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European Archives of Oto-Rhino-Laryngology

, Volume 274, Issue 11, pp 3825–3836 | Cite as

Surgical options in benign parotid tumors: a proposal for classification

  • Miquel QuerEmail author
  • Vincent Vander Poorten
  • Robert P. Takes
  • Carl E. Silver
  • Carsten C. Boedeker
  • Remco de Bree
  • Alessandra Rinaldo
  • Alvaro Sanabria
  • Ashok R. Shaha
  • Albert Pujol
  • Peter Zbären
  • Alfio Ferlito
Review Article

Abstract

Different surgical options are currently available for treating benign tumors of the parotid gland, and the discussion on optimal treatment continues despite several meta-analyses. These options include more limited resections (extracapsular dissection, partial lateral parotidectomy) versus more extensive and traditional options (lateral parotid lobectomy, total parotidectomy). Different schools favor one option or another based on their experience, skills and tradition. This review provides a critical analysis of the literature regarding these options. The main limitation of all the studies is the bias of selection for different surgical approaches. For this reason, we propose a staging system that could facilitate clinical decision making and the comparison of results. We propose four categories based on the size of the tumor and its location within the parotid gland. Category I includes tumors up to 3 cm, which are mobile, close to the outer surface and close to the parotid borders. Category II includes deeper tumors up to 3 cm. Category III comprises tumors greater than 3 cm involving two levels of the parotid gland, and category IV tumors are greater than 3 cm and involve more than 2 levels. For each category and for the various pathologic types, a guideline of surgical extent is proposed. The objective of this classification is to facilitate prospective multicentric studies on surgical techniques in the treatment of benign parotid tumors and to enable the comparison of results of different clinical studies.

Keywords

Benign parotid tumors Pleomorphic adenoma Warthin’s tumor Parotidectomy Superficial parotidectomy Partial parotidectomy Extracapsular dissection 

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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Miquel Quer
    • 1
    • 2
    Email author
  • Vincent Vander Poorten
    • 2
    • 3
  • Robert P. Takes
    • 4
  • Carl E. Silver
    • 5
  • Carsten C. Boedeker
    • 6
  • Remco de Bree
    • 7
  • Alessandra Rinaldo
    • 8
  • Alvaro Sanabria
    • 9
  • Ashok R. Shaha
    • 10
  • Albert Pujol
    • 1
  • Peter Zbären
    • 2
    • 11
  • Alfio Ferlito
    • 12
  1. 1.Department of Otolaryngology-Head and Neck SurgeryUniversity Hospital de la Santa Creu i Sant Pau, Universitat Autonòma de BarcelonaBarcelonaSpain
  2. 2.European Salivary Gland SocietyGenevaSwitzerland
  3. 3.Otorhinolaryngology-Head and Neck Surgery and Department of Oncology, Section Head and Neck OncologyUniversity Hospitals Leuven, KU LeuvenLeuvenBelgium
  4. 4.Department of Otolaryngology-Head and Neck SurgeryRadboud University Medical CenterNijmegenThe Netherlands
  5. 5.Department of SurgeryUniversity of Arizona College of MedicinePhoenixUSA
  6. 6.Department of Otorhinolaryngology-Head and Neck SurgeryHELIOS HanseklinikumStralsundGermany
  7. 7.Department of Head and Neck Surgical Oncology, Utrecht Cancer CenterUniversity Medical Center UtrechtUtrechtThe Netherlands
  8. 8.University of Udine School of MedicineUdineItaly
  9. 9.Department of Surgery, School of MedicineUniversidad de Antioquia, Fundación Colombiana de Cancerología -Clínica VidaMedellinColombia
  10. 10.Head and Neck Service, Memorial Sloan-Kettering Cancer CenterNew YorkUSA
  11. 11.Department of Otorhinolaryngology-Head and Neck SurgeryUniversity HospitalBerneSwitzerland
  12. 12.Coordinator of the International Head and Neck Scientific Group, International Head and Neck Scientific GroupPaduaItaly

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