British Journal of Oral and Maxillofacial Surgery 52 (2014) 179–184 Available online at www.sciencedirect.com Robot-assisted versus endoscopic submandibular gland resection via retroauricular approach: a prospective nonrandomized study Hyoung Shin Lee a , Dae Kim b , So Yoon Lee c , Hyung Kwon Byeon d , Won Shik Kim d , Hyun Jun Hong d , Yoon Woo Koh d,∗ , Eun Chang Choi d a Department of Otolaryngology Head and Neck Surgery, Kosin University College of Medicine, Busan, South Korea b Department of Otolaryngology and Head and Neck Surgery, Queen Alexandra Hospital, Portsmouth & Cancer Sciences, University of Southampton, United Kingdom c Department of Otolaryngology Head and Neck Surgery, Catholic University College of Medicine, Seoul, South Korea d Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea Accepted 2 November 2013 Available online 17 December 2013 Abstract The aim of this study was to compare the short-term clinicopathological results of robot-assisted and endoscopic resection of the submandibular gland by the retroauricular approach. We present a prospective, non-random, study of 35 patients who had endoscope-assisted (n = 22), or robot-assisted (n = 13), resection of the submandibular gland using a retroauricular approach. Patients selected one of the two methods, and short-term clinical outcomes were then compared, including maximum diameter of the tumour and gland, length of incision, total operating time, amount of operative bleeding, amount and duration of drainage, duration of hospital stay, cosmesis, and complications. The operation was feasible in all patients with no appreciable operative complications or need to convert to a conventional open operation. The operating time of the robot-assisted group (63.4 (6.3) min) was comparable with that of the endoscopic group (66.5 (9.1) min) (p = 0.15). There were no differences in the other clinical outcomes between the 2 groups. Both groups of patients were extremely satisfied with their postoperative cosmesis, and did not differ significantly (p = 0.89). Robotic and endoscopic resection of the submandibular gland gave comparable early surgical outcomes and excellent cosmetic results. Despite the technical convenience for the surgeon, the robot gave no apparent clinical benefit over the endoscope in this series. © 2013 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved. Keywords: Submandibular gland; Robotic; Endoscopic; Face lift; Hairline Introduction A traditional transcervical incision of the upper neck is a safe and effective approach for resection of the submandibular gland. However, the external scar that is left in this highly ∗ Corresponding author at: Department of Otorhinolaryngology, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, South Korea. Tel.: +82 2 2228 3607; fax: +82 2 393 0580. E-mail address: ywkohent@yuhs.ac (Y.W. Koh). visible area may be considered a problem by many patients and can occasionally lead to a disfiguring, hypertrophic scar, or keloid. Recently, we reported our surgical techniques of ‘endoscopic’ 1 and ‘robot-assisted’ 2 resection of the subman- dibular gland through a retroauricular incision, which is not only feasible, but also gives excellent cosmesis, leaving a scar that is hidden by the auricle and hair. These techniques and the feasibility of endoscopic sialadenectomy 3–5 and robot-assisted sialadenectomy 6,7 of the submandibular gland have also been presented by other authors. In our previous 0266-4356/$ – see front matter © 2013 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.bjoms.2013.11.002