Surgical Management of Parotid Lesions

Abstract
In the past, the recurrence rate of tumors of the parotid gland has been exceedingly high. This fact is surprising, since approximately 80% of parotid tumors are considered to be benign. Kirklin and associates,1 reviewing all parotid tumors treated at the Mayo Clinic from 1907 through 1944, found a recurrence rate of 32% in 30 years. Malignant lesions of this gland represent 20% to 35% of all parotid tumors.1-3 The poor results in the treatment of parotid tumors stem largely from inadequate removal of the primary lesion. The two most important reasons for this are fear of injuring the facial nerve and lack of knowledge of the technique in dissecting the nerve from parotid tissue.4,5 Therefore, about eight years ago, we instituted a more aggressive approach to the treatment of lesions of the parotid gland. Most benign tumors since 1951 have been removed by subtotal (superficial) parotidectomy