Clinicopathologic Features and Postoperative Outcomes of Parotidectomy: A 16-Year Retrospective Cohort Study from a Tertiary Referral Center

Background: Parotid gland tumors pose diagnostic and surgical challenges due to their histological heterogeneity and proximity to the facial nerve. This study aimed to evaluate clinicopathological features and postoperative outcomes with a specific focus on facial nerve function in patients undergoing parotidectomy. Methods: This retrospective study included 314 patients who underwent parotidectomy between 2008 and 2024 at a tertiary center. Demographic data, tumor histology, and postoperative complications—particularly facial nerve paralysis within the first three months—were analyzed. Histopathological features including capsular, perineural, and lymphovascular invasion were also assessed. Results: Of all cases, 79% were benign, 14.6% malignant, and 6.4% non-neoplastic. Pleomorphic adenoma and Warthin tumor were the most common benign entities, while mucoepidermoid carcinoma was the most frequent malignancy. Malignant tumors were associated with higher rates of positive surgical margins (44.2% vs. 12.5%, p < 0.001), capsular invasion (25% vs. 7%, p < 0.001), and tumor necrosis (22% vs.