Resected specimen size: A reliable predictor of severe Frey syndrome after parotidectomy

Hung Ju Lin, Jenn-Ren Hsiao, Jeffrey S. Chang, Chi Lun Hu, Ting Rong Chen, Wei-Ting Lee, Cheng-Chih Huang, Chun-Yen Ou, Shu-Wei Tsai, Yu Cheng Lu, Sen-Tien Tsai, Wen-Yuan Chao, Chan-Chi Chang

Research output: Contribution to journalArticle

Abstract

Background: Frey syndrome is a common complication after parotidectomy. This study aimed to investigate the potential predictors for developing severe Frey syndrome after parotidectomy and to identify patients who may benefit from additional preventive maneuvers. Methods: A total of 485 patients received parotidectomy because of parotid tumors at the Otolaryngology Department of the National Cheng Kung University Hospital, from July 2009 to November 2015. Only 115 of 485 patients were included in this study and to fill in a questionnaire to determine the occurrence and severity of Frey syndrome. Results: A total of 115 parotidectomies were identified. 84 (73%, 84/115) patients were aware of the discomfort and were thus considered symptomatic. 39 (34%, 39/115) patients considered the symptoms apparently affected their quality of life. MSI tests showed that 56 (49%, 56/115) patients had a positive MSI test. By combining the results from symptom questionnaire and MSI test, 23 patients (20%, 23/115) had a severe form of Frey syndrome. Among all clinicopathological variables, the resected specimen size was the only significant predictor of the severe Frey syndrome group (P = 0.04). Disease pathology, tumor size, and adjuvant radiotherapy did not correlate with the severe Frey syndrome. Using receiver operating curve analysis, the best cutoff value of the resected specimen size (in largest dimension) for predicting severe Frey syndrome was 40 mm(sensitivity: 71.7%, specificity: 42.0%; area under the curve = 0.6483). The odds ratio of severe Frey syndrome with every 10 mm increase in the largest diameter of resected specimen was 1.30 (95% confidence interval, 1.01-1.68; P = 0.04). Conclusions: Resected specimen size is the only significant predictor of developing severe Frey syndrome after parotidectomy. Preventive interventions may have to be considered in high-risk patients whose resected specimen size (in largest dimension) is greater than 40 mm.

Original languageEnglish
Pages (from-to)2285-2290
Number of pages6
JournalHead and Neck
Volume41
Issue number7
DOIs
Publication statusPublished - 2019 Jul 1

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Gustatory Sweating
Adjuvant Radiotherapy
Otolaryngology
Area Under Curve
Neoplasms
Odds Ratio
Quality of Life
Confidence Intervals
Pathology

All Science Journal Classification (ASJC) codes

  • Otorhinolaryngology

Cite this

@article{8b01484164834a988b29c47e3b499132,
title = "Resected specimen size: A reliable predictor of severe Frey syndrome after parotidectomy",
abstract = "Background: Frey syndrome is a common complication after parotidectomy. This study aimed to investigate the potential predictors for developing severe Frey syndrome after parotidectomy and to identify patients who may benefit from additional preventive maneuvers. Methods: A total of 485 patients received parotidectomy because of parotid tumors at the Otolaryngology Department of the National Cheng Kung University Hospital, from July 2009 to November 2015. Only 115 of 485 patients were included in this study and to fill in a questionnaire to determine the occurrence and severity of Frey syndrome. Results: A total of 115 parotidectomies were identified. 84 (73{\%}, 84/115) patients were aware of the discomfort and were thus considered symptomatic. 39 (34{\%}, 39/115) patients considered the symptoms apparently affected their quality of life. MSI tests showed that 56 (49{\%}, 56/115) patients had a positive MSI test. By combining the results from symptom questionnaire and MSI test, 23 patients (20{\%}, 23/115) had a severe form of Frey syndrome. Among all clinicopathological variables, the resected specimen size was the only significant predictor of the severe Frey syndrome group (P = 0.04). Disease pathology, tumor size, and adjuvant radiotherapy did not correlate with the severe Frey syndrome. Using receiver operating curve analysis, the best cutoff value of the resected specimen size (in largest dimension) for predicting severe Frey syndrome was 40 mm(sensitivity: 71.7{\%}, specificity: 42.0{\%}; area under the curve = 0.6483). The odds ratio of severe Frey syndrome with every 10 mm increase in the largest diameter of resected specimen was 1.30 (95{\%} confidence interval, 1.01-1.68; P = 0.04). Conclusions: Resected specimen size is the only significant predictor of developing severe Frey syndrome after parotidectomy. Preventive interventions may have to be considered in high-risk patients whose resected specimen size (in largest dimension) is greater than 40 mm.",
author = "Lin, {Hung Ju} and Jenn-Ren Hsiao and Chang, {Jeffrey S.} and Hu, {Chi Lun} and Chen, {Ting Rong} and Wei-Ting Lee and Cheng-Chih Huang and Chun-Yen Ou and Shu-Wei Tsai and Lu, {Yu Cheng} and Sen-Tien Tsai and Wen-Yuan Chao and Chan-Chi Chang",
year = "2019",
month = "7",
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doi = "10.1002/hed.25683",
language = "English",
volume = "41",
pages = "2285--2290",
journal = "Head and Neck",
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Resected specimen size : A reliable predictor of severe Frey syndrome after parotidectomy. / Lin, Hung Ju; Hsiao, Jenn-Ren; Chang, Jeffrey S.; Hu, Chi Lun; Chen, Ting Rong; Lee, Wei-Ting; Huang, Cheng-Chih; Ou, Chun-Yen; Tsai, Shu-Wei; Lu, Yu Cheng; Tsai, Sen-Tien; Chao, Wen-Yuan; Chang, Chan-Chi.

