Extracapsular Dissection Versus Superficial and Total Parotidectomy for Benign Parotid Tumours: A Retrospective...

Extracapsular dissection (ECD) has emerged as a less invasive alternative to conventional parotidectomy techniques for the management of benign parotid tumours. This retrospective, single-centre study in Scotland, conducted between January 2015 and December 2022, compared the clinical outcomes of ECD with those of superficial (SP) and total parotidectomy (TP) across 55 patients treated by a single surgeon. Thirty-four patients underwent ECD, 17 SP, and 4 TP. Data on pathology, complications, surgical margins, and recovery were analysed, with the Freeman-Halton extension of Fisher's exact test applied to compare ECD and SP outcomes (p < .01). Patients were followed up for a mean duration of 4.8 years (median 4.5 years, range 1-9.5 years). ECD demonstrated favourable results, with lower rates of temporary facial nerve palsy (15%) compared to SP (35%) and TP (75%), and only one case of persistent palsy, noted in the ECD group. Although seromas were more frequent following ECD (18%), no haematomas or recurrences were observed in any cohort. Same-day discharge was achieved in 82% of ECD cases, significantly higher than SP (6%) and TP (0%) (p < .00001). Capsule integrity and tumour-free margins exceeded 88% across all groups, with no significant intergroup differences. Despite a smaller average tumour size in the ECD group, this did not affect outcomes. Overall, ECD provided equivalent oncological safety with superior recovery metrics, supporting its selective use in benign parotid disease.