Lessons From a Case of Failed Attempt to Remove Pleomorphic Adenoma of the Accessory Parotid Gland via Transoral Approach

An accessory parotid gland is salivary gland tissue that exists separately anterior to the parotid gland. Since malignant tumors can be found in about 50% of accessory parotid tumors, the standard treatment is radical resection via externa l approach. However, with the development of endoscopic surgery in the head and neck field, the transoral approach using an endoscope is also being tried. Although this technique could remove benign tumors without skin incision, there may be cases where removal via transoral approach may prove difficult. The authors experienced a case of failed attempt to remove pleomorphic adenoma in the accessory parotid gland via transoral approach in a 24-year-old male patient. We analyzed the causes of surgical failure in this case from various perspectives. We believe that our lessons from this failed case could help determine the appropriate surgical indications of transoral approach in the accessory parotid gland tumor.