Results
A total of 123 patients (41 cases and 82 controls) were included in the study. Patient demographics and pre-operative characteristics are presented in Table 1. The mean age of the study cohort was 50.8±12.9 years, with a female predominance (69/123, 56.1%). No statistically significant differences between the FS and control group were found for any of the pre-operative characteristic.
Comparison of intraoperative characteristics and the final pathology is presented in Table 2. No significant differences were found between the groups regarding tumor location and final pathology. A borderline significance was found for surgery type as the FS group had higher rates of total parotidectomies compared with the control group (25.0% vs. 10.5%, p=0.054). Revision surgery was performed in 5 patients (12.2%) in the FS group and 6 (7.3%) in the control group. Parapharyngeal involvement was found in 2 patients (4.9%) in the FS group and 6 (7.3%) in the control. The most common pathology was pleomorphic adenoma in both groups (65.9% and 50.0% of patients in the FS and control group, respectively). Malignant tumors were found in 4.9% and 3.7% of patients in the FS and control group, respectively.
The mean LOS in the FS group was significantly lower than that in the control group (1.0±0.3 vs. 1.5±0.6 days; p<0.001, Figure 2). Within the control group, the mean number of days with a drain was 1.6±0.6, with a mean volume of 19.5±15.9 cc of drainage per hospitalization day. Two patients were discharged with their drain, which was removed after 2 days in our outpatient clinic. No differences in mean VAS score was noted between the FS and the control groups - either on post-operative day 1 (0.9±1.1 vs. 1.0±0.9, p=0.645) or on the day of discharge (0.8±1.0 vs. 0.6±0.8, p=0.509).
Complications were minimal and included transient facial nerve palsies as well as salivary and serous collections and infections. No permanent complications occurred in any of our patients regardless of the use of FS or drain. Comparisons of post-operative complications are presented in Table 3. No significant difference was found. The rate of post-operative seroma aspirations and delivery of post-operative antibiotics were lower in the FS group compared with the control group but did not reach statistical significance (Table 3). In the FS group 3 patients were each aspirated twice, and in the control group 12 patients were aspirated 1-3 times (p=0.282). The mean volume of aspirations was similar in both groups (1.0±3.6 cc in the FS group and 1.0±3.2 cc in the control group, p=0.299).