Abstract
Objective: Compare the efficacy and feasibility of alternative approaches: endoscopic resection via retro-auricular (RA) approach and transoral (TO) approach for submandibular gland (SMG) resection.
Method: Retrospective analysis of surgical outcomes. We performed 21 endoscopic resections of benign lesions of SMG via RA approach and 11 resections via TO approach since 2010. The following variables were assessed: age, gender, tumor size, histopathologic type, operation time, length of hospital stay, scar satisfaction, and complications.
Results: There were no statistically significant differences in patient profiles, tumor size, and histopathologic type between 2 groups. The cosmetic result was generally excellent and all patients were satisfied with the outcomes. However, in the first endoscopic surgery which was done for a large tumor in SMG, temporary weakness in the marginal branch of facial nerve was observed. There was no permanent palsy. Five patients in TO approach group had complaints of limitations of movement of tongue and numbness for several days. Excision via TO approach had the benefit of length of hospital stay over RA approach. However, the operation time took longer in patients who had small space of mouth floor.
Conclusion: These 2 alternative approaches have distinct advantages. 1) Endoscopic resection of SMG via RA approach can be indicated for small benign tumors, sialadenitis and invisible or hiding scar. 2) Transoral approach for those who do not want an external scar, or do not have relatively small space of floor of mouth due to mandibular hypoplasia or narrow width of mandible body.
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