1.Single-Center clinical application and analysis of Robot-Assisted endoscopic salivary gland surgery via a postauricular approach.
Ping HAN ; Faya LIANG ; Peiliang LIN ; Ying LI ; Renhui CHEN ; Xiaoming HUANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(11):1028-1033
Objective:Traditional salivary gland surgery involves incisions in the visible facial and cervical regions, leaving postoperative scars that affect cosmesis. This study aims to investigate the clinical efficacy, safety, and application value of robot-assisted endoscopic resection of benign submandibular and parotid gland lesions via a postauricular approach, while clarifying its advantageous differences compared with endoscopic surgery. Methods:Clinical data of 23 patients who underwent robot-assisted endoscopic surgery via a postauricular approach(11 parotid gland cases and 12 submandibular gland cases) from January 2017 to February 2025 were retrospectively analyzed. Meanwhile, A matched control group of patients who received postauricular endoscopic surgery during the same period was selected as the control group in a 1∶1 ratio(11 parotid gland cases and 12 submandibular gland cases). Indicators such as operation time, intraoperative blood loss, complications, and postoperative aesthetic satisfaction scores(Numeric Satisfaction Scale, NSS) were collected and compared between the two groups. The inclusion criteria were limited to benign lesions of the parotid superficial lobe(diameter ≤5 cm, without deep lobe involvement) and benign submandibular gland lesions(diameter ≤4 cm, without extension through the mylohyoid muscle). Results:All robot-assisted surgeries were successfully completed without conversion to open surgery. In the robot group, there were 7 male patients(mean age 39.5 years) and 16 female patients(mean age 35.9 years). For parotid gland surgeries, the mean operation time was (114.00±38.35) minutes. For submandibular gland surgeries, the mean operation time was(140.00±30.75) minutes.Temporary facial paralysis occurred in 0 of patients after robotic submandibular gland surgery (vs.8% in the endoscopic group) and 18% after robotic parotid gland surgery (vs.27 % in the endoscopic group),all of which resolved within 1 month, with no occurrence of salivary fistula or infection. Patients had high aesthetic satisfaction(NSS scores: 8.90±1.20 for parotid surgeries and 9.00±0.70 for submandibular surgeries). No tumor recurrence was observed during the 8-77 month follow-up period. Conclusion:Robot-assisted endoscopic salivary gland surgery via a postauricular approach is safe and feasible. With three-dimensional high-definition visualization and precise mechanical manipulation, it outperforms traditional endoscopic surgery in reducing blood loss, lowering the risk of nerve injury, and achieving long-term cosmetic outcomes. It is particularly suitable for young patients and cases with benign lesions of the parotid superficial lobe or submandibular gland that have high aesthetic demands. However, this surgical approach is not suitable for deep parotid lobe tumors, and its long-term efficacy requires verification through large-sample studies.
Humans
;
Robotic Surgical Procedures/methods*
;
Retrospective Studies
;
Endoscopy/methods*
;
Submandibular Gland/surgery*
;
Parotid Gland/surgery*
;
Female
;
Male
;
Operative Time
;
Salivary Glands/surgery*
;
Adult
;
Middle Aged
2.Case report of robot-assisted resection of benign parotid gland tumor via hairline incision under facial nerve monitoring.
Xijun LIN ; Fang LIAO ; Xiaoming HUANG ; Faya LIANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(11):1053-1056
A 30-year-old female patient with a benign tumor in the superficial lobe of the left parotid gland underwent tumor resection via a 5 cm intra-hairline incision, using the da Vinci Xi surgical robot combined with the NIM-Response 3.0 facial nerve monitoring system. During the operation, facial nerve branches were located and protected through facial nerve monitoring, and the robotic arms were used for precise tumor dissection. Postoperatively, the facial nerve function, incision healing, and tumor recurrence were observed. duration of the procedure was 120 minutes, and the tumor(2.0 cm×1.5 cm) was completely resected. Postoperative pathological examination indicated a pleomorphic adenoma. During the 3-month postoperative follow-up, the patient's facial nerve function remained normal, no salivary fistula occurred, the incision was hidden within the hairline, no tumor recurrence was found in the ultrasound reexamination, and the patient was highly satisfied with the appearance. The surgical approach of robot-assisted resection of benign parotid gland tumor via a hairline incision under facial nerve monitoring has significant advantages in facial nerve protection and cosmetic effect, and is suitable for patients with benign parotid gland tumors meeting specific conditions.
Humans
;
Female
;
Adult
;
Parotid Neoplasms/surgery*
;
Facial Nerve
;
Robotic Surgical Procedures/methods*
;
Adenoma, Pleomorphic/surgery*
;
Parotid Gland/surgery*
;
Monitoring, Intraoperative
3.Application of supraclavicular fasciocutaneous island flap for reconstruction after removal of tumors in parotid and auricle area.
