Techniques of Endoscope-Assisted Parotidectomy: A Narrative Review

The modern-day parotidectomy has evolved considerably with the advent of plastic surgery and the introduction of endoscopes in minimally invasive head and neck surgery. The paper reviews various endoscopic-assisted approaches to parotidectomy that have been introduced over time by surgeons with respect to technique and surgical outcomes.

We performed English language searches of Medline/PubMed and Embase databases till August 2022. We used ‘parotidectomy’ and the following text terms—endoscopic, endoscope assisted, and minimally invasive. Reference lists of the selected articles were screened to include relevant studies. The abstract and full text (in some cases) of each identified publication was screened for relevant data on novel approaches to endoscopic parotidectomy. Duplicate studies based on the same patient data sets and studies involving less than ten patients were excluded.

The paper reviewed the endoscope-assisted preauricular approach, postauricular approach, using two small skin incisions, postauricular approach, retroauricular approach, hairline approach and intraoral approach. Though the studies conducted so far for comparing these techniques with conventional open parotidectomy have been encouraging with respect to cosmetic outcomes and complications, at present, the absence of well-designed prospective observational and interventional studies does not warrant them to be widely employed in clinical practice. This review will guide surgeons in performing endoscope-assisted parotidectomy incisions in selected patients and provide impetus to further study and improve these techniques. Currently, these should remain limited to the hands of experienced surgeons.