Surgical treatment of parotid tumor involving the deep lobe is:-
Management of salivary gland tumors1) Surgery (principle Rx) - Surgical excision alone or in combination with radiotherapy- For Parotid tumor: depending on the involvement* Superficial parotidectomy* Deep lobe parotidectomy* Total parotidectomy* Radical parotidectomy- Other salivary gland tumors - En block excision of tumor + gland 2) Neck dissection: performed in- Clinically palpable nodes- High grade malignancies3) Radio therapy - Indications* High Grade tumor* Large primary tumor* Perineural invasion* Invasion of Lymph node* Positive margins* Cervical lymph node metastasis 4) No role of chemotherapy- In salivary gland tumors due to* Incomplete & sho-lived response* No survival advantages Types of Parotidectomy1. Superficial or lateral or classical parotidectomy:* For benign and malignant tumors involving superficial lobe* Salivary tissue lateral to facial nerve is removed2. Deep lobe parotidectomy:* For benign and malignant tumor involving deep lobe* Salivary tissue deep to facial nerve is removed3. Total conservative parotidectomy* For benign and malignant tumor involving both superficial + deep lobe* All salivary tissue is removed* Facial nerve is preserved4. Radical parotidectomy* For tumors invading facial nerve* All salivary tissue is removed + excision of facial nerve5. Extended radical parotidectomy* Radical parotidectomy + removal of adjacent structures (mandible, temporal bone,muscles)
Total parotidectomy with facial nerve preservation
Total parotidectomy with facial nerve sacrifice
Deep lobe parotidectomy with facial nerve preservation
Deep lobe parotidectomy with facial nerve sacrifice
Salivary Glands