Extracapsular dissection versus partial superficial parotidectomy: a systematic review and meta-analysis

To compare perioperative outcomes and surgical safety between extracapsular dissection (ECD) and partial superficial parotidectomy (PSP) for benign parotid tumors through a systematic review and meta-analysis.

PubMed, Embase, and the Cochrane Library were searched for studies published up to March 2025. English-language studies that directly compared ECD and PSP in patients with benign parotid tumors were included. Data were extracted independently by two authors, and meta-analyses were conducted using a random-effects model. Outcomes included operative duration, drainage volume, hospital stay, tumor size, incidences of Frey syndrome, facial nerve (FN) injury (temporary and permanent), recurrence, as well as the rate of complete tumor excision.

Fourteen studies met the inclusion criteria. Compared with PSP, ECD was associated with shorter operative duration (mean difference [MD], - 15.42 min; 95% confidence interval [CI], - 23.47 to - 7.37), lower drainage volume (MD, - 31.32 mL; 95% CI, - 32.88 to - 29.76), shorter hospital stay (MD, - 0.54 days; 95% CI, - 0.78 to - 0.29), and reduced rates of both Frey syndrome (risk difference [RD], - 0.03; 95% CI, - 0.05 to - 0.00) and temporary FN injury (RD, - 0.12; 95% CI, - 0.20 to - 0.05). No significant differences were found in tumor size, recurrence, permanent FN injury, complete excision rate, or other complications.

ECD and PSP demonstrate comparable surgical safety for benign parotid tumors. ECD offers certain perioperative advantages and may be a suitable option for appropriately selected patients. Further prospective studies are warranted to confirm these findings.