Pediatric Parotidectomy: A 20-Year Experience at a Single Institution

Abstract

Objectives:

Review a single institution’s experience with parotidectomy in pediatric patients.

Methods:

A retrospective chart review was performed on children undergoing parotidectomy between 1994 and 2013. Data included presenting symptoms, tumor histology, postoperative complications, facial nerve weakness, and disease recurrence.

Results:

Forty-two pediatric patients underwent parotidectomy. Preoperatively, 16 patients (38%) presented with an asymptomatic mass, 7 (17%) had pain, 18 (43%) had recurrent infection, and 6 (14%) had skin involvement. Surgical pathology revealed 20 (48%) infectious or inflammatory lesions, 15 (36%) benign lesions, and 7 (17%) malignant lesions. The infectious and inflammatory lesions included granulomatous infections (26%), hyperplastic lymphadenopathy (12%), and chronic sialadenitis (10%). Lymphangioma (14%) and pleomorphic adenoma (12%) were the most common benign lesions. Malignant lesions included one (2.4%) of each of the following: acinic cell carcinoma, adenoid cystic carcinoma, mucoepidermoid carcinoma, melanoma, scute lymphoblastic leukemia, Hodgkins lymphoma, and Langerhans histiocytosis. The patient with adenoid cystic carcinoma had recurrence of disease, and required a second extirpative surgery. Facial weakness occurred in 19 (45%) patients. Of these, 9 (47%) had infectious or inflammatory lesions. Permanent weakness occurred in 5 (12%) patients. The facial nerve was intentionally resected in one patient (recurrent adenoid cystic carcinoma); the other 4 had surgery for infectious or inflammatory lesions. Additional complications included facial pain (3 patients), wound infection, seroma, and Frey syndrome (one each).

Conclusions:

Short-term facial paresis is common in pediatric parotidectomy, especially when surgery is for infectious or inflammatory disease. Parotid neoplasms are uncommon and malignancies are especially rare.