title: [Endoscope-assisted parotidectomy for benign tumors via a short hidden auricular incision].
abstract: OBJECTIVE
  To evaluate a technique of endoscope-assisted parotidectomy for benign tumor via a short hidden auricular incision.
  
  
  METHODS
  Twenty-six volunteer patients were selected for the new approach, 16 with mixed tumor, 9 Warthin's tumor and 1 lymphoepithelial cyst. The tumor size was 1.6 approximately 3 cm (average 2.2 cm) and the incision ranged 3.5 approximately 5.5 cm(average 4.5cm) divided into two parts: 1) basic segment--started from anterio-superior crease of tragus, went downward along tragal margin and pre-earlobial fold,and stopped at earlobe root; 2) extended segment--went from earlobe root, curved down posterio-inferiorly. The length of the latter was generally not beyond 1 cm. The procedure began with raising the myo-cutaneous flap and dissecting the whole posterior portion of the gland. Thus, two working spaces needed for endoscopic manipulation could be artificially created with suitable retracting instruments. Endoscopic view was then established, and the surgeons operated continuously in the later steps. Modified techniques, such as the antegrade facial nerve dissection, retrograde great auricular nerve dissection and direct coagulate-cut method with ultrasonically activated scalpel, were employed to archive the goals of endoscopical nerve preservation and tissue resection.
  
  
  RESULTS
  All tumors were entirely removed. No postoperative paralysis occurred, excepting 1 case who suffered from an temporary paralysis for two months. The appearance was good due to overlapping the short scar onto the irregular line of auricular contour and hiding its lowest part in the earlobe shadow.
  
  
  CONCLUSIONS
  Parotidectomy for benign tumors could be safely done via a much-shortened incision, assisted by an endoscope. The postoperative stress of patients can be obviously reduced with the minimally invasive manipulation and the good appearance.
authors.affiliation: Department of Head and Neck-plastic and Reconstructive Surgery, Sir Run Shaw Hospital, Medical College, Zhejiang University, Hangzhou 310016, China.
authors.forename: Li
authors.initials: L
authors.lastname: Gao
authors.forename: Yan
authors.initials: Y
authors.lastname: Shao
authors.forename: Lei
authors.initials: L
authors.lastname: Xie
authors.forename: Ying
authors.initials: Y
authors.lastname: Hu
authors.forename: Hua
authors.initials: H
authors.lastname: Li
authors.forename: Xue-Hong
authors.initials: XH
authors.lastname: Ye
authors.forename: Chun-Yi
authors.initials: CY
authors.lastname: Song
mesh_terms: D000235:Adenolymphoma / Q000601:surgery; D004724:Endoscopy / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010306:Parotid Gland / Q000601:surgery; D010307:Parotid Neoplasms / Q000601:surgery*; D017060:Patient Satisfaction; D015203:Reproducibility of Results; D016896:Treatment Outcome