Clinical and radiological evidence to support superficial parotidectomy asthe treatment of choice for chronic parotid sialadenitis: a retrospective study

We present a retrospective series of 23 consecutive parotidectomies, over a 10-year period (1989-1999) for 22 patients with chronic sialadenitis unres ponsive to conservative measures. There were 10 male and 12 female patients . Mean age was 52 years (range 12-72), and mean duration of symptoms 4.5 ye ars (range 8 months-30 years). All patients had preoperative sialography an d 2 had computed tomography to exclude a neoplasm. A complete superficial p arotidectomy with preservation of the main duct was done in all cases. Fift een patients developed temporary facial nerve weakness postoperatively and 7 developed Frey's syndrome. There were no cases of permanent facial nerve palsy. Nineteen patients reported complete resolution of their symptoms, an d 3 patients had mild persisting symptoms that did not necessitate any furt her treatment. Histologically there was evidence of sialadenosis in one cas e and benign lymphoepithelial lesion in another; the others showed evidence of chronic sialadenitis of varying degrees of severity Fifteen patients ba d postoperative sialograms, of which 11 showed evidence of some filling of residual parotid gland parenchyma and in 8 patients there was filling of a normal-looking accessory lobe. In this series, superficial parotidectomy wi th preservation of the main duct was safe and effective, with minimal tong- term complications, for most patients with chronic parotid sialadenitis tha t was unresponsive to conservative measures and, in some patients, it allow ed some preservation of function. The potential damage to the facial nerve and the cosmetic problems associated with a total or near-total parotidecto my were avoided. (C) 2001 The British Association of Oral and Maxillofacial Surgeons.