[An evaluation of parotid gland masses]

We retrospectively evaluated patients who underwent surgery for parotid gland masses.

A total of 50 patients (25 females, 25 males; mean age 48.5 years; range 18 to 76 years) who underwent surgery for parotid gland masses were evaluated with regard to age, sex, preoperative diagnostic methods, histopathologic diagnoses, and surgical techniques.

Preoperative diagnostic studies included ultrasonography, fine-needle aspiration biopsy, computed tomography, and magnetic resonance imaging. Histopathological diagnoses were benign in 33 patients (66%), malignant in nine patients (18%), and tumor-like pathologies in eight patients (16%), the most common being pleomorphic adenoma (n=28, 56%), Warthin's tumor (n=4, 8%), and squamous cell carcinoma (n=4, 8%). Superficial and total parotidectomies were performed in 40 (80%) and 10 (20%) patients, respectively. Nine patients with malignant tumors also had neck dissection and postoperative radiotherapy. Mortality occurred in one patient with metastasis to the parotid gland. One patient with lipoma developed recurrence two years after surgery. Follow-up was five years in 28 patients (56%), three years in 12 patients (24%), and two years in five patients (10%). Complete and transient facial paralysis developed in 10 patients and five patients following total and superficial parotidectomy, respectively.

Superficial parotidectomy is the minimal surgery for parotid gland masses. If the deep lobe of the gland is involved, total parotidectomy should be performed with preservation of the facial nerve. In malignant tumors, neck dissection and postoperative radiotherapy should be added.