NSQIP Outcomes of Superficial Parotidectomy: The Case for Extracapsular
Dissection
Abstract
Objectives: To compare outcomes of patients with benign
neoplasms undergoing superficial parotidectomy, with or without facial
nerve dissection, the latter a surrogate for extracapsular dissection
technique. Methods: Retrospective review of the American
College of Surgeons National Surgical Quality Improvement Project
(NSQIP) database providing 30-day postoperative outcome data from 676
sites nationwide. Inclusion criteria were primary diagnosis of benign
salivary neoplasm, age 18-89 years, primary procedure superficial
parotidectomy either with (CPT 42415 (SPwFND)) or without (CPT 42410
(SPwoFND)) facial nerve dissection between 2012-2019. We analyzed
demographics, operative time, length of stay, perioperative
complications, readmission, and reoperation rates between the two
procedure groups. NSQIP contained no information on postoperative facial
paralysis or estimated blood loss. Results: In total, 2651
patients underwent SPwFND while 764 underwent SPwoFND. Operative time
was shorter (111.59 +/- 63.417) for SPwoFND than for SPwFND (135.05 +/-
64.313, p<;0.0001). Fewer patients undergoing SPwoFND required
overnight stay than those undergoing SPwFND (41.5% vs 59.4%,
p<0.001). There were no significant differences between rates
of reoperation, unplanned readmission, or perioperative complications
between the groups. Conclusion: SPwoFND nerve dissection had a
shorter operative time and led to fewer postoperative overnight stays
than SPwFND, with no significant differences in rates of reoperation,
unplanned readmission, or perioperative complications. This suggests
that for appropriately selected patients, SPwoFND may be a comparable
treatment option with the benefit of lower resource utilization than
SPwFND.