Selective deep lobe parotidectomy: a systematic review and meta-analysis of outcomes

Deep lobe parotid tumours are difficult to remove due to their location and proximity to the facial nerve. Total parotidectomy is standard but has high complication rates. Selective deep lobe parotidectomy preserves the superficial lobe and may reduce morbidity. This study is the first systematic review and meta-analysis of selective deep lobe parotidectomy outcomes. A PRISMA-based systematic review and meta-analysis was performed. Databases searched on 23 August 2025 included MEDLINE, Embase, CINAHL, PubMed, Google Scholar, and CENTRAL. Eligible studies reported outcomes of selective deep lobe parotidectomy. Data were analysed with a random-effects model, and risk of bias was assessed using the Newcastle-Ottawa Scale. Eight studies (299 patients) met the study criteria. All tumours were benign. Pleomorphic adenoma accounted for 225 cases (75.3%); other benign histologies were less commonly found. No malignancies were reported. Temporary facial weakness occurred in 24.2%, permanent weakness in 3.0%, Frey's syndrome 1.1%, infection 0.8%, contour deformity 11.8%, haematoma 3.1%, seroma 2.7%, auricular numbness 36.7%, and recurrence 0.8%. Heterogeneity was low. Selective deep lobe parotidectomy is a safe option for benign deep lobe tumours with low complication and recurrence rates. Larger prospective comparative studies with long-term follow up are required.