Deep Lobe Parotid Tumours

Michael A. Cooper DDS, MD, Canberra Oral and MaxilloFacial Surgery, Braddon, Australia
Peter Vickers MB, BS, BDS, FRCS, FDSRCS, FRACDS, FACCS, Maxillofacial Surgery, Macquarie University, Sidney, Australia
Statement of the problem

The investigation and fine needle aspiration cytology of deep lobe parotid tumours may be difficult due to their position and presentation. Management is surgical and complex. The tumours may be accessed via a conventional facial nerve splitting procedure, via mandibular osteotomy to the parapharyngeal space or both. These tumours are rare and the majority benign pleomorphic adenomas. Malignancies confirmed post operatively will require adjunctive radiotherapy.

Materails and Methods

A review of case records disclosed 8 deep lobe parotid tumours that presented to The Department of MaxilloFacial Surgery over 15 years

Method of Data Analysis

Sample Size 8 Deep lobe tumours

Duration of study 15 years

Statistical Methods N/A

Subjective analysis confirmed 1 maliganany ( Acoinic cell carcinoma) and 7 pleopmorphic adenomas in the series

Results of Investigation

Of the 8 tumours 1 malignant, 7 benign.

Of the 8 tumours 3 accessed via division facial nerve and 5 via mandibular osteotomy

Of the 8 tumours nil evidence facial nerve paresis post operatively

Of the 8 tumours nil recurrence

Conclusions

A thorough knowledge of the anatomy and MRI/CT investigations will determine whether separation of facial nerve divisions and/or mandibular osteotomy is required to effect tumour removal

References 

1. Approaches to the diagnosis and treatment of tumors of the parapharyngeal space.[Head Neck Surg. 1982]

2. A review of tumours of the deep lobe of the parotid salivary gland.[Br J Oral Maxillofac Surg. 1986]