# Cervical Branch Retrograde Superficial Parotidectomy for Tail of Parotid Lesions

## TL;DR

A new surgical technique for removing parotid tail lesions reduces facial nerve damage and improves cosmetic outcomes.

## Contribution

A retrograde dissection technique starting with the cervical branch is introduced for safer and more cosmetically favorable parotidectomy.

## Key findings

- The technique preserved the facial nerve trunk and marginal mandibular branch in 5 patients.
- Shorter incisions and smaller facial flaps were achieved without compromising resection integrity.
- Excellent functional and cosmetic outcomes were observed in all cases.

## Abstract

Facial nerve dysfunction following superficial parotidectomy is one of the most well‐known and dreaded complications of the procedure, leading to significant postoperative impairments in affected patients. In lesions involving the parotid tail, the marginal mandibular branch is at particular risk. In contrast, injury to the cervical branch is usually of minimal consequence. Classically, facial nerve dissection in parotidectomy is performed anterograde from the main trunk. In patients presenting with benign superficial parotid tail lesions, however, we often begin with the identification of the cervical branch and perform retrograde dissection to decrease the risk of injury to both the main trunk and the marginal mandibular branch. This technique also allows for the preservation of the great auricular nerve, a shorter incision, and a smaller elevated facial flap, yielding better cosmetic and functional results without compromising the integrity of the resection. Here we describe this technique used for 5 consecutive patients with excellent outcomes.