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Video

Head and Neck Surgery

(A636) Surgical Approaches and Recurrences in Primary Deep Lobe Parotid Malignancies: A Systematic Review and Meta-Analysis

Monday, October 13, 2025
12:00 PM - 1:00 PM EDT
Location: OTO EXPO, Posters

    Presenting Author(s)

  • Fayssal Alqudrah, PharmD

    Medical Student
    Department of Otolaryngology-Head and Neck Surgery, Rutgers Robert Wood Johnson Medical School
    Piscataway, NJ, United States

    • Co-Author(s)

  • Victoria Huynh, BS

    Medical Student
    Medical College of Georgia, Augusta University
    Savannah, Georgia, United States

    • Senior Author(s)

  • Taha Mur, MD

    Assistant Professor
    Department of Otolaryngology-Head and Neck Surgery, Rutgers Robert Wood Johnson Medical School
    Piscataway, New Jersey, United States

    • Co-Author(s)

  • Mina A. Beshy

    Medical Student
    Department of Otolaryngology, Rutgers Robert Wood Johnson Medical School
    New Brunswick, New Jersey, United States

Disclosure(s):
Fayssal Alqudrah, PharmD: No relevant relationships to disclose.
Victoria Huynh, BS: No relevant relationships to disclose.
Taha Mur, MD: No relevant relationships to disclose.


Introduction: Primary deep lobe parotid (DLP) malignancies pose significant challenges in surgical management. Preliminary evidence shows varying recurrence rates associated with transoral and transcervical surgical approaches. We performed a systematic review and meta-analysis to evaluate the association between transoral and transcervical approaches and recurrence rates of primary DLP malignancies.

Methods: PubMed, Scopus, and EMBASE were searched for studies up to November 2024 comparing transoral and transcervical approaches in untreated malignant and benign tumors originating in prestyloid, poststyloid, and deep lobe of parotid compartments. Data on tumor recurrences, histopathology, imaging modality, tumor size, follow-up, adjuvant chemoradiotherapy, and distant metastasis outcomes were extracted. The quality of included studies were assessed using MINORS criteria, and pooled risk ratios (RR) with 95% confidence intervals (CI) were calculated using Stata software.

Results: Adhering to PRISMA guidelines, 16 studies met the final inclusion criteria. A total of 269 cases were analyzed, including 60 primary malignant DLP tumors. The most frequently reported recurrent primary malignant DLP tumors were carcinoma ex-pleomorphic adenoma (17.78%), adenoid cystic carcinoma (13.3%), and squamous cell carcinoma (10%) with an average tumor size of 4.6 cm. Primary malignant DLP tumors had a significantly higher recurrence risk than primary benign DLP tumors (RR 2.68; 95% CI 1.54-4.64; p=0.001). However, no statistically significant difference in tumor recurrence was detected between the transoral approach (RR 0.80; 95% CI 0.36 to 1.83; p=0.609) and transcervical approach (RR 0.80; 95% CI 0.35 to 1.82; p=0.595) groups.

Conclusions: While primary malignant DLP malignancies can be associated with an increased risk of recurrence, no significant association was found between tumor recurrences in the transoral and transcervical approaches. Further prospective studies with larger sample sizes are needed to better understand the impact of different surgical approaches on primary DLP malignancy recurrences.