Extra-capsular dissection for benign parotid tumours

The most common benign tumour of the parotid is pleomorphic adenoma (PA). Some studies have shown that limited surgery to manage these types of tumours is viable option. Extra-capsular dissection (ECD) is one of these minimally invasive techniques. This study aimed to evaluate the morbidity associated with ECD in managing benign parotid tumours and to demonstrate that the technique can be used outside specialist centres. Twenty-six consecutive patients, diagnosed with benign parotid gland tumours were treated by ECD. Their benign status was determined by history, clinical criteria and fine needle aspiration cytology. Inclusion criteria were a discrete mobile lump, more than 3 cm in diameter and clinical/histological evidence of benign biological behaviour. A single surgeon (the author) operated on all cases. Follow up ranged from 2 to 72 months. In 23 patients, the tumour was located entirely within the superficial lobe of the parotid. Postoperative pathology consisted mainly of 17 PA. Fifteen percent had transient damage to the facial nerve. None had recurrence. ECD seems to be an alternative to superficial parotidectomy for most superficial parotid lumps. It appears to be a safe technique in trained hands.