In: Head and Neck, Vol. 41, No. 7, 01.07.2019, p. 2285-2290.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Resected specimen size

T2 - A reliable predictor of severe Frey syndrome after parotidectomy

AU - Lin, Hung Ju

AU - Hsiao, Jenn-Ren

AU - Chang, Jeffrey S.

AU - Hu, Chi Lun

AU - Chen, Ting Rong

AU - Lee, Wei-Ting

AU - Huang, Cheng-Chih

AU - Ou, Chun-Yen

AU - Tsai, Shu-Wei

AU - Lu, Yu Cheng

AU - Tsai, Sen-Tien

AU - Chao, Wen-Yuan

AU - Chang, Chan-Chi

PY - 2019/7/1

Y1 - 2019/7/1

N2 - Background: Frey syndrome is a common complication after parotidectomy. This study aimed to investigate the potential predictors for developing severe Frey syndrome after parotidectomy and to identify patients who may benefit from additional preventive maneuvers. Methods: A total of 485 patients received parotidectomy because of parotid tumors at the Otolaryngology Department of the National Cheng Kung University Hospital, from July 2009 to November 2015. Only 115 of 485 patients were included in this study and to fill in a questionnaire to determine the occurrence and severity of Frey syndrome. Results: A total of 115 parotidectomies were identified. 84 (73%, 84/115) patients were aware of the discomfort and were thus considered symptomatic. 39 (34%, 39/115) patients considered the symptoms apparently affected their quality of life. MSI tests showed that 56 (49%, 56/115) patients had a positive MSI test. By combining the results from symptom questionnaire and MSI test, 23 patients (20%, 23/115) had a severe form of Frey syndrome. Among all clinicopathological variables, the resected specimen size was the only significant predictor of the severe Frey syndrome group (P = 0.04). Disease pathology, tumor size, and adjuvant radiotherapy did not correlate with the severe Frey syndrome. Using receiver operating curve analysis, the best cutoff value of the resected specimen size (in largest dimension) for predicting severe Frey syndrome was 40 mm(sensitivity: 71.7%, specificity: 42.0%; area under the curve = 0.6483). The odds ratio of severe Frey syndrome with every 10 mm increase in the largest diameter of resected specimen was 1.30 (95% confidence interval, 1.01-1.68; P = 0.04). Conclusions: Resected specimen size is the only significant predictor of developing severe Frey syndrome after parotidectomy. Preventive interventions may have to be considered in high-risk patients whose resected specimen size (in largest dimension) is greater than 40 mm.

AB - Background: Frey syndrome is a common complication after parotidectomy. This study aimed to investigate the potential predictors for developing severe Frey syndrome after parotidectomy and to identify patients who may benefit from additional preventive maneuvers. Methods: A total of 485 patients received parotidectomy because of parotid tumors at the Otolaryngology Department of the National Cheng Kung University Hospital, from July 2009 to November 2015. Only 115 of 485 patients were included in this study and to fill in a questionnaire to determine the occurrence and severity of Frey syndrome. Results: A total of 115 parotidectomies were identified. 84 (73%, 84/115) patients were aware of the discomfort and were thus considered symptomatic. 39 (34%, 39/115) patients considered the symptoms apparently affected their quality of life. MSI tests showed that 56 (49%, 56/115) patients had a positive MSI test. By combining the results from symptom questionnaire and MSI test, 23 patients (20%, 23/115) had a severe form of Frey syndrome. Among all clinicopathological variables, the resected specimen size was the only significant predictor of the severe Frey syndrome group (P = 0.04). Disease pathology, tumor size, and adjuvant radiotherapy did not correlate with the severe Frey syndrome. Using receiver operating curve analysis, the best cutoff value of the resected specimen size (in largest dimension) for predicting severe Frey syndrome was 40 mm(sensitivity: 71.7%, specificity: 42.0%; area under the curve = 0.6483). The odds ratio of severe Frey syndrome with every 10 mm increase in the largest diameter of resected specimen was 1.30 (95% confidence interval, 1.01-1.68; P = 0.04). Conclusions: Resected specimen size is the only significant predictor of developing severe Frey syndrome after parotidectomy. Preventive interventions may have to be considered in high-risk patients whose resected specimen size (in largest dimension) is greater than 40 mm.

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