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Updated: Feb 26, 2026

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Bipolar dissection technique in parotid gland surgery.

Andreas Knopf1, Clemens Heiser1, Özlem Karasoy1

  • 1a Department of Otorhinolaryngology/Head and Neck Surgery , Klinikum rechts der s Isar, Technische Universität München , München , Germany.

Acta Oto-Laryngologica
|July 26, 2017
PubMed
Summary

Bipolar dissection (BP) offers a faster and safer approach to parotid gland surgery (PGS), reducing operation time, bleeding, and salivary fistula risk. This technique proves effective across various surgical extents.

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Area of Science:

  • Otolaryngology
  • Surgical Techniques
  • Head and Neck Surgery

Background:

  • Parotid gland surgery (PGS) requires balancing tumor removal with preserving facial nerve function.
  • Complications of PGS are often linked to surgical extent, necessitating safe and efficient preparation methods.
  • Bipolar dissection (BP) is presented as a novel, rapid, and secure technique for parotid gland dissection.

Purpose of the Study:

  • To evaluate the safety and efficacy of bipolar dissection (BP) in parotid gland surgery (PGS).
  • To compare BP with traditional cold dissection in terms of operative time and postoperative complications.
  • To assess the impact of BP on facial nerve palsy, bleeding, salivary fistula, and Frey's syndrome.

Main Methods:

  • A retrospective analysis of 319 patients undergoing various parotidectomies (superficial, total, radical).
Keywords:
Bipolar dissectionfacial nerve palsyoutcomeparotid glandparotidectomy

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  • Clinical parameters including age, sex, tumor type, and surgical outcomes were analyzed.
  • Subgroup analysis compared outcomes between cold dissection and bipolar dissection (BP) techniques.

    • Main Results:

    • Facial nerve palsy rates significantly increased with the extent of parotid gland surgery (PGS).
    • Bipolar dissection (BP) significantly reduced operation time (p=0.04), postoperative bleeding (p=0.001), and salivary fistula (p=0.045) compared to cold dissection.
    • No significant differences were observed in the risk of Frey's syndrome or overall postoperative bleeding between the two methods.

    Conclusions:

    • Bipolar dissection (BP) is a fast, safe, and effective preparation technique for parotid gland surgery (PGS).
    • BP facilitates achieving sufficient radicality while preserving functional structures, regardless of the surgical extent.
    • The widespread availability and benefits of BP make it a valuable tool in modern parotid gland surgery.