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Conservative vs Superficial Parotidectomy
Arch Otolaryngol Head Neck Surg. 1999;125:1166.
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Recurrence following parotidectomy for pleomorphic adenoma is attributed to spillage, inadequate resection, or multicentric foci. Consequently, an adequate envelope of normal parotid tissue must be included with the tumor. This concept has prompted many surgeons to perform a complete superficial parotidectomy for a lateral lobe tumor. However, this very concept is violated when the tumor abuts the facial nerve or when a dumbbell-shaped tumor extends behind the mandibular ramus.
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Larry J. Shemen, MD, FRCS
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The other advantage of a complete superficial parotidectomy is a lowered risk of postoperative salivary fistula if only the deep lobe is left in situ, as the latter accounts for only 20% of the total parotid volume. However, a reduced risk of fistula formation following conservative parotidectomy can be achieved by either ligating the Stensen duct or cauterizing smaller ductules.
The singular advantage of conservative parotidectomy is that it avoids any unnecessary trauma to the facial . . . [Full Text of this Article]
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