Endoscopic versus conventional open parotid gland surgery: a systematic review and meta-analysis

statistic. Eleven studies involving 1188 patients were included. Tumor diameter and operative time did not differ significantly between the endoscopic and conventional groups. Endoscopic parotidectomy was associated with significantly reduced intraoperative blood loss (MD -42.28 mL, 95% CI -61.56 to -23.01) and lower postoperative drain output (MD -40.73 mL, 95% CI -68.60 to -12.86). No statistically significant differences were observed for drain duration, salivary fistula formation, auricular skin numbness, or Frey syndrome. A lower OR of temporary facial nerve dysfunction was observed in the endoscopic group, while permanent facial nerve paralysis and surgical site infection rates were low and comparable between approaches. All included studies were of moderate methodological quality, and the overall certainty of evidence was low. Endoscopic parotid gland surgery appears to be a feasible alternative to conventional parotid gland surgery in selected patients, providing modest perioperative advantages without compromising postoperative outcomes. However, the small absolute magnitude of these differences suggests limited clinical impact, indicating that this approach represents a cosmetically favorable and safe option rather than a clearly superior technique. Given the limited number of studies, regional concentration of the available evidence, and substantial heterogeneity across several outcomes, further high-quality, multicenter prospective studies are needed to better define its clinical significance and generalizability.