Yu Chao LUO ; Qing Lai TANG ; Xin Ming YANG ; Zi An XIAO ; Gang Cai ZHU ; Dan Hui YIN ; Qian YANG ; Pei Ying HUANG ; Shi Ying ZENG ; Shi Sheng LI
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2023;58(5):486-491
Objective: To evaluate the efficacy of supraclavicular fasciocutaneous island flap (SIF) for repairing the defect of parotid or auricle regions after tumor resection. Methods: From February 2019 to June 2021, 12 patients (11 males and 1 female, aged 54-77 years old), of whom 4 with parotid adenoid cystic carcinoma and 8 with auricular basal cell carcinoma underwent reconstruction surgery for postoperative defects in the parotid gland area and auricular area with SIF in the Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital of Central South University and their clinical data were retrospectively analyzed. Size of the SIF, time for harvesting SIF, neck lymph node dissection and postoperative complications were recorded. Results: The flap areas were (6-9) cm × (8-13) cm, and the harvesting time for SIF ranged from 40 to 80 min, averaging 51.7 min. The donor sites were directly closed. All patients underwent ipsilateral levels Ⅰ-Ⅲ neck dissection, with 4 cases undergoing additional level Ⅳ neck dissection and 2 cases undergoing level Ⅳ-Ⅴ neck dissection. Of the 12 SIF, 10 were completely survival and 2 had flap arterial crisis with partial flap necrosis, in addition, 1 had donor site wound dehiscence. With follow-up of 10-42 months, there were no tumor recurrences in 10 patients, 1 patient was lost to follow-up at 10 months postoperatively, and 1 patient experienced local tumor recurrence at 11 months after surgery and died 15 months later. Conclusion: SIF is an easily harvested flap with good skin features matching the skin in parotid and auricle regions and less damage to donor site, and this flap has no need for microvascular anastomosis technique. SIF is feasible and effective for repairing defects in parotid and auricle area.
Male
;
Humans
;
Female
;
Middle Aged
;
Aged
;
Plastic Surgery Procedures
;
Parotid Gland/surgery*
;
Retrospective Studies
;
Neoplasm Recurrence, Local
;
Surgical Flaps/blood supply*
;
Skin Transplantation/methods*
;
Postoperative Complications
;
Treatment Outcome
4.Clinicopathologic analysis of micro and mini parotid gland tumors.
Bing Yu LI ; Zu Nan TANG ; Lei Hao HU ; Wen Bo ZHANG ; Yao YU ; Guang Yan YU ; Xin PENG
Journal of Peking University(Health Sciences) 2022;54(2):335-339
OBJECTIVE:
To investigate the clinicopathological characteristics of micro and mini parotid gland tumors and to provide reference for their clinical diagnosis and treatment.
METHODS:
Patients with parotid gland tumors treated in the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology from December 2012 to April 2020 were selected. Relevant clinical data of the patients with tumor diameter ≤20 mm detected by preoperative CT were collected to analyze the clinicopathological characteristics and prognosis of micro and mini parotid gland tumors. And the collected data were divided into two groups with diameter 11-20 mm and diameter ≤10 mm according to tumor diameter measured by preoperative CT. The clinicopathological differences between the two groups were statistically analyzed.
RESULTS:
A total of 2 067 patients with primary epithelial parotid gland tumors were collected, and 685 patients with tumor diameter ≤20 mm were examined by CT, accounting for 33.1%. The ratio of male to female patients with micro and mini parotid gland tumors was 1 ∶1.93, the average age was (45.3±13.8) years (12-83 years), and the median course of disease was 12 months (1 week to 30 years). Among them, 635 cases (92.7%) were benign tumors, 50 cases (7.3%) were malignant tumors, and the ratio of benign to malignant was 12.7 ∶1. The most common benign tumor was pleomorphic adenoma, and the most common malignant tumor was mucoepidermoid carcinoma. The micro and mini parotid gland tumors were divided into 11-20 mm group (n=611) and ≤10 mm group (n=74), the clinical characteristics comparison of the two groups of gender ratio, average age, course of di-sease had no statistical difference (P>0.05). In the 11-20 mm diameter group, the percentage of benign and malignant tumor was 92.8% (567/611) and 7.2% (44/611) respectively, and the ratio of benign to malignant tumors was 12.9 ∶1. In the ≤10 mm diameter group, the percentage of benign and malignant tumor was 91.9% (68/74) and 8.1% (6/74) respectively, and the ratio of benign to malignant tumors was 11.3 ∶1. There was no significant difference between the two groups (P>0.05). Fifty patients with malignant tumor were followed up for the median follow-up period of 39.5 months (1-91 months). Local recurrence occurred in 2 patients with one death. The overall 2-year survival rate was 93.7% and the 5-year survival rate was 89.3%.
