Aga Khan University, Pakistan
Dr. Awan did his MBBS from Nishtar Medical College in 1990. He did his residency training at Pakistan Institute of Medical Sciences, Islamabad and Aga Khan University Hospital, Karachi and got his post graduate degree (FCPS) from College of Physicians and Surgeons, Pakistan in Otolaryngology and Head and Neck Surgery in 1998. He got his further training in the field of Otology (Ear diseases and surgery) from Wurzberg University, Germany and Portmann Institute, France. Dr. Awan has special interest in Cochlear Implant surgery and started a CI program at AKU in 2005 first of its kind in the country. Dr. Awan has keen interest in research activities and has 50+ national and international publications to his credit. Currently Dr. Awan is working as Associate Professor and Consultant Otolaryngologist at AKUH, he is head of ENT department and also leading the Cochlear Implant Program at Aga Khan University.
Objective: To analyze the clinical presentation, histopathology, complications and outcomes of parotidectomy.
Material and methods: Retrospective chart review was performed of 193 patients who underwent parotidectomy from January 2005 to December 2015 at the Aga Khan University Hospital, Karachi. Data collected included age, gender, comorbid, signs and symptom, perioperative facial nerve function, details of surgery, FNA, histopathology and complications.
Results: Out of 193 patients undergoing parotidectomy, 110(57 %) were males and 83 (43%) were females, mean age being 48.21 and 43.76 years respectively. Mean duration of symptoms was 41.33 months and most common symptom was pre-auricular swelling present in all patients followed by pain present in 29 patients (15%) and facial nerve weakness in 6 patients (3.1%). FNAC was performed preoperatively and results were compared with final histopathology. 158 patients (81.86 %) underwent superficial parotidectomy while 35 patients (18.14 %) underwent total parotidectomy. The final histological diagnosis showed benign lesion in 147 (76.2%) patients and 46 patients (23.8%) had malignant lesions. 23 (11.9%) patients had transient nerve paralysis while 11 (5.7%) had complete facial nerve paralysis after surgery and majority of them were seen after total parotidectomy. 6 (3.1%) patients developed post-operative hematoma and 2 (1%) developed frey’s syndrome. 33 (71.73%) patients were sent for adjuvant radiation therapy out of 46 patients with malignancy and 9 (19.6%) patients with malignancy developed recurrence.
Conclusion: Parotidectomies are performed for almost all parotid masses and are usually associated with good postoperative outcomes. Malignancies of the parotid are rare with most of the masses benign in nature. FNA can prove to be a valuable tool for preoperative counseling of the nature of the disease and prognosis. With modern day procedures facial nerve can be saved in most of the surgical interventions.