[Surgery of malignant parotid tumors]

Surgical treatment of malignant parotid tumors was described from the viewpoints of radical cure and postoperative function. The function of the parotid gland is originally the secretion of saliva, but this is generally compensated for by the remaining major and minor salivary glands. Therefore, postoperative dysfunction involves possible facial palsy, deformity of the face and Frey's syndrome due to extirpated gland parenchyma and surrounding tissues. For these reasons, preservation of the facial nerve is required and resection of the gland should be as limited as the condition demands. If these procedures are impossible, plastic surgery such as nerve grafting and skin or musculocutaneous flaps is utilized. Postoperative irradiation is not applied except for unusual cases. Because malignant tumors of the parotid gland are histologically and biologically very different, preoperative examination is important for select the subsequent treatment. Superficial parotidectomy for a tumor in the superficial lobe and total parotidectomy for one in the deep lobe is the general concept adopted today. However, uniform application of this concept does not seem to simultaneously fulfil both purposes. In order to satisfy radical and functional results, delicately applied surgical techniques applied to individual cases are recommended according to the findings of appropriate preoperative and intraoperative examinations.