Robotic-assisted surgery for tumors in the anterior parotid and midcheek regions: a comparative study with conventional approaches

Abstract

Introduction To compare robotic-assisted and conventional surgical approaches for anterior parotid and midcheek tumors regarding surgical outcomes, complications, cosmetic results, and oncologic safety. Methods Between March 2020 and March 2024, a total of 47 patients who underwent surgery for anterior parotid or midcheek tumors at Yongin Severance hospital were included in the study. Among them, 22 underwent robotic-assisted surgery and 25 underwent conventional surgery. Clinical data including demographics, tumor characteristics, operative outcomes, complications, cosmetic satisfaction, and oncologic outcomes were analyzed and compared between the two groups. Results The robotic group demonstrated significantly lower mean intraoperative blood loss (24.9 +/- 12.6 mL vs. 32.7 +/- 17.2 mL; p = 0.04) and longer mean operative time (93.6 +/- 8.9 min vs. 73.2 +/- 7.2 min; p = 0.01). No facial nerve palsy occurred in the robotic group, compared to two cases in the conventional group. Cosmetic satisfaction scores were significantly higher in the robotic group (mean VAS 1.4 vs. 5.09; p < 0.001). Postoperative drainage volumes (57.3 +/- 10.5 mL vs. 62.5 +/- 12.4 mL; p = 0.45) and length of hospital stay (3.7 +/- 0.2 vs. 4.2 +/- 0.7 days; p = 0.09) did not differ significantly between groups. At a mean follow-up of 24.6 months, no tumor recurrences were observed in either group. Conclusions In this study, robotic-assisted surgery for anterior parotid and midcheek tumors was associated with reduced intraoperative blood loss and favorable cosmetic outcomes, with a possible advantage in facial nerve preservation, while maintaining oncologic feasibility compared to conventional approaches.