Dissection with harmonic scalpel versus cold instruments in parotid surgery.

Area of Science:

• Surgical Oncology
• Head and Neck Surgery
• Minimally Invasive Techniques

Background:

• The harmonic scalpel (HS) is increasingly utilized in head and neck procedures.
• Prior studies suggest HS offers benefits like reduced operative time and blood loss.

Purpose of the Study:

• To compare the efficacy of harmonic scalpel (HS) parotidectomy with traditional cold instrument (CI) and electrocautery methods.
• To evaluate the benefits of HS in parotid surgery.

Main Methods:

• A prospective study randomized 130 patients with benign parotid tumors into HS and CI groups.
• Exclusion criteria were applied, leaving a final cohort for analysis.

Main Results:

• HS parotidectomy resulted in significantly shorter admission times (3.9 vs. 4.7 days).
• Facial nerve impairment was lower in the HS group (84% vs. 60%), and Frey's syndrome incidence was reduced (9% vs. 29%).
• Multivariate analysis confirmed HS's association with shorter admissions and lower Frey's syndrome risk.

Conclusions:

• The harmonic scalpel is effective in parotid surgery for preventing Frey's syndrome.
• HS reduces early facial nerve dysfunction and hospital admission times.
• Utilizing HS in parotidectomies can lead to decreased medical costs and improved quality of life.