Which of the following is not decreased with the use of extracapsular dissection for parotid tumors (as opposed to facial nerve dissection techniques)?

A) Temporary facial nerve palsy
B) Permanent facial nerve palsy
C) Frey's syndrome
D) Salivary fistula

View Answer

Answer: Salivary fistula

A total of 2988 patients were included in this study. The analysis showed that the increasing performance of extracapsular dissection was associated with a progressive reduction in the incidence of temporary facial nerve palsy, permanent facial nerve palsy and Frey's syndrome, while the rate of salivary fistula remained the same.

Paradigm shift in surgery for benign parotid tumors: 19 years of experience with almost 3000 cases.  Bianca Bär, Konstantinos Mantsopoulos, Heinrich Iro.  Laryngoscope. 2020 Aug;130(8):1941-1946.


Only about one quarter of otolaryngologists answered correctly.

Extracapsular dissection for parotid tumors

Surprisingly the distribution of answers from head and neck surgeons is split across the board. The most popular answer by far was Frey’s syndrome with more than a third of ENTs (35%) submitting this answer. The least popular answer was Permanent facial nerve palsy (19%), while the correct answer, Salivary fistula (24%), and Temporary facial nerve palsy (22%)  were answered nearly the same amount of the time.

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