Head & Neck Institute Outcomes
Head and Neck Surgery and Oncology
Does Neck Dissection Affect Post-Operative Outcomes in Parotidectomy? A National Study
2005-2017
The objective of this study was to characterize post-operative complications in parotidectomy with neck dissection. Patients age ≥ 18 receiving a parotidectomy or parotidectomy with neck dissection between 2005 and 2017 were eligible for inclusion. Patients with unknown demographic variables were excluded. Univariate and multivariable logistic regression analyses were performed.
Post-Operative Outcomes Analysis Comparing Parotidectomy With and Without Neck Dissection (N = 13,609)
2005-2017
| Outcome | Parotid (N = 11,243) | Parotid With Neck Dissection (N = 2366) | 𝙋-Value |
|---|---|---|---|
| Total operation time (Mean ± SD) | 152.9 ± 99.0 | 335.9 ± 189.2 | <0.0001 |
| Days from operation to discharge (Mean ± SD) | 1.04 ± 2.14 | 3.90 ± 4.76 | <0.0001 |
| 30-day return to OR | 186 (1.7%) | 133 (5.6%) | <0.0001 |
| Any readmission | 181 (1.9%) | 113 (5.4%) | <0.0001 |
| Death within 30 days | 12 (0.1%) | 16 (0.7%) | <0.0001 |
| Any complication | 399 (3.5%) | 330 (13.9%) | <0.0001 |
| Surgical complications | 305 (2.7%) | 260 (11.0%) | <0.0001 |
| Superficial SSI | 176 (1.6%) | 63 (2.7%) | 0.0002 |
| Deep Incisional SSI | 43 (0.4%) | 27 (1.1%) | <0.0001 |
| Organ Space SSI | 21 (0.2%) | 5 (0.2%) | 0.7954` |
| Wound dehiscence/Disruption | 30 (0.3%) | 28 (1.2%) | <0.0001 |
| Transfusion Intra/Post Op (e.g. due to severe bleeding) | 53 (0.5%) | 175 (7.4%) | <0.0001 |
| Medical complication | 117 (1.0%) | 111 (4.7%) | <0.0001 |
| Pneumonia | 24 (0.2%) | 31 (1.3%) | <0.0001 |
| Unplanned intubations | 14 (0.1%) | 22 (0.9%) | <0.0001 |
| Urinary tract infection | 34 (0.3%) | 15 (0.6%) | 0.0144 |
| DVT/Thrombophlebitis | 16 (0.1%) | 6 (0.3%) | 0.2207 |
| Pulmonary embolism | 5 (0.0%) | 9 (0.4%) | 0.0001 |
| On ventilator > 48 hours | 13 (0.1%) | 19 (0.8%) | <0.0001 |
| CVA/Stroke with Neurological deficit | 11 (0.1%) | 10 (0.4%) | 0.0003 |
| Cardiac arrest requiring CPR | 6 (0.1%) | 8 (0.3%) | <0.0001 |
| Myocardial infarction | 10 (0.1%) | 15 (0.6%) | <0.0001 |
| Sepsis | 19 (0.2%) | 16 (0.7%) | <0.0001 |
| Septic shock | 4 (0.0%) | 4 (0.2%) | 0.0353 |
| Progressive renal failure | 7 (0.1%) | 1 (0.0%) | 1.000 |
| Acute renal failure | 3 (0.0%) | 3 (0.1%) | 0.580 |
Nationwide data demonstrates that parotidectomy with neck dissection is associated with increased rates of post-operative complications; however, neck dissection did not significantly impact readmission or reoperation rates. These findings indicate that neck dissection is a relatively safe addition to parotidectomy and provide novel evidence in the management of parotid malignancies.
