Removal of the submandibular gland by a retroauricular approach.

OBJECTIVE To evaluate the benefit of a retroauricular approach by comparing it with a conventional transcervical approach for removal of the submandibular gland. DESIGN Prospective clinical study. SETTING Academic center. PATIENTS Thirty patients with benign submandibular gland disorders. INTERVENTIONS Patients were divided into 2 surgical groups to undergo retroauricular (n = 15) and conventional (n = 15) procedures matched by age, sex, marital status, and pathologic condition. The retroauricular approach used an incision along the postauricular sulcus and hairline and subcutaneous tunneling to the gland; the conventional approach used an incision along a natural skin crease overlying the gland. MAIN OUTCOME MEASURES The operation time, complications, hospital stay, and subjective satisfaction of incision scar checked by visual analog scale were compared between groups. RESULTS The submandibular gland disorders were comparable between groups: pleomorphic adenoma (n = 15), chronic sialadenitis with sialolithiasis in the gland (n = 5) or hilum (n = 8), and Küttner (n = 1) or Kimura (n = 1) disease. Mean +/- SD operation times were 49 +/- 17 minutes in the retroauricular group and 38 +/- 15 minutes in the controls (P = .08). Mean +/- SD hospital stay and complication rates were comparable between groups. The mean +/- SD score of patient satisfaction was 8.9 +/- 0.9 in the retroauricular group and 4.2 +/- 2.9 in the conventional group (P<.001). The incision scar was commonly less visible in the retroauricular group because of hiding by the auricle and natural hair when comparing with the control group. CONCLUSION The retroauricular approach can provide better cosmetic outcome than the conventional transcervical approach and without significant complications.