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Juergen O. Ussmueller, MD; Michael Jaehne, MD; Bjoern-Georg Neumann, MD

Arch Otolaryngol Head Neck Surg. 2004;130:187-189.

Objective  To evaluate the benefits, as well as the possible complications, of the use of diathermy scissors in parotid gland surgery.

Design  Prospective study of the surgical procedures of the diathermy scissors and a retrospective comparison with a conventionally treated control group concerning cut-closure time.

Setting  Tertiary care referral academic center.

Patients  Prospective examination of 30 unselected patients undergoing superficial (n = 23) or subtotal/total (n = 10) parotidectomies performed with diathermy scissors. Indications were benign tumors (n = 18), malignant tumors (n = 12), and cystic lesions (n = 3). In a control group (n = 50), 36 superficial and 21 subtotal/total parotidectomies were performed.

Results  The use of diathermy scissors reduces the need to frequently change dissecting and coagulating surgical instruments. The scissors reduce intraoperative bleeding and therefore improve visualization and orientation in the surgical field. Postoperative bleeding or seroma and Frey syndrome were not observed. In 1 case, a salivary fistula was present for 3 weeks. Three cases of transient facial weakness occurred, all of which completely resolved by 6 months after surgery. In the control group, the cut-closure time ranged from 50 to 120 minutes (average, 87.6 minutes) during superficial parotidectomy; it ranged from 80 to 160 minutes (average, 130.0 minutes) during subtotal and total parotidectomy. In comparison, in the study group, the average time gain was 16 minutes during superficial parotidectomy when diathermy scissors were used, a statiscally significant difference (P = .03). During subtotal and total parotidectomy with diathermy scissors, the average time gain was 19.3 minutes and was statistically not significant (P = .23).

Conclusions  The results of the present study show that diathermy scissors are very well suited for most of the surgical steps in parotid gland surgery. They provide an elegant, safe, and fast surgical procedure, especially in the hands of an experienced surgeon.

From the Department of Otorhinolaryngology–Head and Neck Surgery, University Hospital Eppendorf, Hamburg, Germany. The authors have no relevant financial interest in this article.

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