CONCLUSION
The majority of micro and mini parotid gland tumors was benign lesion. There was a good prognosis for micro and mini parotid gland carcinoma. Early surgical treatment was recommended for micro and mini parotid gland tumors.
Adenoma, Pleomorphic/surgery*
;
Adult
;
Carcinoma, Mucoepidermoid/pathology*
;
Female
;
Humans
;
Male
;
Middle Aged
;
Parotid Gland
;
Parotid Neoplasms/surgery*
;
Retrospective Studies
5.Application analysis of a modified retroauricular hairline incision in the resection of a benign parotid gland tumor.
Fen CHEN ; Yu LI ; Xing KE ; Ping-Fan WU ; Ling-Yan GUO ; Zhen-Ge LEI ; Wei-Bin TAN ; Lin-Lin CHEN
West China Journal of Stomatology 2021;39(3):293-299
OBJECTIVES:
This study aimed to evaluate the application value of a modified retroauricular hairline incision and a sternocleidomastoid flap with an inferior pedicle in the resection of benign parotid gland tumors.
METHODS:
Forty-eight patients with benign parotid gland tumors were retrospectively analyzed: 19 cases were included in the experimental group with an improved retroauricular hairline incision and a sternocleidomastoid flap with an inferior pedicle, and 29 cases were assigned in the control group with a modified facelift incision. Operation time, postoperative drainage, postoperative esthetic degree, and incidence of facial nerve paralysis, salivary fistula, and Frey's syndrome were compared.
RESULTS:
After the esthetic procedure, the average score of the experimental group was higher than that of the control group, and the esthetic effect of the former was better than that of the latter (
CONCLUSIONS
The modified retroauricular hairline incision and sternocleidomastoid flap with an inferior pedicle can be applied to resect benign parotid gland tumors safely. It shows a better cosmetic effect and does not cause obvious postoperative complications. Therefore, it should be promoted for tumor treatments.
Esthetics, Dental
;
Humans
;
Parotid Gland/surgery*
;
Parotid Neoplasms/surgery*
;
Postoperative Complications
;
Retrospective Studies
;
Sweating, Gustatory
6.Complications of the retromandibular transparotid approach for low condylar neck and subcondylar fractures: a retrospective study.
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2018;44(2):73-78
OBJECTIVES: The goal of this study was to evaluate the rates of complications, morbidity, and safety with the transparotid approach. MATERIALS AND METHODS: A retrospective study was conducted and consisted of 53 surgically treated patients in the past five years for low condylar neck and subcondylar fractures. Only patients with malocclusion and who underwent open reduction with internal fixation with the retromandibular transparotid approach were included. The examined parameters were postoperative suboptimal occlusion, deflection, saliva fistula, and facial nerve weakness. RESULTS: Fifty-three patients had an open reduction with internal fixation on 55 sides (41 males, 77.4%; mean age, 42 years [range, 18–72 years]). Four patients (7.5%) experienced transient facial nerve weakness of the marginal mandibular branch, but none was permanent. Four patients had a salivary fistula, and 5 patients showed postoperative malocclusion, where one needed repeat surgery after one year. One patient showed long-term deflection. No other complications were observed. CONCLUSION: The retromandibular transparotid approach is a safe procedure for open reduction and internal fixation of low condylar neck and subcondylar fractures, and it has minimal complications.
Facial Nerve
;
Fistula
;
Humans
;
Male
;
Malocclusion
;
Mandibular Fractures
;
Neck*
;
Parotid Gland
;
Reoperation
;
Retrospective Studies*
;
Saliva
;
Surgery, Oral
7.Malignant lymphoma on parotid gland: a clinical case.
Hyeong Geun LEE ; Jae Yeol LEE ; Jae Min SONG
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2017;43(2):138-143
Non-Hodgkin's lymphoma on the parotid gland is a relatively rare occurrence among head and neck tumors. The mass of parotid gland lymphoma cannot be distinguished from other benign masses of the parotid gland; therefore, it is important to consider lymphoma in the differential diagnosis when examining parotid swellings and masses. Parotid gland lymphoma is most likely to be B-cell, non-Hodgkin's lymphoma of one of three types, which include follicular, marginal zone, and diffuse large B-cell, although other histologic patterns have been described. We present a review of a patient with diffuse large B-cell lymphoma (DLBCL) who presented to the Department of Oral and Maxillofacial Surgery of Pusan National University Hospital (Yangsan, Korea).
