Ali Hawa M, Rourk Katelyn S, Byrne Jamie O, Tasche Kendall K, Price Daniel L, Van Abel Kathryn M, Yin Linda X, Moore Eric J
Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN, USA.
Department of Quantitative Health Sciences, Rochester, MN, USA.
Ann Otol Rhinol Laryngol. 2025 Aug;134(8):606-612. doi: 10.1177/00034894251335405. Epub 2025 May 5.
To assess the impact of extent of parotidectomy on surgical and oncologic outcomes in low grade mucoepidermoid carcinoma (LGMEC).
A retrospective chart review of all patients undergoing primary surgical treatment for LGMEC from 2000 to 2022 was conducted. Clinical features collected included demographics, facial nerve function, operative techniques, postoperative complications/facial nerve function, and recurrence.
58 patients were included; 10 patients underwent partial parotidectomy (PP), 38 underwent superficial parotidectomy (SP), and 10 underwent near-total/total parotidectomy. PP and SP patients had smaller tumors and more superficial tumors compared to near-total/total parotidectomy group ( = .03). PP and SP were more likely to have negative margins and less locoregional disease compared to near-total/total parotidectomy patients ( < .01). Near-total/total parotidectomy were more likely to undergo facial nerve resection (20% vs 0% for PP & SP respectively) ( = .05). Immediate postoperative facial nerve function was significantly better among PP patients (73% HB I) compared to SP (44% HB I) and near-total/total parotidectomy patients (0% HB I) ( < .01). Most patients regained their facial nerve function although only 40% of the near-total/total parotidectomy patients had a HB I at the time of last follow up ( < .01). Patients were followed for a median of 6.2 years, during which only 1 patient (total parotidectomy) had a recurrence.
PP offers a safe and effective approach for small LGMEC tumors, ensuring better facial nerve function postoperatively with minimal complications compared to more extensive surgery.
评估腮腺切除术范围对低级别黏液表皮样癌（LGMEC）手术及肿瘤学结局的影响。
对2000年至2022年期间接受LGMEC初次手术治疗的所有患者进行回顾性病历审查。收集的临床特征包括人口统计学资料、面神经功能、手术技术、术后并发症/面神经功能以及复发情况。
共纳入58例患者；10例行部分腮腺切除术（PP），38例行浅叶腮腺切除术（SP），10例行近全/全腮腺切除术。与近全/全腮腺切除术组相比，PP组和SP组患者的肿瘤较小且位置更表浅（P = 0.03）。与近全/全腮腺切除术患者相比，PP组和SP组更有可能切缘阴性且局部区域疾病较少（P < 0.01）。近全/全腮腺切除术患者更有可能接受面神经切除（分别为20%，而PP组和SP组为0%）（P = 0.05）。PP组患者术后即刻面神经功能明显优于SP组（73%为House-Brackmann I级）和近全/全腮腺切除术患者（0%为House-Brackmann I级）（P < 0.01）。大多数患者恢复了面神经功能，尽管在最后一次随访时，近全/全腮腺切除术患者中只有40%达到House-Brackmann I级（P < 0.01）。患者的中位随访时间为6.2年，在此期间只有1例患者（全腮腺切除术）复发。
对于小的LGMEC肿瘤，PP提供了一种安全有效的方法，与更广泛的手术相比，术后能确保更好的面神经功能且并发症最少。
