Endoscope-assisted superficial parotidectomy of large benign parotid tumor through a retroauricular hairline–cranial auricular groove incision approach: A retrospective study

ObjectiveTo compare perioperative outcomes, complications, and cosmetic results between endoscope-assisted superficial parotidectomy via a retroauricular hairline-cranial auricular groove incision and a modified Blair incision for large benign superficial-lobe parotid tumors.MethodsThis retrospective study was conducted at a single tertiary center and included consecutive patients undergoing endoscope-assisted or modified Blair superficial parotidectomy (n = 96; 48 patients/group). The outcomes included operative metrics, conversion, complications (Frey syndrome and facial nerve palsy), and scar results assessed at approximately 3 months within the 3-6-month follow-up period using the Patient and Observer Scar Assessment Scale-Observer Scar Assessment Scale 5-50 and Patient Scar Assessment Scale 6-60, wherein lower scores indicate better results. Group comparisons were performed using appropriate parametric or nonparametric tests and χ² or Fisher's exact test.ResultsAll endoscope-assisted procedures were completed without conversion. Compared with the endoscope-assisted group, the traditional group had higher blood loss (56.3 ± 5.4 vs. 22.4 ± 6.7 mL), greater postoperative drainage volume (118.7 ± 21.5 vs. 58.5 ± 12.3 mL), and longer drainage duration (6.1 ± 1.1 vs. 3.4 ± 0.5 days; all P < 0.01). Furthermore, the operative time was longer and minor sensory events were fewer in the endoscope-assisted group (P < 0.05). No Frey syndrome or persistent facial nerve palsy was observed during the 3-6-month follow-up period. Overall, the Patient and Observer Scar Assessment Scale scores favored the endoscope-assisted group (both P < 0.01).ConclusionEndoscope-assisted superficial parotidectomy via a retroauricular hairline-cranial auricular groove incision may offer cosmetic advantages with fewer minor deficits compared with the modified Blair approach, at the cost of longer operative time. As an observational study with a modest sample size, these results should be viewed as suggestive and confirmed in larger prospective cohorts.