Hostname: page-component-7bb8b95d7b-w7rtg Total loading time: 0 Render date: 2024-09-21T05:39:58.521Z Has data issue: false hasContentIssue false
  • English
  • Français

Logistic regression analysis of risk factors for post-operative morbidities in parotidectomy: a retrospective cohort study

Published online by Cambridge University Press:  02 May 2024

Kin Lun Lau Open the ORCID record for Kin Lun Lau [Opens in a new window] ,
Luke Ouma ,
Lou Whitehead ,
Aritra Mukherjee  and
Helen Cocks
Kin Lun Lau*
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Sunderland Royal Hospital, Sunderland, UK
Luke Ouma
Affiliation:
Population Health Sciences Institute, Newcastle University, Newcastle, UK
Lou Whitehead
Affiliation:
Population Health Sciences Institute, Newcastle University, Newcastle, UK
Aritra Mukherjee
Affiliation:
Population Health Sciences Institute, Newcastle University, Newcastle, UK
Helen Cocks
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Sunderland Royal Hospital, Sunderland, UK
*
Corresponding author: Kin Lun Lau; Email: kennylau@doctors.org.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

In this study, we reviewed the post-operative complications in parotidectomy and its association with various patient, tumour and surgical factors.

Methods

All parotidectomies performed in our regional unit between 2013 to 2020 were identified. Electronic medical record and clinic letters were reviewed for any post-operative complications. A logistical regression model was applied on data collected on twelve patient factors, three tumour factors and four surgical factors.

Results

379 cases of parotidectomy were identified in the eight-year study period. 55% (n = 210) were documented with nine types of post-operative complications. This study identified age >80 (odds ratio = 1.89, p = 0.018), active smoker (odds ratio = 0.94, p = 0.018), total parotidectomy approach (odds ratio = 1.77, p = 0.012), longer operation time (odds ratio = 0.006, p = 0.015) and hypertension (odds ratio = 1.23, p = 0.019) were associated with a higher risk of facial nerve palsy. Predictive factors were also identified for auricular nerve numbness and Frey syndrome.

Conclusion

This study revealed the incidences and potential predictors of post-operative complications in parotidectomy. Notably, the grade of operator (consultants/ registrars) had no effect on the possibility of adverse outcome, reflecting patient safety was not compromised for training. These findings can be used in patient counselling and guide treatment options to minimise post-operative complications.

Keywords

head and neck neoplasmsparotid neoplasmsfacial nerve
Type
Main Article
Information
The Journal of Laryngology & Otology , First View , pp. 1 - 6
Copyright
Copyright © The Author(s), 2024. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Kin Lun Lau takes responsibility for the integrity of the content of the paper

Presented at the North of England Otolaryngology Scientific Meeting, May 2023, Sheffield, United Kingdom

