[Diagnosis and therapy of salivary gland tumors]

The diagnostic and therapeutic approach to tumors of the salivary glands is discussed on the basis of 327 cases of parotid gland tumors seen at the ENT Department of the University of Zurich between 1959 and 1976. In view of the slow growth rate of salivary gland tumors, history and clinical findings cannot be used to identify malignant neoplasms. The histological diagnosis is therefore the prerequisite for correct therapy. Diagnostic errors may result when the total tumor mass is not available for histological investigation. For this reason we advise "surgical biopsy" (total extirpation of the tumor) when a malignant tumor cannot be ruled out by aspiration biopsy or examination of frozen sections. Radical surgical removal plays the major role in the therapy of salivary gland tumors. Highly malignant neoplasms demand a combined oncological approach usually involving surgery and radiotherapy. Familiarity with the temporal bone is necessary for the complete removal of highly malignant tumors of the parotid gland, because of their frequent infiltration of the intratemporal portion of the facial nerve. The application of the modern principles of reconstructive surgery and of microsurgical techniques has widened the scope of radical surgery of salivary gland tumors and considerably reduced the subsequent morbidity.