TREATMENT OF BENIGN PAROTID-GLAND TUMORS - INDIVIDUALLY ADAPTED OR STANDARDIZED RADICAL SURGERY

Background: Several authors demand emphatically that the minimal opera tive procedure in benign parotid gland tumors has to be a superficial parotidectomy. Material: Of a consecutive series of 372 patients with benign parotid tumors treated in our department between 1973-1996 81% of the patients could be followed up 1-24 years. In 10.9% a total paro tidectomy was per formed, in 16% a lateral parotidectomy and in 73.1% a simple extirpation of the tumor (often taking away a small margin of surrounding parotid parenchyma). The operating microscope and microsu rgical techniques were used in all of these operations. Results: Of al l the followed-up patients 2.3 % developed a recurrence. There were no recurrences of cystadenolymphomas or of rare types of adenomas. Recur rences of primary treated pleomorphic adenomas occurred in 3.0%. In re current pleomorphic adenomas a further recurrence could be seen in 7.4 % of the cases. The over-all incidence of permanent facial nerve weakn ess was 2.1%: 0.7% after extirpation, 3.3% after lateral parotidectomy and 9.7% after total parotidectomy. We observed in 6.3% a gustatory s weating. Conclusion: Our data prove that with simple extirpation simil ar results compared to lateral parotidectomy can be achieved concernin g recurrence, function of the facial nerve and the Frey's syndrome. We suggest a surgical management adapted to the extent, the size and the location of the parotid gland tumors. In our opinion lateral or total parotidectomy should be reserved for tumors of larger amount or deep located tumors.