Selective Deep-Lobe Parotidectomy for Benign Parotid Gland Tumors

Abstract

Background: Deep‑lobe tumors have been shown to possess a significantly thicker capsule with less tumor penetration compared to  superficial tumors. Thus, more conservative surgical approaches, rather than aggressive methods, have been proposed for treating  benign deep-lobe tumors of the parotid gland.

Aim: To evaluate the surgical outcomes and oncological safety of selective deep-lobe  parotidectomy (SDLP) in patients with benign lesions located in the deep lobe of the parotid gland. Methods: Twenty-two patients who  underwent SDLP were enrolled in the study. Data on age, sex, tumor size, hospitalization duration, recurrence, cosmetic outcomes, and  complications—including facial nerve (FN) impairment, Frey’s syndrome (FS), sialocele, first‑bite syndrome (FBS), wound infection,  hematoma, and seroma —were retrospectively evaluated from hospital records. Facial contour symmetry was rated by each patient using  a 0–10 VAS score at least six months post-surgery.

Results: Final histopathological examination revealed that the most common  tumor was pleomorphic adenoma (PA) (59.1%). Three patients (13%) experienced temporary paralysis of the marginal branch of the FN,  with a House-Brackman Grade III, which resolved spontaneously within two months post-surgery. No cases of permanent FN paralysis,  FS, FBS, or sialocele were observed in any patients. The mean VAS score for facial contour symmetry was 9.43 ± 0.78. No recurrence were  noted in any patients over a median follow‑up period of 71.7 ± 21.2 months.

Conclusion: SDLP may facilitate the safe surgical removal of  benign lesions located in the deep lobe of the parotid gland, with oncological safety, reduced complication rates, and improved cosmetic  outcomes.