Excision of Deep Lobe Parotid Tumor

Kepal N. Patel MD; Jatin P. Shah MD, FACS

Product Details
Product ID: ACS-2371
Year Produced: 2005
Length: 7 min.


Tumors arising in the deep lobe of the parotid gland are rare, however they represent the most common neoplasms encountered in the parapharyngeal space. By definition, they arise in parotid tissue lying medial to the facial nerve. Patients usually present with diffuse enlargement and fullness in the retromandibular portion of the gland. Swelling of the soft palate associated with a parotid mass is diagnostic of a tumor originating in the deep lobe of the parotid gland. Appropriate surgical management is the mainstay of treatment and is necessary to minimize risk of recurrence and facial nerve injury. Knowledge of the anatomy of the parapharyngeal space is crucial in planning the approach. Appropriate preoperative workup including CT/MR imaging helps evaluate the extent and nature of disease. This video demonstrates the technical complexities and considerations involved in excision of lesions of the deep parotid lobe. We present a 73 year old male with a large right parapharyngeal space tumor consistent with a deep lobe parotid neoplasm. A superficial parotidectomy is initially performed to help identify and protect the facial nerve and its branches. The deep lobe parotid tumor is then excised. The surgical anatomy and procedure along with the postoperative management is outlined. Familiarity with the management of parotid neoplasms is necessary for surgeons involved in the care of patients with salivary gland tumors.