The majority of parotid tumors are pleomorphic adenomas, and surgical treatment is still the main treatment modality. In the 20th century, due to the lack of understanding of the facial nerve anatomy and the pathological characteristics of the envelope of pleomorphic adenoma, the main surgical procedure for this disease was simple tumor enucleation, but it was easy to lead to recurrence after surgery; attempts were made to control the recurrence rate by expanding the scope of resection, so extraperitoneal resection was used in clinical practice, and although the envelope of the tumor was removed, the recurrence rate was still not well controlled. Superficial parotidectomy and total parotidectomy obviously reduced the recurrence rate, but with the aggravation of facial nerve injury, it seems to be overkill. Partial parotidectomy is a new form of parotid surgery that not only reduces the recurrence rate and facial nerve injury rate, but is also supported by basic pathological evidence and is currently a more advanced surgical procedure. However, there is still a controversy between the classic superficial parotidectomy and the advanced partial parotidectomy. The advantages and disadvantages of both procedures have been investigated in terms of orthopedics, pathology, and genetic testing methods. This article explores the evolution of parotidectomy in terms of the evolution of parotid surgery. The parotid gland is the most common site of salivary gland tumors, with the highest incidence of benign tumors represented by pleomorphic adenomas [ 1-3 ]. Although medical treatment has made great progress in recent years, and new antitumor drugs are emerging, surgery is still the main treatment for benign parotid tumors. Surgical procedures for benign parotid tumors include early enucleation, late extraperitoneal resection, and nowadays, superficial lobectomy, total lobectomy and partial resection of the parotid gland are commonly used. At present, there is still a great controversy at home and abroad regarding the choice of surgical approach and the safe margin range of surgery for benign parotid tumors. 1. Then Bailey made a series of modifications to this procedure [ 9-11 ]. Parotidectomy has been performed for nearly 190 years. In the 20th century, due to the lack of understanding of the facial nerve anatomy and the pathological characteristics of pleomorphic adenoma envelope, the incidence of postoperative facial palsy was high and the main procedure for this disease was simple tumor enucleation. The reason is that although enucleation helps to protect the facial nerve better during surgery, it is not enough to cure the parotid tumor, and microscopic studies of the surrounding tissues reveal that such surgery leads to residual tumor tissue, which can cause recurrence. In 1979, Gleave et al [ 16 ] first proposed extraperitoneal resection of parotid tumors by separating the tumor along the outer wall of the tumor. Piekarski et al [ 17 ] found that the postoperative tumor recurrence rate was 8.2% in patients who underwent extraperitoneal resection, and the incidence of postoperative facial palsy was also 8.2% in this group. The main focus of research at that time was the control of recurrence rates. After Patey et al. proposed the theory of multicentricity of parotid tumors, it was suggested that total parotid lobectomy with preservation of the facial nerve should be performed to reduce the possibility of postoperative recurrence. The incidence of gustatory sweating syndrome after total parotidectomy is 2.7 times that of superficial parotidectomy and 4.7 times that of regional parotidectomy. As the anatomy of the facial nerve has advanced and surgical techniques have matured, the complications of superficial parotidectomy have decreased dramatically, while the efficacy of the procedure has been confirmed by numerous studies, calling into question the total parotidectomy procedure. At this time, basic research on parotid pleomorphic adenoma showed that parotid pleomorphic adenoma rarely grew multicentrically, which laid the theoretical foundation for the superficial parotid lobectomy as the classic parotid procedure at that time. In recent years, with the increasing demand for quality of life, many studies have shown that superficial lobectomy of the parotid gland reduces the recurrence rate, but increases the incidence of facial nerve injury and Frey syndrome compared to extraperitoneal resection. The complete excision of the superficial lobe of the parotid gland causes depression of the sublobular region, which affects the postoperative facial appearance of patients. Therefore, how to improve the quality of patient’s survival while reducing the recurrence rate has become a hot topic of research in surgical treatment of parotid tumors. Because of the significant complications, it has been questioned whether superficial parotidectomy is an overkill for a critical tumor such as parotid pleomorphic adenoma. As a result, partial parotidectomy was proposed and started to be used in clinical practice. Superficial lobectomy is a compromise between superficial parotidectomy and parotidectomy, which is similar to extraperineal resection, but the scope of resection is slightly wider than that of extraperineal resection. Some studies have shown that superficial parotidectomy can reduce postoperative complications and its efficacy has been confirmed. In terms of basic research, serial sections of pleomorphic adenoma showed that the tumor has the characteristics of extraperitoneal infiltration and outgrowth, but such infiltration and outgrowth are within 1 cm from the tumor envelope. In our previous study, we found that the infiltration and outgrowth of parotid pleomorphic adenoma tumors <4 cm in diameter were confined to the envelope, and the incidence of Frey syndrome, numbness in the auricular region, and facial appearance were significantly reduced in the modified procedure group compared with the conventional procedure. Thus, superficial lobectomy of the parotid gland is considered the standard procedure for parotid surgery for diameter tumors [ 29-30 ]. Superficial lobectomy is a well-established surgical procedure for the treatment of benign parotid tumors and is considered the best option for superficial parotid lobe tumors from both theoretical and clinical postoperative perspectives. Although there are also reports in the literature that support the view that extraperitoneal resection has no effect on the postoperative recurrence rate, the safety boundary is clearly insufficient according to basic studies. The main reason why the recurrence rate was not increased by the follow-up of patients reported in these literatures is considered to be the lack of years of follow-up and the development of new techniques that have reduced the recurrence rate. In recent years, various advanced techniques and methods have been applied to parotid surgery to increase the efficacy and reduce postoperative complications. 3.1 Application of spiral waterjet in parotid surgery Waterjet, as the name implies, uses water as a knife and uses the high-speed cutting force of water to cut off the surrounding tissues without generating heat, which is its biggest advantage. However, whether the huge pressure will affect the facial nerve needs to be further studied. At present, there are only experimental studies on animal bodies abroad , and clinical studies on this technology in China [ 39 ] point out that it has certain advantages compared with traditional surgery, but this advantage is not obvious. 3.2 Endoscopic and microscope-assisted parotid surgery Minimally invasive surgery is a more advocated surgical method in recent years, characterized by reduced damage to surrounding tissues and fewer complications. The application of endoscopic surgery is mainly for cosmetic needs. The use of endoscopic assistance for superficial parotid lobe tumor surgery provides excellent cosmetic results without the occurrence of permanent facial paralysis after surgery. For open surgery, whether intraoperative magnification of the field of view can be reduced. 4. Summary Partial excision of the superficial lobe of the parotid gland is currently a reliable surgical procedure that has been advocated by many scholars, and the evolution of history confirms this result. Partial parotidectomy removes relatively little normal tissue, and the incidence of postoperative complications such as facial nerve dysfunction and Frey's syndrome is significantly reduced, improving the quality of patient survival. Postoperative complications and postoperative parotidectomy. Aesthetics may seem to be an irreconcilable issue, and scholars have struggled to find a balance. A prospective randomized study trial conducted jointly by multiple institutions may be helpful in determining the choice of parotid tumor treatment, but there are too many obstacles and unpredictable factors to implement such a study. The use of new techniques can significantly reduce parotid complications. More studies are needed to confirm the long-term efficacy of superficial partial parotidectomy as a new procedure.