Objective:To summarize the preliminary experience of endoscopically assisted mid-cheek benign tumor resection using a single preauricular or transoral incision and to evaluate its indications, advantages, and disadvantages.Methods:Thirty-six patients with benign mid-cheek tumors were prospectively enrolled, including 11 males and 25 females, aged (37.2± 15.9) years and ranged from 11 to 65 years old. The patients were randomly divided into two groups: endoscope-assisted tumor dissections through a single preauricular incision (preauricular group, 19 cases) or transoral incision (transoral group, 17 cases). Their surgical approaches were introduced, and the tumor long-axis length, incision length, operative time, estimated intraoperative bleeding, postoperative drainage amount and time, aesthetic satisfaction, perioperative complications, and follow-up were recorded and analyzed.Results:The difference between the tumor long-axis lengths in the preauricular group [(2.2±0.9) cm] and the transoral group [(2.1± 0.7) cm] was not statistically significant ( t=0.46, P=0.687), and all surgical procedures were completed as planned. There was no significant difference in the incision size ( t=1.57, P=0.100) or operative time ( t=0.44, P=0.736). Compared with the preauricular group [(30.8±8.7) ml], transoral group [(23.6±8.9) ml] significantly reduced intraoperative blood loss ( t=2.97, P=0.006) and improved aesthetic pleasure ( t=3.44, P=0.015). Two cases of earlobe numbness and one case of temporary facial palsy were observed in the preauricular group; two cases of postoperative effusion were noted in the transoral group, and no signs of nerve injury were detected. No tumor recurrence was found during the 1-54-month of follow-up. Conclusions:Endoscopic-assisted preauricular or transoral incision for dissecting mid-cheek benign tumors provides excellent aesthetic and minimally invasive results, reducing complications and obtaining satisfactory aesthetic results.

In salivary gland disease, accessory parotid gland (APG) lesions are relatively low, and tumor is the most common manifestation. Currently, surgery is the primary treatment method for APG tumors. Although numerous surgical procedures are available, there is no standard protocol. Due to the location of the APG in the midcheek area, the complications and aesthetic concerns connected with conventional surgery for treating APG tumors sometimes cause significant distress to patients. With the progress of medical technology as well as improving patients' aesthetic and functional requirements, surgical excision methods and incision design are constantly improving. More beautiful and minimally invasive treatments, such as concealed transoral approach and endoscopically aided extracapsular dissection of APG, have been gradually developed. This review focuses on surgical techniques, benefits, and drawbacks of APG tumor surgery that have been carried out and provides an outlook based on the preliminary application of endoscopically assisted accessory parotid tumor resection.