Abstract:
Objectives: Drainless parotidectomy has been reported
infrequently, mostly in patients undergoing limited partial
parotidectomies. Evicel is a fibrin sealant (FS) glue whose use has not
been reported in head and neck surgeries so far. The aim of the study
was to investigate the impact of drainless parotidectomy using FS on the
surgical outcome.
Design: A retrospective matched case-control series
Settings: A single academic center
Participants: All cases of patients who underwent drainless
parotidectomies, including deep lobe tumors and revision surgeries, were
compared to age, sex, body mass index and tumor-matched controls in
which a suction drain was inserted.
Main outcome measures: length of hospital stay (LOS). Secondary
outcomes included post-operative seroma and related complications.
Results: A total of 123 patients (41 cases and 82 controls)
were included in the study. Pre-operative and intra-operative
characteristic did not differ significantly between the FS group and
controls. A borderline significance was found for surgery type as the FS
group had higher rates of total parotidectomy compared with the control
group (25.0% vs. 10.5%, p=0.054). LOS was significantly shorter in the
FS group (1.0±0.3 vs. 1.5±0.6 days, p<0.001). The rates of
post-operative seroma, aspirations, local infection and post-operative
antibiotic treatment were all lower in the FS group compared with the
control group, but did not reach statistical significance.
Conclusion: A drainless parotidectomy using the EVICEL FS is
safe, reduces LOS, and may reduce post-operative seroma and its
associated complications. This procedure may be applied to deep parotid
tumors, parapharyngeal involvement and revision surgery.