Abstract
We examined 224 patients who underwent surgery for parotid lesions during the 8 years from January 2012 to December 2019. There were 192 benign lesions, with pleomorphic adenoma and Warthin’s tumor in 92 （47.9％） and 59 cases （30.7％）, respectively. Furthermore, 32 patients had malignant tumors. The accuracy of fine-needle aspiration cytology was 80.4％ and 62.7％ for pleomorphic adenoma and Warthin’s tumor, respectively. The positive diagnosis rate of malignant tumors was 75.0％ for highly malignant tumors and 27.3％ for low- and middle-grade malignant tumors. Among the benign cases, the anterograde and retrograde approaches were used in 130 and 56 cases, respectively. Postoperative facial nerve palsy was observed in 25.0％ of the benign cases, with complete recovery observed in all but four cases. Of the four patients with residual facial palsy, three had paresis, while the remaining patient had a facial schwannoma for which intercapsular resection was performed, although complete paralysis persisted. The incidence of postoperative facial nerve palsy according to location was 21.1％, 27.8％, and 28.9％ for superficial lobe tumors, deep lobe tumors, and tumors in the lower pole, respectively. The incidence of postoperative facial paralysis based on the approach was 23.7％ and 33.9％ for the anterograde and retrograde approaches, respectively, with no significant difference between them. The average surgery time was 139.7min for benign cases and 180.0min for superficial and deep lobe tumors. In terms of the approach to the facial nerve, the anterograde and retrograde approaches averaged 156.6min and 120.6min, respectively, the difference being significant. The operation time and postoperative hospital stay were significantly shorter for the retrograde than for the anterograde approach. It may be useful to select the surgical approach based on the localization of the lesion.
