The Qualitative and the Quantitative Assessment of the deep lobe of parotid gland after superficial parotidectomy

Tirkey A.J; Joseph V.; Rajinikanth J.; Pranay G.; Muthusami John C.; Oomen R.

Volume : VI, Issue : IX, September - 2016

The Qualitative and the Quantitative Assessment of the deep lobe of parotid gland after superficial parotidectomy

Tirkey A. J, Joseph V. , Rajinikanth J. , Pranay G. , Muthusami John C. , Oomen R.

Abstract :

Introduction – Superficial parotidectomy is the commonest procedure performed for benign lesion arising in the superficial lobe of the parotid gland. It is believed that after superficial parotidectomy the remaining gland eventually undergoes atrophy. There are not many studies to access the functioning of the remaining deep lobe. This study attempts to examine the quantitative and qualitative function of the remnant parotid gland after superficial Methods – Twenty patients were prospectively analyzed who underwent superficial parotidectomy for the benign lesions. They underwent similar operation as for superficial parotidectomy; stention’s duct was generally preserved after identification if technically it was feasible to be preserved. Postoperatively the remnant gland and the contra lateral gland were assessed using Technetium 99(Tc–99) and the modified Saxon’s test (MST) on the tenth day and six weeks after surgery. The function and the percentage of the remnant gland were calculated. Results–Functional assessment on the operated side by Tc99m scan in 20 patients showed reduction in 16 patient (mean 10.7%),increase uptake in 3 patients(mean 10%), no uptake in 1 patient. The decrease in uptake function when the duct was ligated as in 2 patients was 50% and 75%. Modified Saxon‘s test on the operated side showed that in 11 cases, there was actually increase in the saliva weight on the second measurement. In 6 cases, there was decrease in the saliva secreted. In one case there was no change in the weight. The percentage saliva secretion and the percentage function showed a similar trend (either increase or decrease) on the Saxon’s test and the scan in 7 patients. The mean percentage function on the first and second Scintigraphy was 50.6% and 37% and this was statistically significant (p=0.017). The mean percentage function of the 18 patients whose Stention’s duct were preserved at first and second test was 49.3%and 35.9% respectively and mean secreted saliva weight of 99.5mg and102.4mg. in remaining 4 patient 2 had duct ligated and in two patient with duct unknown the difference was not significant .In the non operated side there was a significant compensatory increase in the uptake function from 69% to 75.36%(p=0.01) but no significant increase in the saliva secretion. Conclusion – The hypothesis that the deep lobe atrophies lobe of parotid gland atrophies and stops functioning is false.