Surgical Management of Malignant Parotid Tumors: A Systematic Review of Techniques, Outcomes, and Functional Preservation
DOI:
https://doi.org/10.69667/lmj.2517225Keywords:
Parotid Neoplasms, Parotidectomy, Facial Nerve Preservation, Minimally Invasive Surgical Procedures.Abstract
Malignant tumors of the parotid gland pose notable management hurdles due to their histological variety and inconsistent clinical presentations. This systematic review assesses modern surgical techniques and their effects on oncological and functional results. An extensive search of the PubMed, Scopus, and Cochrane databases (2010–2023) was performed, concentrating on studies that reported surgical methods, survival statistics, and postoperative complications. After screening 2317 records, 14 studies met the inclusion criteria and were included in the qualitative synthesis. The selected articles were rigorously evaluated for bias and relevance. Total parotidectomy remains the foundational approach for high-grade and advanced-stage tumors, assuring oncologic control. Nevertheless, superficial parotidectomy is becoming increasingly preferred for low-grade, localized tumors, optimizing the balance between tumor removal and function preservation. New techniques, including minimally invasive and nerve-sparing methods, show decreased morbidity, particularly regarding facial nerve function and aesthetic outcomes. Intraoperative imaging and neuromonitoring enhance accuracy, lowering the incidence of positive margin rates. Adjuvant radiotherapy is commonly utilized for patients with high-risk characteristics, leading to better locoregional control. Managing parotid malignancies necessitates a customized strategy, incorporating innovative techniques to balance oncological effectiveness with quality of life. Future studies should aim to standardize protocols and investigate long-term functional outcomes.
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