Efficacy Of Different Superficial Parotidectomies For The Treatment Of Benign Neoplasm Of Superficial Parotid Gland : A Meta-analysis

Objective : To systematically review the clinical effects and safety of partial superficial parotidectomy(PSP) and superficial parotidectomy(SP) for the treatment of benign neoplasm of superficial parotid gland using meta-analysis. Methods:A systematic review of partial superficial parotidectomy(PSP) and superficial parotidectomy(SP) for the treatment of benign neoplasm of superficial parotid gland was performed by searching the data bases including CNKI、CBMdisc、Wan Fang Data 、VIP、 Pub Med、EMbase、The Cochrane Library and Web of Knowledge using “Parotid gland benign tumor”、“Partial superficial parotidectomy”、“Superficial parotidectomy” as key words. We compare the incidence of complications which are related to PSP and SP for the treatment of benign neoplasm of superficial parotid gland. All the data published from the beginning to May 2015.The literatures were screened independently and strictly according to the inclusion and exclusion criteria, as well as we traced the references to the relevant documents. After assessing the methodological quality of the included studies,Rev Man5.2 software was used for meta-analysis. With the main outcome measures included transient or permanent facial paresis、salivary fistula or subcutaneous effusion、Frey’s syndrome、facial asymmetry or scar deformity、the tumor recurrence、the occur of great auricular analgesia 、reduction of salivary flow or xerostomia,we adopted the relative risk(RR value) and 95% confidence interval(95% CI) for the evaluation of curative effect. Results:A total of 11(9 in Chinese,2 in English) studies involving 809 patients(413 cases in experimental group,396 cases in control group) were included. The results of meta-analysis showed there were significant differences between the PSP group and SP group in transient or permanent facial paresis[RR=0.41, 95%CI(0.23,0.72), P=0.002],salivary fistula or subcutaneous effusion[RR=0.32, 95%CI(0.16,0.64), P=0.001], Frey’s syndrome[ RR = 0.38, 95 % CI(0.26,0.55), P < 0.00001 ], facial asymmetry or scar deformity [ RR = 0.19, 95 % CI(0.12,0.31), P < 0.00001 ], there was no significant difference in tumor recurrence between the two groups[RR=0.97,95%CI(0.31,3.06),P=0.96], the occur of great auricular analgesia was less in PSP group than SP group[RR=0.39,95%CI(0.27,0.58),P<0.00001], reduction of salivary flow or xerostomia[RR=0.04, 95%CI(0.02,0.09), P<0.00001].Conclusions:Compared with the traditional superficial parotidectomy(SP) technique in the treatment of parotid benign tumor, superficial parotidectomy(PSP) has a shorter operative time, less surgery complications and does not increase the risk of cancer recurrence. Given the included studies are mostly non-randomized controlled clinical trials, and its research has the possibility of selection bias, measurement bias and publication bias, the strength of this proof has largely reduced. Therefore, it is also necessary to have more high quality of prospective randomized controlled trials to be explored and confirmed in the future.