Extracapsular dissection for benign parotid tumors: A meta-analysis

Objectives/Hypothesis: Recent studies suggest that extracapsular dissection (ECD) is an option for the resection of certain benign parotid tumors. This study investigates complication rates and effectiveness of ECD versus superficial parotidectomy (SP) for the treatment of primary benign parotid neoplasms. Study Design: Systematic literature review with meta-analysis. Methods: Studies available for inclusion evaluated the complications and effectiveness of ECD and SP as surgical techniques for the treatment of solitary, benign parotid tumors. An Ovid/Medline search revealed nine articles that met inclusion criteria. A critical review and meta-analysis of these articles was performed. Results: The included studies evaluated a total of 1,882 patients. There was no observed difference in tumor recurrence between the ECD and SP groups (odds ratio [OR], 0.557; 95% confidence interval [CI], 0.271-1.147). There was a significantly lower rate of transient facial nerve paresis (OR, 0.256; 95% CI, 0.174-0.377) in the ECD group (59 of 741; 8.0%) compared to the SP group (81 of 397; 20.4%); however, there was no observed difference in permanent facial paralysis between the ECD and SP groups (OR, 0.878; 95% CI, 0.282-2.730). Frey's syndrome was less often observed (OR, 0.117; 95% CI, 0.071-0.191) after ECD (27 of 602; 4.5%) compared to SP (75 of 287; 26.1%). Conclusions: This systematic review with meta-analysis suggests that ECD has a similar recurrence rate as SP with fewer postoperative complications. ECD may be considered an alternative surgical modality for select benign parotid neoplasms.