Endoscopic Versus Conventional Parotidectomy for Benign Parotid Tumors

Endoscopic Versus Conventional Parotidectomy in the Management of Benign Parotid Tumors : A Prospective Comparative Study

To compare endoscopic and conventional parotidectomy in the management of benign parotid tumors regarding surgical outcomes, facial nerve preservation, operative time, postoperative complications, and cosmetic results, in order to evaluate the safety, feasibility, and potential advantages of the endoscopic minimally invasive technique.

Parotid gland tumors account for approximately 3-6% of all head and neck tumors, and nearly 70-80% arise from the superficial lobe of the gland, with the majority being benign lesions such as pleomorphic adenoma and Warthin tumor . A considerable proportion of these tumors occur in the inferior pole of the parotid gland, where surgical management aims to achieve complete tumor excision while preserving facial nerve function and maintaining satisfactory cosmetic outcomes .

Conventional parotidectomy performed through a modified Blair incision remains the standard surgical approach for benign parotid tumors . This technique offers adequate surgical exposure and good tumor control; however, it is associated with several limitations including visible facial scarring, potential facial nerve injury, Frey's syndrome, and postoperative sensory disturbances .

In recent years, minimally invasive surgical approaches have been introduced to overcome these limitations. Endoscopic parotidectomy has emerged as a promising technique for selected benign parotid tumors. The magnified endoscopic view may facilitate more precise dissection and improved identification of facial nerve branches while allowing smaller incisions and potentially better cosmetic outcomes .

Despite encouraging results reported in several studies, the available evidence comparing endoscopic parotidectomy with the conventional approach remains limited. Therefore, further prospective comparative studies are required to evaluate the safety, efficacy, and cosmetic advantages of this minimally invasive technique.

Inclusion Criteria:

1. Adults aged 18 years or older
2. Patients with benign parotid tumors involving the superficial lobe of the parotid gland
3. Tumors located in the inferior pole with or without limited deep lobe extension
4. Tumor size suitable for minimally invasive approach ≤4 cm
5. Patients fit for surgery under general anesthesia
6. Patients willing to provide informed consent and comply with follow-up

Exclusion Criteria:

1. Recurrent parotid tumors
2. Previous parotid surgery on the affected side
3. Pre-existing facial nerve dysfunction
4. Previous neck surgery or extensive cervical/anterior chest wall scarring
5. Significant comorbidities contraindicating surgery or general anesthesia
6. Suspected or confirmed malignant parotid tumors