Endoscope-assisted superficial parotidectomy of large benign parotid tumor through a retroauricular hairline–cranial auricular groove incision approach: A retrospective study

Objective To compare perioperative outcomes, complications, and cosmetic results between endoscope-assisted superficial parotidectomy via a retroauricular hairline–cranial auricular groove incision and a modified Blair incision for large benign superficial-lobe parotid tumors. Methods This retrospective study was conducted at a single tertiary center and included consecutive patients undergoing endoscope-assisted or modified Blair superficial parotidectomy (n = 96; 48 patients/group). The outcomes included operative metrics, conversion, complications (Frey syndrome and facial nerve palsy), and scar results assessed at approximately 3 months within the 3–6-month follow-up period using the Patient and Observer Scar Assessment Scale—Observer Scar Assessment Scale 5–50 and Patient Scar Assessment Scale 6–60, wherein lower scores indicate better results. Group comparisons were performed using appropriate parametric or nonparametric tests and χ 2 or Fisher’s exact test. Results All endoscope-assisted procedures were completed without conversion. Compared with the endoscope-assisted group, the traditional group had higher blood loss (56.3 ± 5.4 vs. 22.4 ± 6.7 mL), greater postoperative drainage volume (118.7 ± 21.5 vs. 58.5 ± 12.3 mL), and longer drainage duration (6.1 ± 1.1 vs. 3.4 ± 0.5 days; all P < 0.01). Furthermore, the operative time was longer and minor sensory events were fewer in the endoscope-assisted group (P < 0.05). No Frey syndrome or persistent facial nerve palsy was observed during the 3–6-month follow-up period. Overall, the Patient and Observer Scar Assessment Scale scores favored the endoscope-assisted group (both P < 0.01). Conclusion Endoscope-assisted superficial parotidectomy via a retroauricular hairline–cranial auricular groove incision may offer cosmetic advantages with fewer minor deficits compared with the modified Blair approach, at the cost of longer operative time. As an observational study with a modest sample size, these results should be viewed as suggestive and confirmed in larger prospective cohorts.