Surgery for tumors in the mid-cheek area are challenging. Endoscopic-assisted dissection of benign mid-cheek tumors is gradually being reported. This study evaluated the indications, advantages and disadvantages of endoscopically assisted mid-cheek benign tumor resection using a single preauricular or transoral incision and compared it with the conventional approach.

Fifty-four patients with benign mid-cheek tumors could be divided into three groups: a conventional (20 patients) parotidectomy access surgery group, another two endoscope-assisted tumor dissections groups through a single preauricular incision (17 patients) or transoral incision (17 patients). Their surgical approaches were introduced, and the tumor long-axis length, incision length, operative time, estimated intraoperative bleeding, postoperative drainage amount and time, aesthetic satisfaction, perioperative complications, and follow-up were recorded and analyzed.

The tumor long-axis lengths were comparable between the groups, and all surgical procedures were completed as planned. The endoscopic procedure group improved the incision size, intraoperative blood loss, drainage, perioperative complications, and cosmetic satisfaction. Meanwhile, aesthetic pleasure is highest with the transoral incision. No tumor recurrence was found during the 1-54-month of follow-up.

Endoscopic-assisted preauricular or transoral incision for dissecting mid-cheek benign tumors is more aesthetic and minimally invasive than conventional surgical approaches with available results, reducing complications, narrowing the surgical incision, and obtaining satisfactory aesthetic results.

This study investigates the clinical and patient-reported outcomes of full-endoscopic parotidectomy compared to the conventional approach.

Between July 2021 and December 2023, patients who underwent parotidectomy were prospectively enrolled and assigned to either the full-endoscopic parotidectomy group (Group I) or the conventional surgery group (Group II). Clinical outcomes were evaluated, and patient-reported outcomes were assessed using a Visual Analogue Scale and five FACE-Q scales.

A total of 293 patients were prospectively included, with 146 in the full-endoscopic group and 147 in the conventional group. Blood loss was significantly lower in the full-endoscopic group (regression coefficient, 0.61; 95% CI, 0.15 to 1.07), as was the rate of immediate facial paralysis (0.76; 95% CI, 0.25 to 1.27). The full-endoscopic group also showed superior outcomes on the Visual Analogue Scale (- 0.14; 95% CI, - 0.23 to - 0.05) and FACE-Q scales for Appearance-Related Psychosocial Distress (1.15; 95% CI, 0.59 to 1.71), Social Function (- 0.37; 95% CI, - 0.59 to - 0.15), Satisfaction with Facial Appearance (- 0.44; 95% CI, - 0.64 to - 0.23), Psychological Function (- 0.39; 95% CI, - 0.58 to - 0.20), and Satisfaction With Outcome (- 0.42; 95% CI, - 0.66 to - 0.19).

Full-endoscopic parotidectomy yields less blood loss and a reduced incidence of immediate facial paralysis compared to conventional surgery. Patients undergoing full-endoscopic parotidectomy reported better aesthetic and psychological outcomes.

The combined analysis of clinical and patient-reported outcomes is valuable in guiding surgical planning. These findings provide valuable insights for patients considering full-endoscopic parotidectomy and underscore the importance of addressing functional, aesthetic, and psychological aspects for both patients and healthcare providers.

This study proposes a novel surgical technique for the excision of benign parotid tumors, utilizing a extracapsular dissection guided by a three dimensional digital model of the facial nerve(3DFN-ECD) and compares its clinical efficacy with the extracapsular dissection (ECD) method. This prospective study included 68 patients with benign parotid tumors. The control group (40 patients) received the ECD treatment, while the experimental group (28 patients), underwent the 3DFN-ECD approach proposed in this study. Preoperative three-dimensional double-echo steady-state water excitation sequence (3D-DESS-WE) of MRI was employed to visualize the tumor and facial nerve, and the Mimics software was used to reconstruct a three-dimensional digital model of the facial nerve and parotid tumor. The surgical incision and facial nerve dissection were planned based on the relationship between the tumor and the facial nerve. Postoperative facial nerve function and aesthetic outcomes of the incisions were compared between the two surgical techniques. There was no significant difference in the postoperative complications between the two groups. Postoperative facial nerve function scores in the 3DFN-ECD group were significantly higher than those in the control group at 1 week (p < 0.001) and 4 weeks (p < 0.001). The incidence of temporary facial nerve paralysis was significantly lower in the 3DFN-ECD group (P = 0.036), and the visual analogue scale score for aesthetic outcomes of the surgical incision was significantly improved (p < 0.001). The novel 3DFN-ECD surgical approach proposed in this study significantly reduces the risk of facial nerve injury and improves the aesthetic outcomes of the parotid tumor surgical incision.

Endoscopic surgery is an effective technique for preserving the nipple and areola, as well as for sentinel lymph node biopsy and breast implant reconstruction. However, the technical challenges associated with endoscopic surgery have limited its widespread adoption.

In the normal single-port endoscopic surgery, the ultrasonic knife was accessed through the retractor. In our modified procedure, a tiny 5 mm incision was made at the lateral margin underneath the breast, serving as the second entry port for the ultrasonic scalpel, which was referred to as the "Haigui-1 hole". Preoperative and postoperative indicators such as blood loss, operative time, and postoperative drainage volume were collected. Differences between parameters were compared using Student's t test.

Endoscopic surgery with the assistance of the "Haigui-1 hole" led to preserved breast aesthetics with minimal scarring. Moreover, "Haigui-1 hole" surgery significantly reduced the operation time, intraoperative bleeding, and postoperative drainage volume compared to normal single-port endoscopic surgery.

The "Haigui-1 hole" procedure, which involves the addition of a second entrance to improve the maneuverability of the ultrasonic knife, is worthy of further promotion.

Frey syndrome, also known as ototemporal nerve syndrome or gustatory sweating syndrome, is one of the most common complications of parotid gland surgery. This condition is characterized by abnormal sensations in the facial skin accompanied by episodes of flushing and sweating triggered by cognitive processes, visual stimuli, or eating.

To investigate the preventive effect of acellular dermal matrix (ADM) on Frey syndrome after parotid tumor resection and analyzed the effects of Frey syndrome across various surgical methods and other factors involved in parotid tumor resection.

Retrospective data from 82 patients were analyzed to assess the correlation between sex, age, resection sample size, operation time, operation mode, ADM usage, and occurrence of postoperative Frey syndrome.

Among the 82 patients, the incidence of Frey syndrome was 56.1%. There were no significant differences in sex, age, or operation time between the two groups (P > 0.05). However, there was a significant difference between ADM implantation and occurrence of Frey syndrome (P < 0.05). ADM application could reduce the variation in the incidence of Frey syndrome across different operation modes.

ADM can effectively prevent Frey syndrome and delay its onset.