Surgical Outcomes of U-Shaped Incisions Versus Conventional Incisions in Parotidectomy

Importance Modified Blair and Facelift incisions are conventional approaches to parotid pathologies. However, they frequently result in prominent scars in cosmetically sensitive regions. A newer alternative, U-shaped incision offers a minimally visible scar along the contour of the pinna while enabling management of parotid pathologies. Objective This study aimed to compare the cosmetic and surgical outcomes between U-shaped incision and conventional incisions including Modified Blair and Facelift incisions. Design/Setting/Participants/Intervention or Exposures This is a multicenter case-control study on 16 patients who underwent parotidectomy using U-shaped incisions for parotid tumors between 2019 and 2022. Seventeen disease characteristics-matched controls underwent conventional approach were included, amounting to a total of 33 patients. Main Outcome Measures The surgical outcomes including perioperative events, postoperative complications, and cosmetic outcomes using the Visual Analog Scale (VAS) score of scar satisfaction and the Patient Scar Assessment Scale (PSAS) were analyzed. Results There were no significant differences in the age ( P = .817), tumor diameter ( P = .398), and pathologies ( P = .300) among the 2 groups. No significant differences in length of stays ( P = .087) and resection margin ( P = .117) were found. U-shaped incision group had a significantly less mean operating time (145 minutes, P < .001) and mean blood loss (10.45 ml, P = .043), compared to the conventional group which had 243 minutes and 43 ml, respectively. A significantly higher overall scar satisfaction based on VAS score in U-shaped incision group ( P = .009) was noted. No significant differences between the 2 groups were found in the overall PSAS score and all the subscores. There were no significant differences in postoperative complications including facial nerve dysfunction ( P = .520) between the 2 groups except the presence of a significantly higher sialocele in U-shaped incision group ( P = .011). Conclusion The present study indicated that U-shaped incision is a safe alternative with better cosmetic outcomes over conventional incisions and comparable surgical outcomes. Relevance Surgeons are encouraged to adopt the U-shaped incision to achieve better cosmetic results while ensuring oncological safety.