Feasibility of Periauricular Incision for Parotidectomy: A Retrospective Study

Various incisions are used in parotid surgery, yet they often result in visible scarring on the neck and potential deformities. This study aimed to assess the efficacy and feasibility of utilizing a periauricular approach for excising parotid tumors irrespective of their location and size.

This retrospective study involved 46 consecutive patients with parotid lesions, who underwent minimally invasive excision through a periauricular incision performed by a single surgeon between January 2022 and January 2024. Basic demographic data were recorded. Parameters such as the need for incision extension, total volume of drainage, length of hospital stay, postoperative complications, and final pathological diagnosis were also documented.

The main trunk of the facial nerve was successfully identified in all patients, and the tumors were excised without requiring incision extension. Warthin tumor was the most common pathology (n=20, 43%). Three patients (6.5%) had malignant tumors. The inferior portion of the superficial lobe was the most frequent tumor location (n=18, 39%), with 11% of patients having deep lobe parotid tumors. Median operation time was 114 min (range, 90-170), tumor size was 2.8 cm (range, 1-6.5 cm), and drainage volume was 45 mL (range, 10-80). Postoperative complications occurred in 7 patients, with sialocele formation being the most common (n=5, 11%). No serious complications like permanent facial paralysis or skin necrosis were observed.

The periauricular approach is feasible for parotid tumors across all levels of the parotid gland. Its cosmetic advantage lies in the smaller scar size that does not extend into the neck.