Problems with reoperation of the parotid gland and facial nerve

The decision as to how to handle recurrent benign disease in the parotid gland can be a perplexing problem. It may cover the gamut of clinical observation, through conservative surgery to radical ablation. The situation is a balance between the nature of the biological process, the possibility of cure or control, and the status of the facial nerve. These problems can be exceptionally difficult in analysis and philosophical management, and are frequently pinioned between technical craftsmanship, curability, and deformity. An understanding, however, of the variety of possibilities--and particularly their relationship to the facial nerve--will help to position these cases within the realm of surgical reality. A new technique of interfascicular dissection is proposed in certain instances.