Surgical treatment in non-neoplastic parotid disease: indications and results

Non-neoplastic disease of the parotid gland is an important entity, requiring differential diagnosis and management. The incidence of non-neoplastic parotid disease (NNPD) is increasing and makes up about 25% of cases for which parotidectomy is indicated. NNPD can be categorized as type I (asymptomatic soft diffuse enlargement or circumscribed firm nodular enlargement) or type II (inflammatory lesions with recurrent pain and swelling, obstructive or nonobstructive). Concern over possible malignancy is highest in type I nodular lesions and least in type II lesions. Operative treatment may be indicated for exclusion of tumour, relief of recurrent pain and swelling and patient anxiety. In 62 patients with NNPD who were operated on, the relevant clinical factors included radiation, diabetes, tuberculosis, Sjögren's syndrome and pulmonary sarcoidosis. Superficial parotidectomy was effective, being associated with low morbidity, and can be recommended as acceptable treatment, providing there is a complete patient history and operation is carried out by a surgeon experienced in parotid surgery.