The Effect of Endoscopy-assisted Transoral Parotid Gland Tumor Excision Compared With Traditional Operation

NCT07028437 | Completed

• 1 other identifier: SYSJS-2024-075-02
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

Endoscopic-assisted surgery has become a popular technique in salivary gland surgery, particularly for parotid gland tumors. However, this technique has not yet been routinely applied to transoral parotid tumor resection. This retrospective study aimed to evaluate the outcomes of gland-preserving surgery in patients with benign parotid tumors undergoing endoscopic-assisted transoral resection. The study included 30 patients with benign parotid tumors who underwent gland-preserving tumor resection: 15 underwent endoscopic-assisted transoral resection, while the other 15 underwent conventional tumor resection via the Blair S-shaped incision. Surgical feasibility, perioperative variables, postoperative appearance, and functional outcomes were assessed. In both groups, all tumors were completely removed with negative margins. No significant differences were observed between the two groups in terms of intraoperative blood loss, postoperative drainage volume, average incision length, or facial nerve injury. However, the endoscopic-assisted transoral group demonstrated superior cosmetic outcomes. No tumor recurrence was observed during the 1-6 month follow-up period. Therefore, endoscopic-assisted transoral parotid tumor resection is a safe approach for benign parotid tumors, offering both favorable functional and aesthetic results.

Conditions

Benign Tumor of Parotid Gland; Endoscope-assisted Surgery; Gland Preservation; Minimally Invasive Surgery

Keywords

transoral parotid gland tumor excision; Endoscope-assisted; minimally invasive

Outcome Measures

Primary Outcomes (2)

• VAS for aesthetic

  The assessment of postoperative aesthetics includes the Visual Analogue Scale (VAS); 0-10. 0 indicates a poor result and 10 indicates a good result.

  1、3、6 months after surgery

• aesthetic

  The appearance assessment section of the University of Washington Quality of Life Questionnaire (UW-QOL)

  1、3、6 months after surgery

Secondary Outcomes (1)

• Incidence of postoperative complications

  1、3、6 months after surgery

Study Arms (2)

Endoscopic-assisted transoral approach for parotid tumor resection

EXPERIMENTAL

A 5-7 cm curvilinear incision was made with electrocautery on the buccal mucosa along the anterior border of the pterygomandibular raphe on the affected side. The mucosal flap was elevated superiorly, with preservation of the parotid duct and buccal nerve. Two assistants were required to maintain retractor elevation, and hold the endoscope. Electrocautery dissection was performed in three dimensions to expose the anterior borders of both the medial pterygoid muscle and masseter muscle, along with the tumor mass. The surgeon manipulated either electrocautery or ultrasonic scalpel for precise dissection, and used forceps to retract or displace muscular and parotid tissues. Hemoclips were applied to achieve hemostasis. Blunt dissection through normal peri-tumoral tissue ensured complete tumor resection while preserving critical structures including facial nerve branches, buccal nerve, and parotid duct.

Procedure: Endoscopic-assisted transoral approach for parotid tumor resection

Blair S-shaped incision for parotid tumor

OTHER

The traditional parotid tumor resection surgery employs a Blair S-shaped incision, starting from the anterior edge of the tragus, extending along the auricle to the earlobe, then curving downward along the posterior border of the mandibular ramus to a point 2-3 cm below the mandibular angle. The skin and subcutaneous tissues are incised to the superficial layer of the parotid fascia, followed by anterior flap elevation while preserving the branches of the greater auricular nerve. The parotid gland and tumor are then exposed, with careful dissection of the facial nerve before removing the tumor and gland. The preservation of critical structures is similar to that in the endoscopic-assisted transoral approach group. A negative-pressure drainage tube is placed at the incision site, and the wound is closed in layers.

Procedure: Blair S-shaped incision for parotid tumor

Interventions

Endoscopic-assisted transoral approach for parotid tumor resection PROCEDURE

The buccal mucosa was incised in front of the mandibular ligament of the inner wing of the mouth, the submucosal tissue was separated, and important structures such as the buccal nerve, parotid duct, and facial nerve were protected. The tumor was completely resected while preserving the parotid gland.

Endoscopic-assisted transoral approach for parotid tumor resection

Blair S-shaped incision for parotid tumor PROCEDURE

The Blair S-shaped incision was made through an anterior auricular incision. After cutting the skin, the flap was reflapped. The greater auricular nerve and facial nerve were separated and protected, and the tumor was completely resected.

Blair S-shaped incision for parotid tumor

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients with primary benign parotid tumors all underwent CT, MRI and ultrasound-guided FNAC examinations of parotid tumors before the operation. All the patients underwent glandular preservation surgery.

You may not qualify if:

• The tumor diameter is greater than 6cm, has undergone radiotherapy, is a highly malignant tumor, a tumor invading the skin, and a recurrent tumor.

Sponsors & Collaborators

• Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University: lead

Study Sites (1)

Sun Yat-sen Memorial Hospital, Sun Yat-sen University

Guangzhou, Guangdong, 510120, China

Location

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Chief Physician

Study Record Dates

• First Submitted: June 11, 2025
• First Posted: June 19, 2025
• Study Start: January 1, 2023
• Primary Completion: March 1, 2025
• Study Completion: March 1, 2025
• Last Updated: June 19, 2025

Record last verified: 2025-06

Locations

CN (1)