Is This Novel Incision for Benign Parotid Tumors the Answer for Improved Esthetics and Access?

J Maxillofac Oral Surg. 2022 Dec;21(4):1304-1310. doi: 10.1007/s12663-021-01605-1. Epub 2021 Jun 25.

Abstract

Background: Incision scars and postoperative cosmesis are critical in the management of benign parotid tumors. Traditional incisions have a typical visible scar in the retromandibular area or require wide skin flaps.

Purpose: In this study, we introduced a new surgical approach called the tri-split flap approach and evaluated its technical feasibility and surgical outcomes.

Materials and methods: Eleven patients with clinically benign parotid gland tumors underwent the tri-split flap approach and were followed for six to ten months postoperatively. Facial weakness, salivary fistula formation, first bite syndrome, earlobe numbness, and the subjective cosmetic results were evaluated.

Results: All tumors were completely excised, and the patients were highly satisfied with the esthetic outcome of the surgery. No patients developed wound dehiscence, facial nerve injury, or first bite syndrome during the follow-up period. One patient developed a minor salivary fistula that resolved after three weeks.

Conclusion: The tri-split flap approach not only provides adequate exposure of the surgical site to achieve complete resection of benign parotid gland neoplasms but also results in a very short and highly concealed post-operative scar. This technique is a potential surgical approach in parotidectomy.

Supplementary information: The online version contains supplementary material available at 10.1007/s12663-021-01605-1.

Keywords: Cosmesis; Head and neck surgery; Parotid neoplasms; Parotidectomy; Y-V plasty.