Author(s)
Christopher D. Badger, MD
Margaret C. Michel, BS
Joseph F. Goodman, MD
Punam G. Thakkar, MD
Arjun S. Joshi, MD
Affiliation(s)
George Washington University;
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should understand the utility of the minimum fascia tumor distance (MFTD) in the selection of candidates for extracapsular dissection of benign parotid tumors. Objectives: There is a growing body of literature supporting the use of extracapsular dissection (ECD) for the treatment of benign superficial lobe parotid tumors. Prior studies have suggested the minimum distance between the parotideomasseteric fascia and the tumor edge or minimum fascia tumor distance (MFTD) as a useful measurement in the identification of superficial parotid tumors. The objective of this study is to demonstrate the utility of the MFTD in selecting candidates for extracapsular dissection of benign parotid tumors. Study Design: A retrospective case control study. Methods: Twenty patients with prior surgical excision of benign parotid tumors were identified. All patients identified underwent preoperative ultrasonography. Ultrasound images were reviewed and the MFTD was recorded. Tumors with an MFTD less than 3mm were considered superficial and good candidates for ECD. The primary outcome recorded was the successful completion of ECD versus more extensive resection, such as superficial parotidectomy or total parotidectomy. Results: Thirteen patients (65%) had an MFTD less than 3mm. Of these patients, 10 successfully underwent ECD. The remaining 7 patients with an MFTD of 3 mm or greater had 6 patients that required conversion to superficial parotidectomy or total parotidectomy. An MFTD less than 3 mm had a sensitivity and specificity for successful ECD of 76.9% and 85.7% respectively. These results were found to be significant (OR 20.0, 95% CI 2.06 - 246.0). Conclusions: ECD is an important technique in selected benign parotid tumors. MFTD is a useful measurement in the selection of candidates for ECD benign tumor removal.