Superficial parotidectomy: three-year experience using modified Blair's incision


  • Waseem A. Shoda Department of General Surgery, Mansoura Military Hospital, Mansoura, Egypt



Parotidectomy, Superficial lesions, Blair's incision, Facial nerve function, House-Brackmann facial nerve grading system


Background: This study presents a series of parotidectomy for superficial benign parotid tumors.

Methods: 18 patients had freely mobile superficial benign parotid lesions of grade zero on House-Brackmann facial nerve grading system underwent parotidectomy through modified Blair incision, with meticulous dissection of the main trunk and branches of facial and the greater auricular nerves with parotid duct sparing. Postoperative (PO) facial nerve functions were assessed and graded after patient was fully conscious, on the 5th PO day, and 6th PO month. Collected data included operative time, intraoperative blood loss, duration of hospital stay, wound drainage and PO complications.

Results: Mean operative time was 115 (±20.4) minutes and mean intraoperative blood loss was 250 (±60). PO analgesia was provided as non-steroidal anti-inflammatory drugs injection on patient's request. Mean duration of PO hospital stay was 8 (±1.9) hours and of wound drainage was 3 (±0.7) days. No wound infection nor seroma had developed and stitches were allowed for spontaneous removal. Immediate postoperatively 4 patients (22.2%) had incomplete facial nerve weakness; 3 of grade II and one of grade III, at the 5th day PO, two patients still had grade II nerve affection and at the 6th PO month, one patient (5.5%) still had grade II nerve affection.

Conclusions: superficial parotidectomy through modified Blair's incision is feasible, safe and allows nerve, vessels and duct sparing even for cases with recurrent swelling. Incomplete facial weakness was encountered in only one patient at the 6th month PO, but was of grade II.



Martino M, Fodor D, Fresilli D, Guiban O, Rubini A, Cassoni A, et al. Narrative review of multiparametric ultrasound in parotid gland evaluation. Gland Surg. 2020;9(6):2295-311.

Kim J, Kim M, Choi S. High grade carcinoma ex pleomorphic adenoma of parotid gland: a case report. J Korean Assoc Oral Maxillofac Surg. 2020;46(5):348-52.

Matsumoto F, Ohba S, Fujimaki M, Kojima T, Sakyo A, Kojima M, et al. Efficacy of modified face lift incision for the resection of benign parotid gland tumor located anteriorly or superiorly. Auris Nasus Larynx. 2021;S0385-8146(21)00032-8.

Auger S, Kramer D, Hardy B, Jandali D, Stenson K, Kocak M, et al. Functional outcomes after extracapsular dissection with partial facial nerve dissection for small and large parotid neoplasms. Am J Otolaryngol. 2021;42(1):102770.

Mlees M, Elbarbary A. Superficial or partial superficial parotidectomy for the treatment of primary benign parotid tumors. J Surg Oncol. 2020;122(7):1315-22.

Badger C, Michel M, Goodman J, Thakkar P, Joshi A. Minimum fascia tumor distance for selection of extracapsular dissection for benign parotid tumors: A preliminary study. Am J Otolaryngol. 2021;42(1):102776.

House JW, Brackmann DE. Facial nerve grading system. Otolaryngol Head Neck Surg. 1985;93(2):146-7.

Lee DH, Yoon TM, Lee JK, Lim SC. Clinical features of pediatric parotid tumors: 10-year experience of a single institute. Acta Otolaryngol. 2013;133(11):1213-8.

Ramdass MJ Maharaj K, Mooteeram J, Dwarika W, Tilluckdharry C, Barrow S. Parotid gland tumours in a West Indian population: Comparison to world trends. Mol Clin Oncol. 2015;3(1):167-70.

Ton G, Lee L, Ng H, Liao H, Chen Y, Tu C, et al. Efficacy of laser acupuncture for patients with chronic Bell's palsy: A study protocol for a randomized, double-blind, sham-controlled pilot trial. Medicine (Baltimore). 2019;98(15):e15120.

Paolucci T, Cardarola A, Colonnelli P, Ferracuti G, Gonnella R, Murgia M, et al. Give me a kiss! An integrative rehabilitative training program with motor imagery and mirror therapy for recovery of facial palsy. Eur J Phys Rehabil Med. 2020;56(1):58-67.

Kütük S, Özkan Y, Topuz M, Kütük M. The Efficacy of Electro-Acupuncture Added to Standard Therapy in the Management of Bell Palsy. J Craniofac Surg. 2020;31(7):1967-70.

Sun Z, Tian Y, Tan Y, Tao D, Li W, Ding J, et al. Effectiveness of Kinesio taping on peripheral facial paralysis: A protocol for systematic review and meta-analysis. Medicine (Baltimore). 2020;99(46):e23090.

Manzoor N, Khattab M, Sherry A, Perkins E, Attia A, Cmelak A, et al. Transient Subacute Facial Nerve Dysfunction After Dual Modality Treatment of Large Vestibular Schwannomas. Otol Neurotol. 2021;42(2):e209-15.

Pinzi V, Marchetti M, De Martin E, Cuccarini V, Tramacere I, Ghielmetti F, et al. Multisession radiosurgery for intracranial meningioma treatment: study protocol of a single arm, monocenter, prospective trial. Radiat Oncol. 2020;15(1):26.

Cheung S, Kwan W, Tsui K, Chow T. Partial parotidectomy under local anesthesia for benign parotid tumors - An experience of 50 cases. Am J Otolaryngol. 2018;39(3):286-9.

Carta F, Chuchueva N, Gerosa C, Sionis S, Caria R, Puxeddu R. Parotid tumours: clinical and oncologic outcomes after microscope-assisted parotidectomy with intraoperative nerve monitoring. Acta Otorhinolaryngol Ital. 2017;37(5):375-86.

Wolber P, Volk G, Horstmann L, Finkensieper M, Shabli S, Wittekindt C, et al. Patient's perspective on long-term complications after superficial parotidectomy for benign lesions: Prospective analysis of a 2-year follow-up. Clin Otolaryngol. 201;30(4):344-50.

Venkatesh S, Srinivas T, Hariprasad S. Parotid Gland Tumors: 2-Year Prospective Clinicopathological Study. Ann Maxillofac Surg. 2019;9(1):103-9.

Li T, Liu Y, Wang Q, Qin Y, Gao W, Li Q, et al. Parotidectomy by an endoscopic-assisted postauricular-groove approach Head Neck. 2019;41(9):2851-9.

Li M, Li S, Tang Q, Yang X, He X: [Feasibility and efficacy of partial superficial parotidectomy with V-shaped incision] Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2020;55(7):658-63.

Khafif A, Niddal A, Azoulay O, Holostenco V, Masalha M. Parotidectomy via Individualized Mini-Blair Incision. ORL J Otorhinolaryngol Relat Spec. 2020;82(3):121-9.

Jiang Q, Cao Z, Wei Y, Zhang Q, Yan J, Zhang J. The application of modified cosmetic incision and skin adhesive in parotid benign tumor functional surgery] Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018;32(16):1255-9.

Zhang J, Jiang Q, Na S, Pan S, Cao Z, Qiu J. Minimal Scar Dissection for Partial Parotidectomy via a Modified Cosmetic Incision and an Advanced Wound Closure Method. J Oral Maxillofac Surg. 2019;77(6):1317.e1-9.






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