Bipolar dissection technique in parotid gland surgery

Background: Parotid gland surgery (PGS) has to manage the balancing act between sufficient radicality and preservation of functional structures. While many studies evaluate post-therapeutic complication due to different extent of surgery, the current study introduces bipolar dissection (BP) being a fast and safe preparation technique. Methods: Analysis of clinical parameters (age, sex, tumour entity, treatment modalities, facial nerve palsy, bleeding, saliva fistula and Frey’s syndrome) of 319 consecutively included patients who underwent extracapsular dissection and superficial/total/radical parotidectomy. Subgroup analysis was done according to the preparation technique (cold vs BP). Results: Facial nerve palsy rate increased with the extent of PGS (p <.0001). There were no differences in the risk of post-operative bleeding, salivary fistula and Frey’s syndrome. BP resulted in a significant reduction of operation time (p =.04), postoperative bleeding (p =.001) and salivary fistula (p =.045) when compared with cold preparation. Conclusions: Ubiquitous available BP allows fast and safe PGS regardless its extent.