nouraei sa   [PubMed][Google Scholar] 
ismail y   [PubMed][Google Scholar] 
mclean nr   [PubMed][Google Scholar] 
thomson pj   [PubMed][Google Scholar] 
milner rh   [PubMed][Google Scholar] 
welch ar   [PubMed][Google Scholar] 

Abstract

Objective: To review the results of surgical management of chronic parotid sialadenitis refractory to medical therapy, with particular respect to long-term symptom resolution and development of post-operative complications.

Methods: A retrospective review of parotidectomies performed for chronic intractable parotid sialadenitis. Information was collected about presentation, pre-operative investigations, surgical treatment, post-operative complications and outcome.

Results: 36 parotidectomies were performed for chronic sialadenitis between 1991 and 2002. Age at presentation was 56±9.6 years, with median symptom duration of 2.3 years. For patients with non-specific presentations, magnetic resonance imaging (MRI) was the most useful pre-operative investigation. Superficial parotidectomy with duct preservation was the main treatment with a 94 per cent success rate, and near-total parotidectomy was reserved for patients with extensive deep-lobe involvement. Duct ligation significantly increased the risk of transient facial palsy. There was a 56 per cent and 22 per cent incidence of temporary facial paresis and Frey's syndrome, respectively.

Conclusions: Controversies exist regarding the optimal pre-operative investigation and surgical treatment of chronic parotid sialadenitis. We advocate magnetic resonance image (MRI) scanning for patients with non-specific symptoms of sialadenitis, and sialography in the presence of reasonable clinical suspicion. We propose superficial parotidectomy without parotid duct ligation as the standard of care, with near-total parotidectomy reserved for extensive deep-lobe disease.

(Published Online December 14 2006)
(Accepted October 20 2006)


Key Words: Parotid Gland; Sialadenitis; Parotidectomy; Magnetic Resonance Imaging.

Correspondence:
c1 Address for correspondence: Dr Reza Nouraei, Department of Otolaryngology, Charing Cross Hospital, London, W6 8RF, UK. Fax: 0044 870 4580775 E-mail: RN@cantab.net


Footnotes

1 Presented at the Summer Scientific Meeting of the British Association of Plastic Surgeons, 7 July 2005, Windsor, UK.