Clinical application of harmonic scalpel versus monopolar electrocautery in superficial parotidectomy：A comparative analysis

Abstract:

Objective：To analyze the advantages，disadvantages，and application prospects of harmonic scalpel（HS） and monopolar electrocautery（ME） in superficial parotidectomy. Methods：The clinical data of patients who underwent superficial parotidectomy from June 2016 to June 2017 were retrospectively studied. All surgeries were completed using the same method by experienced surgeons，and the patients were divided into HS group and ME group based on the surgical tool used. Sex，age，pathological diagnosis，tumor diameter，time of operation，intraoperative blood loss，postoperative drainage volume and time，length of postoperative hospital stay，postoperative facial nerve function，and postoperative hematoma and salivary fistula were compared between the two groups. Results：Superficial parotidectomy was performed using HS in 24 patients and ME in 25 patients. Postoperative drainage time（3.13±0.90 vs. 3.72±0.79，t=2.460，P=0.018），length of postoperative hospital stay（5.0±1.10 vs. 5.60±0.76，t=2.221，P=0.031），and degree of post－operative temporary facial paralysis（Z=-2.138，P=0.033） were significantly reduced in the HS group than in the ME group. However，there were no significant differences in intraoperative blood loss，time of operation，postoperative drainage volume，and postoperative hematoma and salivary fistula between the two groups（all P>0.05）. Conclusion：HS is a safe and reliable tool that provides superior protection of the facial nerves and the tissues near the surgical wound to ME during superficial parotidectomy，and should therefore be widely promoted for clinical application.