Harmonic Scalpel versus cold knife dissection in superficial parotidectomy

Area of Science:

• Surgical Technology
• Head and Neck Surgery
• Otology and Neurotology

Background:

• The Harmonic Scalpel (HS) has shown promise in thyroid surgery for reducing operative time and blood loss.
• Conventional techniques for superficial parotidectomy involve vessel ligation and tissue division.
• The safety and efficacy of HS in parotid surgery require further investigation.

Purpose of the Study:

• To compare the Harmonic Scalpel (HS) with conventional techniques for superficial parotidectomy.
• To evaluate differences in operative time, blood loss, and facial nerve injury.

Main Methods:

• Retrospective review of medical records for patients undergoing superficial parotidectomy (1999-2002).
• Exclusion criteria included bleeding disorders, prior facial nerve weakness, prior parotid surgery, malignancy, or total parotidectomy.
• Comparison between Harmonic Scalpel parotidectomy (HS) and conventional parotidectomy (control group).

Main Results:

• Nineteen patients underwent HS, and 21 served as controls; no significant demographic or pathological differences were noted.
• HS was associated with significantly reduced operative time (167.5 min vs. 195.5 min, P = 0.03) and blood loss (37.5 mL vs. 60.0 mL, P = 0.03).
• No significant differences were observed in postoperative drain output or facial nerve function between the groups.

Conclusions:

• The Harmonic Scalpel (HS) is a safe alternative for superficial parotidectomy.
• HS use may lead to decreased operative time and intraoperative blood loss compared to conventional methods.
• HS offers potential benefits without compromising facial nerve integrity.