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Eur Arch Otorhinolaryngol. 2017 Nov;274(11):3825-3836. doi: 10.1007/s00405-017-4650-4. Epub 2017 Jun 21.

Surgical options in benign parotid tumors: a proposal for classification.

Author information

1
Department of Otolaryngology-Head and Neck Surgery, University Hospital de la Santa Creu i Sant Pau, Universitat Autonòma de Barcelona, Mas Casanovas, 90., 08041, Barcelona, Spain. mquer@santpau.cat.
2
European Salivary Gland Society, Geneva, Switzerland. mquer@santpau.cat.
3
European Salivary Gland Society, Geneva, Switzerland.
4
Otorhinolaryngology-Head and Neck Surgery and Department of Oncology, Section Head and Neck Oncology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
5
Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
6
Department of Surgery, University of Arizona College of Medicine, Phoenix, AZ, USA.
7
Department of Otorhinolaryngology-Head and Neck Surgery, HELIOS Hanseklinikum, Stralsund, Germany.
8
Department of Head and Neck Surgical Oncology, Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands.
9
University of Udine School of Medicine, Udine, Italy.
10
Department of Surgery, School of Medicine, Universidad de Antioquia, Fundación Colombiana de Cancerología -Clínica Vida, Medellin, Colombia.
11
Head and Neck Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
12
Department of Otolaryngology-Head and Neck Surgery, University Hospital de la Santa Creu i Sant Pau, Universitat Autonòma de Barcelona, Mas Casanovas, 90., 08041, Barcelona, Spain.
13
Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital, Berne, Switzerland.
14
Coordinator of the International Head and Neck Scientific Group, International Head and Neck Scientific Group, Padua, Italy.

Abstract

Different surgical options are currently available for treating benign tumors of the parotid gland, and the discussion on optimal treatment continues despite several meta-analyses. These options include more limited resections (extracapsular dissection, partial lateral parotidectomy) versus more extensive and traditional options (lateral parotid lobectomy, total parotidectomy). Different schools favor one option or another based on their experience, skills and tradition. This review provides a critical analysis of the literature regarding these options. The main limitation of all the studies is the bias of selection for different surgical approaches. For this reason, we propose a staging system that could facilitate clinical decision making and the comparison of results. We propose four categories based on the size of the tumor and its location within the parotid gland. Category I includes tumors up to 3 cm, which are mobile, close to the outer surface and close to the parotid borders. Category II includes deeper tumors up to 3 cm. Category III comprises tumors greater than 3 cm involving two levels of the parotid gland, and category IV tumors are greater than 3 cm and involve more than 2 levels. For each category and for the various pathologic types, a guideline of surgical extent is proposed. The objective of this classification is to facilitate prospective multicentric studies on surgical techniques in the treatment of benign parotid tumors and to enable the comparison of results of different clinical studies.

KEYWORDS:

Benign parotid tumors; Extracapsular dissection; Parotidectomy; Partial parotidectomy; Pleomorphic adenoma; Superficial parotidectomy; Warthin’s tumor

PMID:
28639060
DOI:
10.1007/s00405-017-4650-4
[Indexed for MEDLINE]

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