Cold Knife Dissection and Bipolar Diathermy Vs Harmonic Scalpel in Parotid Gland Surgery for Benign Tumours

Abstract

IntroductionSurgical techniques for extirpation of tumours of the parotid gland have evolved significantly in recent years. Previous data suggest the use of harmonic scalpel reduced operative time, intraoperative blood loss, postoperative drain production, and incidence of facial nerve injury, in comparison to cold scalpel dissection. Material and methodsRetrospective analysis of 2 group of patients operated using harmonic scalpel versus cold knife dissection and bipolar diathermy and compare operative time and post-surgical complication rate, facial nerve injury, sialocele or salivary fistula formation, after parotidectomy for benign parotid tumours. Results108 patients were included. Regarding surgical time, the mean time to using harmonic scalpel was 114±39 (min.: 60/max.: 240), and the mean time using bipolar diathermy was 135±38 (min.: 90/max.: 285) and this was the only significant difference between the 2 techniques (P=.049). ConclusionsHarmonic scalpel is a safe and effective tool to perform parotid surgery in benign tumours. However, a shorter surgical time was the only advantage found over the traditional cold dissection and bipolar dissection method.