WHEN OPERATING in the region of the parotid gland, the surgeon encounters three fundamental difficulties: (1) the face is a delicate cosmetic region, (2) the facial nerve is very liable to lesions, and (3) there always exists the possibility of postoperative (post-traumatic) fistulas of the parotid gland. Accordingly, he faces three hazards in this region: (1) scar, (2) palsy of the facial nerve, and (3) stubborn fistulas of the parotid gland.
Furthermore, in the region of the parotid gland the surgeon encounters tumors representing an especially interesting oncological problem, tumors which make the whole clinical procedure exceedingly complicated. Tumors appear here which, to date, have not been systematized by the pathologist. Clinicians, for their part, are making every effort to clarify the differential diagnosis of the tumors in question, particularly because tuberculous lymphadenitis of this region and sialolithiasis, with its complications, are hard to distinguish clinically from true tumors. Helpful
RIESSNER D. SURGICAL PROCEDURE IN TUMORS OF PAROTID GLANDPreservation of Facial Nerve and Prevention of Postoperative Fistulas. AMA Arch Surg. 1952;65(6):831-848. doi:10.1001/archsurg.1952.01260020825006