Salivary gland tumours can occur in all the main salivary glands and also in the minor salivary glands as well. By the far the commonest is the parotid gland tumour which is usually benign.
The parotid gland lies just in front of the ear and is the most common site for a salivary gland tumour. 80% of tumours affecting the parotid gland are benign and so do not spread to other parts of the body. Benign tumours can continue to grow unless removed by surgery, although this may take many years for the tumour to get to any significant size. If left there is a very small risk that the tumour may turn malignant.
The traditional surgical approach is to remove a large part of the gland within which the tumour lies. This is known as a superficial parotidectomy.
However, a more minimally invasive approach is to remove just the tumour and leave the majority of the salivary gland. This is known as an extracapsular dissection but it is a specialist technique and is not widely available. It has the advantage of reducing the risk of complications and side effects of parotid gland surgery whilst retaining all of the benefits.
With any parotid gland surgery there is a risk of injury to the facial nerve. The facial nerve supplies movement to the muscles of the face and so injury to the nerve causes weakness and decreased movement to the part of the face affected. If injury occurs it is usually temporary but can take several weeks to months to recover completely. The risk of temporary facial nerve weakness with extracapsular dissection is 10% compared with a superficial parotidectomy which is 30%. The risk of permanent nerve weakness is 1-2% for both a superficial parotidectomy or extracapsular dissection.
Frey’s syndrome is a condition where sweating occurs over the cheek upon eating and is caused by nerve damage during surgery. The risk of this is very low with extracapsular dissection at less than 1% but approaches 40% with a superficial parotidectomy.
The scar after an extracapsular dissection will be smaller than that of a superficial parotidectomy.
Other risks and benefits of any proposed surgery will be discussed in detail during your consultation.