Factors Influencing Sialocele or Salivary Fistula Formation Post-parotidectomy

Abstract

Objectives:

Determine if the extent of parotidectomy or other patient or tumor characteristics influence the rate of sialocele or salivary fistula formation after parotidectomy.

Methods:

A retrospective chart review was performed for all patients who underwent parotidectomy at the University of Wisconsin from 1994 to 2013. Patients who developed a sialocele or salivary fistula at any time postoperatively were identified. Age, sex, area and size of defect, body mass index (BMI), and rate of malignancy were evaluated to assess any relationship to these complications.

Results:

A total of 771 patients underwent parotidectomy at our institution from 1994 to 2013. Of these, 75 (9.7%) developed a sialocele or salivary fistula. Sialoceles or salivary fistulas developed in 96% (72/75) within 1 month post-parotidectomy, and none developed after 6 months. Age, sex, BMI, and histology were not associated with sialocele or salivary fistula formation. Extent of parotidectomy was quantified through assessment of surgical volume of tissue removed. The average volume of tissue removed was 37.8 cubic centimeters (cc) (range 0.2-277 cc; 95% confidence interval [28.4 cc, 47.2 cc]). Sixty-four patients (85.3%) underwent superficial parotidectomy, 7 (9.3%) underwent total parotidectomy, and extent of surgery was not documented in 4 patients (5.3%). 2 patients (2.7%) underwent revision surgery. Of patients who underwent superficial parotidectomy, 28 (43.8%) were complete superficial parotidectomy and 23 (35.9%) were partial inferior superficial parotidectomy.

Conclusions:

Sialocele is an uncommon complication post-parotidectomy. Contrary to other studies, we observed that sialocele formation does not depend on amount of parotid tissue removed, site of parotidectomy, gender, age, BMI, or rate of malignancy.