Pediatric parotidectomy. Indications and complications

OBJECTIVE: To evaluate the surgical results of pediatric parotid gland masses with specific attention to complications.

METHODS: A retrospectively review of medical records n=21 aged one to 18 years who underwent parotidectomy at Doernbecher Children's Hospital, Portland, Oregon, USA from 1993 to 2003. The exclusion criteria were as follows; age above 18 years, incision and drainage of parotid abscess, biopsy of parotid lesions.

RESULTS: Twenty-one children who underwent parotidectomy were included in the study. Seventeen had superficial parotidectomy and 4 had total parotidectomy. One patient had bilateral separate superficial parotidectomy. Sixteen lesions were non-neoplastic. Facial nerve monitor was used in 10 patients. The most common lesions were atypical mycobacterium and first branchial cyst anomaly (5 each). Over all complication rate was 47.6%. The most common complication was temporary facial nerve palsy (33%) followed by ear lobule numbness and Frey's syndrome (14% each). Recurrence occurred in one patient with polycystic disease of the parotid. Duration of follow-up ranged from 3 months to more than 7 years.

CONCLUSION: Parotidectomy in children can present some difficulties for the otolaryngologist. The mutilating complication of facial nerve palsy in childhood can be devastating especially for benign diseases. Parotid surgery in children should be limited to units with appropriate expertise in this challenging field.