Clinically benign parotid tumours: local dissection as an alternative to superficial parotidectomy in selected cases

In a personal series of 162 tumours, 101 were pleomorphic adenomas 28 of which were removed by elective local extra capsular dissection and 73 by a conventional nerve dissection. There were no recurrences in either group after a mean follow-up 10.3 years, range 3-21 years for local dissection and 8.3 years, range 3-22 years for nerve dissection. Frey's syndrome did not occur after local dissection but was present in 25% of patients after a nerve dissection. Of the 162 parotid lumps, 17 proved to be a carcinoma but only one was deemed suitable for a local removal, a low grade muco epidermoid carcinoma of the accessory lobe and no recurrence has occurred after 8 years. In benign disease, local dissection gives similar results to conventional nerve dissection with less morbidity and confirms that tumour recurrence cannot be ascribed to any properties of the tumour but lies in the hands of the surgeon and depends on the care with which the tumour is removed.