Harmonic scalpel assisted superficial parotidectomy.
OBJECTIVE
The Harmonic Scalpel (HS) has been recently widely used to perform a variety of surgical procedures. We reviewed our experience with the use of HS in superficial parotidectomy to determine the safety and efficacy of this procedure, with regard to operative time, postoperative facial nerve function, and drainage output.


METHODS
Nonrandomized retrospective review.


METHODS
The medical records of all patients who underwent superficial parotidectomy for benign pathology at Shaare Zedek Medical Center from January 2006 to July 2009 were retrospectively reviewed. Patients with prior facial nerve weakness or prior parotid surgery or who had undergone concurrent neck dissection or total parotidectomy were excluded.


RESULTS
Fifty-eight patients were reviewed; 26 patients underwent HS parotidectomy and 32 patients underwent conventional (cold knife) parotidectomy (control group). Harmonic Scalpel assisted parotidectomy was associated with significantly decreased length of surgery from 163.12 ± 21.8 minutes for controls to 137.3 ± 18.6 minutes in the HS assisted group (P < .05). The incidence of temporary postoperative facial nerve paresis was significantly reduced from 43% in the controls to 23% in the HS group (P < .05). No permanent facial nerve paralysis was reported. There were differences in the overall postoperative drain output between the HS and control groups, 68 ± 22.3 mL and 73.5 ± 38.2 mL, respectively, but these differences did not achieve significance.


CONCLUSIONS
This study shows that HS assisted superficial parotidectomy for benign pathology is a safe technique and associated with reduced surgical time and incidence of temporary postoperative facial nerve paresis compared with conventional techniques.
Department of Otolaryngology-Head & Neck Surgery, Shaare Zedek Medical Center, Jerusalem, Israel nmuhanna@gmail.com.
Nidal
N
Muhanna
Department of Otolaryngology-Head & Neck Surgery, Shaare Zedek Medical Center, Jerusalem, Israel.
Uri
U
Peleg
Department of Otolaryngology-Head & Neck Surgery, Shaare Zedek Medical Center, Jerusalem, Israel.
Yehuda
Y
Schwartz
Department of Otolaryngology-Head & Neck Surgery, Shaare Zedek Medical Center, Jerusalem, Israel.
Hanan
H
Shaul
Department of Otolaryngology-Head & Neck Surgery, Shaare Zedek Medical Center, Jerusalem, Israel.
Ronen
R
Perez
Department of Otolaryngology-Head & Neck Surgery, Shaare Zedek Medical Center, Jerusalem, Israel.
Jean-Yves
JY
Sichel
D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control; D004322:Drainage; D020220:Facial Nerve Injuries / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D010305:Parotid Diseases / Q000601:surgery*; D010306:Parotid Gland / Q000601:surgery*; D017060:Patient Satisfaction; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013525:Surgical Instruments; D013997:Time Factors; D016896:Treatment Outcome
Harmonic Scalpel; facial nerve paresis; length of surgery; parotidectomy