References

Love, J, Selker, R, Marsman, M, Jamil, T, Dropmann, D, Verhagen, J et al. JASP: Graphical statistical software for common statistical designs. J Stat Softw 2019;88:1–17Google Scholar
Brennan, J, Moore, EJ, Shuler, KJ. Prospective analysis of the efficacy of continuous intraoperative nerve monitoring during thyroidectomy, parathyroidectomy, and parotidectomy. Otolaryngol Head Neck Surg 2001;124:537–43Google Scholar
Laccourreye, O, Brasnu, D, Jouffre, V, Cauchois, R, Naudo, P, Laccourreye, H. Dysfunction of the facial nerve following total conservative parotidectomy for pleomorphic adenoma. Ann Oto-Laryngol Chir Cervico Faciale Bull Soc Oto-Laryngol Hopitaux Paris 1995:63–8Google Scholar
Dulguerov, P, Marchal, F, Lehmann, W. Postparotidectomy facial nerve paralysis: possible etiologic factors and results with routine facial nerve monitoring. Laryngoscope 1999;109:754–62Google Scholar
Bova, R, Saylor, A, Coman, WB. Parotidectomy: review of treatment and outcomes. ANZ J Surg 2004;74:563–8Google Scholar
Gaillard, C, Périé, S, Susini, B, St Guily, JL. Facial nerve dysfunction after parotidectomy: the role of local factors. Laryngoscope 2005;115:287–91Google Scholar
Guntinas-Lichius, O, Klussmann, JP, Schroeder, U, Quante, G, Jungehuelsing, M, Stennert, E. Primary parotid malignoma surgery in patients with normal preoperative facial nerve function: outcome and long-term postoperative facial nerve function. Laryngoscope 2004;114:949–56Google Scholar
Bron, LP, O'Brien, CJ. Facial nerve function after parotidectomy. Arch Otolaryngol Head Neck Surg 1997;123:1091–6Google Scholar
Terrell, JE, Kileny, PR, Yian, C, Esclamado, RM, Bradford, CR, Pillsbury, MS et al. Clinical outcome of continuous facial nerve monitoring during primary parotidectomy. Arch Otolaryngol Head Neck Surg 1997;123:1081–7Google Scholar
Huang, G, Yan, G, Wei, X, He, X. Superficial parotidectomy versus partial superficial parotidectomy in treating benign parotid tumors. Oncol Lett 2015;9:887–90Google Scholar
Stathopoulos, P, Igoumenakis, D, Smith, WP. Partial superficial, superficial, and total parotidectomy in the management of benign parotid gland tumors: a 10-year prospective study of 205 patients. J Oral Maxillofac Surg 2018;76:455–9Google Scholar
Cheng, H, Clymer, JW, Chen, BP-H, Sadeghirad, B, Ferko, NC, Cameron, CG et al. Prolonged operative duration is associated with complications: a systematic review and meta-analysis. J Surg Res 2018;229:134–44Google Scholar
Janhofer, DE, Lakhiani, C, Song, DH. Addressing surgeon fatigue: current understanding and strategies for mitigation. Plast Reconstr Surg 2019;144:693e–9eGoogle Scholar
Hawn, MT, Houston, TK, Campagna, EJ, Graham, LA, Singh, J, Bishop, M et al. The attributable risk of smoking on surgical complications. Ann Surg 2011;254:914–20Google Scholar
Toda, N, Toda, H. Nitric oxide-mediated blood flow regulation as affected by smoking and nicotine. Eur J Pharmacol 2010;649:1–13Google Scholar
Kim, BD, Lim, S, Wood, J, Samant, S, Ver Halen, JP, Kim, JY. Predictors of adverse events after parotidectomy: a review of 2919 cases. Ann Otol Rhinol Laryngol 2015;124:35–44Google Scholar
Dharmashankar, K, Widlansky, ME. Vascular endothelial function and hypertension: insights and directions. Curr Hypertens Rep 2010;12:448–55Google Scholar
Ryan, WR, Fee, WE. Great auricular nerve morbidity after nerve sacrifice during parotidectomy. Arch Otolaryngol Head Neck Surg 2006;132:642–9Google Scholar
Min, HJ, Lee, HS, Lee, YS, Jeong, JH, Cho, SH, Lee, SH et al. Is it necessary to preserve the posterior branch of the great auricular nerve in parotidectomy? Otolaryngol Head Neck Surg 2007;137:636–41Google Scholar
Porter, MJ, Wood, SJ. Preservation of the great auricular nerve during parotidectomy. Clin Otolaryngol Allied Sci 1997;22:251–3Google Scholar
Kanazawa, A, Haginomori, S-I, Takamaki, A, Nonaka, R, Araki, M, Takenaka, H. Prognosis for Bell's palsy: a comparison of diabetic and nondiabetic patients. Acta Otolaryngol 2007;127:888–91Google Scholar
Boos, CJ, Balakrishnan, B, Jessani, S, Blann, AD, Lip, GY. Effects of percutaneous coronary intervention on peripheral venous blood circulating endothelial cells and plasma indices of endothelial damage/dysfunction. Chest 2007;132:1920–6Google Scholar
Vargová, K, Toth-Zsamboki, E, Beres, B, Bencze, J, Kerecsen, G, Gulacsi-Bardos, P et al. Circulating endothelial cell count, plasma vWF and soluble ICAM-1 levels following primary or elective percutaneous coronary intervention. Atherosclerosis 2008;198:366–72Google Scholar
Han, B, Ghanim, D, Peleg, A, Uretzky, G, Hasin, Y. Loss of systemic endothelial function post-PCI. Acute Card Care 2008;10:79–87Google Scholar
Neumann, A, Rosenberger, D, Vorsprach, O, Dazert, S. The incidence of Frey syndrome following parotidectomy: results of a survey and follow-up. HNO 2011;59:173–8Google Scholar
Lee, CC, Chan, RC-L, Chan, JY-W. Predictors for Frey syndrome development after parotidectomy. Ann Plast Surg 2017;79:39–41Google Scholar