Abstract
The authors report their experience regarding parotidectomy performed under a three-dimensional-high-definition
(3D-HD) exoscope, with the aim of evaluating its effectiveness in parotid surgery.
This is a prospective study on nine patients treated by the same surgeon. All patients
underwent parotidectomy for extrafacial primary tumours without preoperative involvement
of the skin or of the facial nerve from March 2019 to June 2019 with the use of a
3D-HD exoscope. Magnification was variable from 8x to 30x with direct vision supplied
by a 3D monitor. Six men and three women, mean (range) age 47.8 (19-74) years underwent
parotidectomy. No patient experienced postoperative complications or definitive facial
palsy. The mean (range) time of surgery was 149.4 (115 - 210) minutes. The 3D exoscope
represents a valid alternative to the operative microscope or surgical loupe for parotid
surgery. It is a light instrument allowing for precise surgical dissection of the
parotid region by reducing the risks for iatrogenic lesions of the facial nerve using
a real 3D magnification of the anatomical structures in HD. Furthermore, its use does
not prolong the operative time and shows high potential for training and educational
purposes since the operating room staff can better perceive the procedure and the
surgeon’s fine gestures. Although the preliminary applications show promising results,
there is still a need for wider scientific validation.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to British Journal of Oral and Maxillofacial SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Parotid tumours: clinical and oncologic outcomes after microscope-assisted parotidectomy with intraoperative nerve monitoring.Acta Otorhinolaryngol Ital. 2017; 37: 375-386
- Clinical experience with a high definition exoscope system for surgery of pineal region lesions.J Clin Neurosci. 2014; 21: 1245-1249
- Three-dimensional, high-definition exoscopic anterior cervical discectomy and fusion: a valid alternative to microscope-assisted surgery.World Neurosurg. 2019; 130: e244-50
- First clinical applications of a high-definition three-dimensional exoscope in pediatric neurosurgery.Cureus. 2018; 10: e2108
- Preliminary clinical experience with the 4 K3-dimensional microvideoscope (VITOM 3D) system for free flap head and neck reconstruction.Head Neck. 2020; 42: 138-140
- Initial experience with 3-dimensional exoscope-assisted transmastoid and lateral skull base surgery.Otolaryngol Head Neck Surg. 2019; 160: 364-367
- The use of the exoscope in lateral skull base surgery: advantages and limitations.Otol Neurotol. 2019; 40: 236-240
- Facial nerve grading system.Otolaryngol Head Neck Surg. 1985; 93: 146-147
- Classification of parotidectomies: a proposal of the European Salivary Gland Society.Eur Arch Otorhinolaryngol. 2016; 273: 3307-3312
- Centripetal approach to the facial nerve in parotid surgery: personal experience.Acta Otorhinolaryngol Ital. 2003; 23: 111-115
- Electromyographic facial nerve monitoring during parotidectomy for benign lesions does not improve the outcome of postoperative facial nerve function: a prospective two-center trial.Laryngoscope. 2009; 119: 2299-2305
Article info
Publication history
Published online: July 07, 2020
Accepted:
June 10,
2020
Identification
Copyright
© 2020 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
