This page was last updated: August 3, 2014
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Parotidectomy 
The incision curves behind the earlobe
and is extended in a crease of the neck
The wound is stitched with absorbable
sutures.  A drain is seen below the incision.
Six weeks later, the scar of a parotidectomy incision is barely visible.
The branches of the facial nerve are carefully identified with an electric stimulator and preserved
BENIGN PAROTID TUMORS

The majority of parotid tumors (80%) are benign.

Pleomorphic adenoma is the most common parotid gland tumor.  It accounts for 70-80% of all benign parotid tumors. The majority of pleomorphic adenomas (90%) arise in the superficial lobe lateral to the facial nerve. Pleomorphic adenomas are painless slowly growing masses. They are usually solitary and well demarcated. They are more common in women.  Malignant transformation is seen in only 2-5% of cases and is usually associated with tumors that have been present for 10-15 years.

Warthin's tumor (benign papillary cystadenoma lymphomatosum) is the second most common benign tumor of the parotid gland.  It accounts  for 2-10% of all parotid gland tumors. Unlike the pleomorphic adenoma, it is more common in older white men and is the most likely to be bilateral in 10% of the cases.


MALIGNANT PAROTID TUMORS

Only 20% of parotid tumors are malignant.

Mucoepidermoid carcinoma is the most common malignant neoplasm of the parotid gland. It accounts for 10 % of all parotid tumors.

Adenoid cystic carcinoma is the second most common malignant tumor (2-6% of all parotid gland tumors). Adenoid cystic carcinoma is particularly nasty in that it has a very high tendency to invade and travel along nerves, making curative resections very difficult.

Facial weakness is sign of malignancy, and indicates a poor prognosis.

This left deep parotid lobe tumor is being "delivered" between the buccal and zygomatic branches of the left facial nerve.  On histopathologic examination, it turned out to be a pleomorphic adenoma (benign mixed tumor)
This cystic Warthin's tumor was located in the tail of the parotid.  The grounding electrode of the facal nerve stimulator is placed in the sternocleidomastoid muscle.
Otolaryngology Houston

Bechara Y. Ghorayeb, MD
OTOLARYNGOLOGY - HEAD & NECK SURGERY
Memorial Hermann Professional Building
1140 Business Center Drive, Suite 560
Houston, Texas 77043
For appointments, call: 713 464 2614