Selective Deep-Lobe Parotidectomy for Benign Parotid Gland Tumors

Deep-lobe tumors have been shown to possess a significantly thicker capsule with less tumor penetration compared to superficial tumors. Thus, more conservative surgical approaches, rather than aggressive methods, have been proposed for treating benign deep-lobe tumors of the parotid gland.

To evaluate the surgical outcomes and oncological safety of selective deep-lobe parotidectomy (SDLP) in patients with benign lesions located in the deep lobe of the parotid gland.

Twenty-two patients who underwent SDLP were enrolled in the study. Data on age, sex, tumor size, hospitalization duration, recurrence, cosmetic outcomes, and complications-including facial nerve (FN) impairment, Frey's syndrome (FS), sialocele, first-bite syndrome (FBS), wound infection, hematoma, and seroma -were retrospectively evaluated from hospital records. Facial contour symmetry was rated by each patient using a 0-10 VAS score at least six months post-surgery.

Final histopathological examination revealed that the most common tumor was pleomorphic adenoma (PA) (59.1%). Three patients (13%) experienced temporary paralysis of the marginal branch of the FN, with a House-Brackman Grade III, which resolved spontaneously within two months post-surgery. No cases of permanent FN paralysis, FS, FBS, or sialocele were observed in any patients. The mean VAS score for facial contour symmetry was 9.43 ± 0.78. No recurrence were noted in any patients over a median follow-up period of 71.7 ± 21.2 months.

SDLP may facilitate the safe surgical removal of benign lesions located in the deep lobe of the parotid gland, with oncological safety, reduced complication rates, and improved cosmetic outcomes.