Retroauricular Hairline Incision for Parotidectomy

Abstract

　An S-shaped incision is most frequently used for surgeries on benign parotid gland tumors. Surgical procedures using a retroauricular hairline incision (RAHI) for parotid gland tumors was first reported in 2009, but no such case has been reported from Japan. Because RAHI leaves no trace of visible scarring in the face and neck, it is more favorable in terms of cosmetics than an S-shaped incision. We operated on 25 cases of benign parotid gland tumors using RAHI between February 2012 and June 2014. In this report, we give a detailed description of the RAHI procedure, and quantify and compare operative time, bleeding, and complication rate between RAHI procedure and conventional methods.
　The mean operative time was 150.2 min. Permanent facial paralysis was observed any RAHI case. However, transient facial paralysis was seen in 20.0% RAHI cases, and this value is similar to data reported previously. Because RAHI does not require a preauricular skin incision, unlike S-shaped and facelift incisions, it is difficult to gain an anterosuperior view of the parotid gland. In other words, tumors in the lower pole of the superficial lobe of the parotid gland are the best indication for RAHI.
　RAHI is a useful approach when performed by surgeons with sufficient experience with standard methods and when surgical indications are accurately determined.