[Salivary gland tumors. Clinical aspects and therapy]

Salivary gland tumors are rare. One-fifth are malignant. The parotid is the gland most often affected, particularly in adenomas. Adenomas and carcinomas are tumors that occur in adulthood; angiomas are the tumors that occur most frequently in childhood. Other than their localization, salivary gland tumors have few specific signs. In the clinical examination the locoregional and functional presentation is evaluated. Imaging studies refine or correct the clinical diagnosis, primarily by visualizing the deeper planes. Morphological diagnosis in benign lesions depends on resection results; in malignant lesions additional intraoperative frozen section is needed, and in questionable cases incisional biopsy. Fine-needle aspiration cytology may provide valuable knowledge when planning therapy. Limited parotid tumors are resected by lateral or subtotal parotidectomy. Carcinomas are resected as needed, with neck dissection added in case of lymph-node involvement. Small adenoid cystic carcinomas can be treated curatively by very wide resection. Aggressive and extensive tumors are irradiated postoperatively. Malignancies not operated upon are irradiated primarily. Facial nerve paralysis can be rehabilitated by different nerve repair or static surgical techniques.