(0332) Surgical Management of Parotid Masses: 2024 Update

Introduction: Salivary gland tumors, which constitute 3% of all neoplasms and 5-10% of head and neck tumors, are most commonly seen between the ages of 20-60. 80-85% of these neoplasms originate from the parotid gland, and 25% are malignant. The malignancy of the tumor is inversely proportional to the size of the gland. Pleomorphic adenoma constitutes 65% of all salivary gland tumors and often develops in the parotid gland. Mucoepidermoid carcinoma is the most common malignant salivary gland tumor.

Methods: The characteristics of patients admitted with parotid masses in four centers in the last decade were evaluated, including the initial symptoms, approach, surgical method applied, and results. It is controversial whether to biopsy parotid masses before surgery or to learn the type of mass by frozen section during surgery.

Results: Nowadays, when the most minimal surgery is applied in all diseases, the principles of performing surgery that leaves minimal scars may conflict with the principles of malignant tumor surgery. Especially if the lesion is located on the face, which is the most visible place, the decision for surgery becomes more difficult. On the one hand, patients demand surgery with minimal scarring. On the other hand, the need to remove the mass with sufficient surgical margins puts the surgeon in a difficult situation.

Conclusions: Our aim should be to perform the most appropriate and minimal surgery and complete the treatment with minimal scarring without giving up the principles of tumor surgery. While more limited surgeries are now being discussed in the treatment of benign parotid gland tumors, we prefer superficial parotidectomy as minimal surgery in our cases and superficial, total, or radical parotidectomy approaches in our patients with malignant histopathology. In necessary cases, treatment is combined with neck dissection and chemoradiation.