Introduction:

Parotidectomy for benign parotid gland tumors is frequently performed by head and neck surgeons. In recent years extracapsular dissection (ECD) has been established as standard surgical treatment for most benign parotid gland tumors. Common incisions used for ECD are the so called "Lazy-S" or the modified Blair"s incision, major surgical approaches causing a large wound surface and corresponding postoperative changes like noticeable scars.

Material and methods:

We present different smaller approaches to perform ECD and retrospectively evaluated our results regarding perioperative complications, surgery duration, length of hospital stay, facial nerve paresis, recurrence rate, presence of dysesthesia, and patient satisfaction concerning the scar. We also analyzed tumor size retrospectively.

Results:

We evaluated 100 cases in which we performed ECDs for benign parotid gland tumors. According to the anatomical location of the tumor we mostly used preauricular, and cervical incisions, as well as U-shaped incisions around the earlobe similar to a facelift approach. Patient satisfaction was high with low rate of complications or long-term sequelae.

Discussion:

We believe that small surgical incisions are elegant and safe approaches for ECD of benign parotid gland tumors. The often used Lazy-S incision can be used as orientation along which incisions can be planned and then be conducted in a smaller and possibly modified variation. In particular, the perilobular incision was found to be applicable for many parotid tumors depending on their location. Precise surgery with minimal bleeding is crucial for the success of these procedures.

Nein