EXCISION of the superficial lobe and in some cases the deep lobe of the parotid has been used as a successful technique in the management of parotid gland fistulas, blastomycosis, tuberculosis, Wharton's tumor, cysts, adenocarcinomas, squamous cell carcinomas, mucoepidermoid carcinomas, abscesses, and chronic suppurations of the gland.
A frozen section may show the lesion to be a lymphosarcoma in which case the wound is closed and external radiation given.
Rarely is it necessary to sacrifice the facial nerve but in some malignancies, particularly squamous cell cancer, this must be done. In this case a nerve graft is performed at the time of the initial surgery.
Biopsy preceding surgery is rarely used, but frozen sections are made during the operation.
The superficial lobe is removed by identifying the tympanomastoid fissure which points directly to the nerve and then separating the posterior margin of the gland from the sternomastoid muscle. Once
KRATZ RC. Problems of the Parotid Gland: Abstract. Arch Otolaryngol. 1965;81(3):262. doi:10.1001/archotol.1965.00750050271014
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