B-Lymphocytes
;
Busan
;
Diagnosis, Differential
;
Head
;
Humans
;
Lymphoma*
;
Lymphoma, B-Cell
;
Lymphoma, Non-Hodgkin
;
Neck
;
Parotid Gland*
;
Surgery, Oral
8.Drainless Parotidectomies versus Conventional Parotidectomies: Randomised Control Study on Efficacy and Safety.
Dennis Yk CHUA ; Christopher Hk GOH
Annals of the Academy of Medicine, Singapore 2016;45(11):513-515
Adenolymphoma
;
surgery
;
Adenoma, Pleomorphic
;
surgery
;
Compression Bandages
;
Drainage
;
Facial Nerve Diseases
;
epidemiology
;
Female
;
Fibrin Tissue Adhesive
;
therapeutic use
;
Health Care Costs
;
Hospitalization
;
economics
;
statistics & numerical data
;
Humans
;
Length of Stay
;
Male
;
Middle Aged
;
Parotid Gland
;
surgery
;
Parotid Neoplasms
;
surgery
;
Postoperative Complications
;
epidemiology
;
Singapore
;
epidemiology
;
Tissue Adhesives
;
therapeutic use
9.Accuracy of fine needle aspiration biopsy in diagnosing parotid gland malignancy.
Kathleen Joy B. Santiago ; Rodante A. Roldan ; Samantha S. Castañ ; eda
Philippine Journal of Otolaryngology Head and Neck Surgery 2016;31(2):24-26
OBJECTIVE: To determine the sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of FNAB in detecting parotid malignancies in our institution.
METHODS:
Design: Restrospective Chart Review
Setting: Tertiary Government Hospital
Participants: Postoperative records of seventy six (76) patients with tumors of the parotid gland preoperatively diagnosed by FNAB.
RESULTS: The sensitivity of FNAB was 46%. The specificity and positive predictive value were both 100% and negative predictive value was 90%. Overall accuracy in diagnosing malignant parotid tumor was 91%.
CONCLUSION: FNAB in this institution is a poor predictor of malignancy, having a sensitivity rate of only 46%. While this may serve as a basis for not recommending pre-operative FNAB for patients with parotid tumors in the interim, other factors should also be considered, including concerns with the actual performance and interpretation of FNAB in our institution.
Human ; General Surgery ; Parotid Gland ; Diagnosis
10.Diagnosis and treatment of rare malignant tumors in external auditory canal.
Fangyuan WANG ; Nan WU ; Zhaohui HOU ; Jun LIU ; Weidong SHEN ; Weiju HAN ; Shiming YANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2015;29(16):1438-1442
OBJECTIVE:
To analyze the diagnosis, therapy and prognosis of the rare cases of malignant tumors in external auditory canal.
METHOD:
Eight cases of rare malignant tumors in external auditory canal were collected except squamous cell carcinoma and adenoid cystic carcinoma. The clinical manifestation, staging, surgical method, secondary treatment and prognosis were analysed.
RESULT:
There were 5 cases of basal cell carcinoma and 2 cases of mucoepidermoid carcinoma and 1 case of myoepithelial carcinoma. Three cases of the 5 basal cell carcinoma in external auditory canal have been misdiagnosed for a long time. After admission, 4 of the 5 basal cell carcinoma were T1 stage and cured only by a complete resection of tumor. One case of T2 stage basal cell carcinoma was found recurrence 2 years later after the first excision of tumor, and was treated with radiotherapy. Tumor was controlled. Two cases of mucoepidermoid carcinoma had been misdiagnosed as a benign tumor and received a resection. One case was found metastasis to the parapharyngeal space and nasopharynx and was treated with concurrent chemotherapy. Tumor was also controlled after 5-years follow-up. Another case was found metastasis to parotid gland and received an expanding tumor resection. No recurrence was detected after a 1-year followed up. One case of T4 stage myoepithelial carcinoma in external auditory canal was a metastasis of parotid and received a partial temporal bone resection. No-recurrence was found 1 year later.
CONCLUSION
Because the tumors above have a very low incidence in external ear canal and the location of tumors are hidden, they are often misdiagnosed and delayed in treatment. Therefore, otologists should pay more attention to avoid the misdiagnosis. To the treatment, complete surgical resection of early-stage tumor is important and for late-stage tumor, a supplemented by chemoradiotherapy may be needed.
Carcinoma, Adenoid Cystic
;
diagnosis
;
surgery
;
Carcinoma, Basal Cell
;
diagnosis
;
surgery
;
Carcinoma, Squamous Cell
;
diagnosis
;
surgery
;
Ear Canal
;
pathology
;
Ear Neoplasms
;
diagnosis
;
surgery
;
Humans
;
Neoplasm Recurrence, Local
;
Neoplasm Staging
;
Parotid Gland
;
pathology
;
Prognosis
;
Retrospective Studies
;
Temporal Bone
;
surgery


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