Evidence map›Paper›PMID 41503816›Full record

ArticleOtolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery2026

Perioperative Outcomes in Antegrade, Retrograde, and Extracapsular Approaches to Parotidectomy in Benign and Malignant Neoplasms.

Andrew D P Prince, Christian Schaaff, David Forner, Kimberly Oslin, Josh Smith, Michael M Alevato, Emma Hershey, Lisa Chionis, Molly E H Neal, Mark E P Prince and 1 more

Abstract readComparative Study
PubMed Full text at PMC Publisher
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Article in Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Andrew D P PrinceDepartment of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA.ORCID https://orcid.org/0000-0001-9359-7739
Christian SchaaffDepartment of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA.
David FornerDepartment of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA.ORCID https://orcid.org/0000-0002-1014-3545
Kimberly OslinDepartment of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Josh SmithDepartment of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Michael M AlevatoDepartment of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Emma HersheyDepartment of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Lisa ChionisDepartment of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Molly E H Neal
Mark E P PrinceDepartment of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Steven B ChinnDepartment of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo compare facial nerve function and perioperative outcomes among antegrade, retrograde, and extracapsular parotidectomy approaches in benign and malignant tumors. STUDY

designRetrospective review.

settingTertiary academic center.

methodsAdults undergoing parotidectomy with facial nerve preservation between 2018 and 2023 were included. Demographic, surgical, and outcome variables were analyzed using bivariate and multivariable regression.

resultsA total of 740 tumors were analyzed (353 benign, 387 malignant). Antegrade dissection was performed in 288 cases (194 malignant), retrograde in 334 (167 malignant), and extracapsular in 118 (26 malignant). Transient and permanent facial weakness occurred in 20% and 5% of cases. After adjustment, extracapsular dissection (odds ratio [OR] = 0.2, 95% confidence interval [CI] 0.1-0.7, P = .0058) significantly reduced transient weakness compared with antegrade dissection. Retrograde dissection (OR = 0.5, 95% CI 0.3-1.1, P = .11) demonstrated a trend toward lower rates of transient weakness relative to antegrade dissection. In malignant tumors, outcomes were similar across approaches. Extracapsular dissection was rarely used in malignant disease and reserved for selected cases. Antegrade dissection had longer operative times in benign and malignant tumors (P < .001). Perioperative complication rates, unplanned visits, recurrence, re-operations, ED visits, and readmissions were low and not significantly different across techniques.

conclusionIn benign parotidectomy, extracapsular dissection significantly reduced transient facial weakness, while retrograde dissection demonstrated a trend toward reduced transient weakness compared with antegrade. In malignant disease, outcomes were similar across approaches. Selective application of extracapsular and retrograde techniques may optimize facial nerve outcomes and operative efficiency.

Indexed as

DissectionParotid GlandParotid NeoplasmsAdultAgedFacial Nerve InjuriesFemaleHumansMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesTreatment Outcomehead and neckparotidectomysalivary malignancysalivary tumorssurgical approach

Identifiers

PMID41503816
PMCPMC12860175

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