Seroma developed in 11% of patients following parotidectomy in a retrospective study of 527 cases published in Frontiers in Surgery.
Researchers reviewed adult patients treated at a tertiary center between March 2020 and March 2025. Seroma was defined as postoperative fluid accumulation requiring aspiration without evidence of salivary fistula. Persistent seroma was defined as fluid collection lasting more than 14 days after drain removal or requiring multiple aspirations.
Among the 56 patients who developed seroma, presentation typically occurred within the first postoperative week following drain removal, with a median onset of 4 days (range, 2-10 days). The median time to resolution was 17 days, and patients required a median of 2 aspirations. Persistent seroma occurred in 19 patients, representing 4% of the total cohort.
Multivariable analysis identified several independent risk factors. Anterior tumor location was associated with about 2.2 times the odds of seroma. Larger tumor size also increased risk, with each additional centimeter associated with a 58% increase in odds. Patients with a body mass index of 25 kg/m² or higher had about 1.8 times the odds, and those who underwent a facelift-type incision had about 1.9 times the odds compared with a modified Blair incision.
Higher cumulative drain output prior to removal was observed in patients who later developed seroma, although drain duration was similar between groups. Drains were routinely removed when 24-hour output fell below 20 mL.
Extent of surgery, surgical approach, facial nerve dissection technique, tumor histology, and lobe involvement were not significantly associated with seroma formation.
The findings suggest that tumor location, tumor size, patient body mass index, and incision type may be more predictive of postoperative seroma than surgical extent. These data may help inform patient counseling and postoperative monitoring strategies.
Although limited by its retrospective design, the study provides practical information on the incidence and risk factors for seroma after parotidectomy.
The authors reported no funding and no conflicts of interest.
Source: Frontiers in Surgery