Benign parotid mass and facial palsy: systematic review

• Published in: Annals of the Royal College of Surgeons of England Vol. 103; no. 1; pp. 47 - 52
• Main Authors: Stewart, K E, Bannon, R, Bannister, M
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.01.2021; Royal College of Surgeons
• Subjects: Abscesses; Algorithms; Antibiotics; Biopsy; Cellular biology; Cystadenoma - complications; Cystadenoma - diagnosis; Cystadenoma - pathology; Cystadenoma - therapy; Cysts; Diagnosis, Differential; Epstein-Barr virus; Etiology; Evidence-Based Medicine - methods; Facial Paralysis - etiology; Facial Paralysis - therapy; Head and Neck Surgery; Humans; Lymphoma - complications; Lymphoma - diagnosis; Lymphoma - pathology; Lymphoma - therapy; Magnetic resonance imaging; Medical prognosis; Medical tests; Neurological disorders; Oral cancer; Organisms; Parotid Gland - pathology; Parotid Neoplasms - complications; Parotid Neoplasms - diagnosis; Parotid Neoplasms - pathology; Parotid Neoplasms - therapy; Patients; Staphylococcus infections; Systematic review; Tuberculosis; Tumors; Viral infections; Facial palsy; Lower motor neurone; Parotid disease; Parotid neoplasms
• ISSN: 0035-8843; 1478-7083
• DOI: 10.1308/rcsann.2020.0194

Parotid masses causing facial palsy are highly indicative of malignancy. A significant number of cases describing benign parotid disease causing facial palsy have been reported. We performed a systematic review of the literature to establish the aetiology, clinical features, investigations and management undertaken during these presentations to assess how these factors differed from malignant presentations and to establish an evidence-based algorithm for their management. A total of 85 cases were identified from 78 articles. Cystadenolymphomas were the most common histopathological type ( = 0.034). Mean facial palsy recovery duration in neoplastic aetiology was longer than for infective aetiology ( = 0.033). A significant association existed between uncommon infective organisms and development of facial palsy ( = <0.0001). Uncommon benign aetiologies are associated with facial palsy. Investigations and management should be guided by patients' clinical presentations, avoiding excessive treatment. Complete facial palsy recovery rates are high, although not immediate.