Abstract / Summary
Abstract Extracapsular dissection (ECD) has gained prominence as a minimally invasive surgical technique for the management of benign parotid tumors. By avoiding extensive glandular dissection and preserving vital structures such as the facial nerve, ECD offers an alternative to traditional superficial parotidectomy (SP), which is often associated with greater morbidity. This narrative review aims to evaluate the clinical utility of ECD in parotid surgery by examining its indications, surgical methodology, patient outcomes, complications, and future implications compared to conventional SP. A narrative review of the literature was conducted using PubMed and Scopus databases, focusing on studies published in the last two decades pertaining to ECD in the treatment of benign parotid tumors. Key areas explored include anatomical considerations, procedural techniques, comparative outcomes, and current challenges in ECD implementation. ECD is associated with significantly lower rates of transient facial nerve palsy (~6.7%) compared to SP (>20%), reduced incidence of Frey’s syndrome (~5% vs 32%), and superior cosmetic outcomes. It is most appropriate for small, well-circumscribed, superficially located benign tumors. Additionally, ECD demonstrates comparable recurrence rates to SP, while offering shorter operative times and reduced hospital stays. Limitations include the potential for incomplete excision in poorly defined tumors and the need for specialized surgical expertise. ECD represents a safe and effective surgical option for selected patients with benign parotid tumors. With further advancements in surgical training, imaging, and instrumentation, ECD holds promise for broader application. Standardized protocols and long-term outcome data are needed to solidify its role in routine clinical practice.