Bilateral Accessory Parotid Glands: Implications for Surgical Planning and Diagnostic Evaluations Revisited

The accessory parotid gland (APG) is a distinct salivary structure situated along the parotid duct, separate from the main parotid gland (PG). Its anatomical variability and proximity to critical facial structures pose diagnostic and surgical challenges, especially in mid-cheek procedures. The aim of this study is to present morphologically distinct APGs and provide detailed morphometric data relevant to surgical planning and anatomical understanding. Bilateral APGs were identified during routine facial dissection of a fixed cadaver. Morphometric parameters including length, diameter, thickness, ductal dimensions, and distances to key surgical landmarks (zygomatic arch, gonion, external acoustic meatus, vermilion border) were measured using digital calipers and analyzed via ImageJ software. The left APG exhibited notably larger dimensions (26.22 × 23.08 mm) compared to previous literature, and was significantly larger than the right side (14.96 × 6.36 mm). The left parotid duct was markedly elongated (40.58 mm) and the segment between the APG and buccinator muscle showed increased diameter and thickness. Measurements revealed that the left APG was considerably closer to the zygomatic arch (8.9 mm) and external acoustic meatus (35.04 mm), emphasizing its surgical relevance. This case highlights rare size and positional variations of APGs, particularly on the left side. The findings emphasize the need for precise preoperative assessment of APGs to avoid complications such as facial nerve injury and incomplete lesion excision. This study contributes valuable morphometric data for improving surgical outcomes in the mid-cheek region.