Partial Parotidectomy Including Deep Lobe and Dumb Bell Tumours

The traditional procedures in the treatment of parotid gland tumours have been superficial and total parotidectomy. However, during the twentieth century, it became apparent that less parotid tissue could be resected reducing the high morbidity and complication rates associated with comprehensive surgery whilst maintaining similar outcomes in tumour control. Partial parotidectomy has now emerged as a standard of care in the treatment of parotid gland pathology. The definition of partial parotidectomy is not well established, but the basis is to remove less parotid tissue than in a comprehensive parotidectomy. In 2016, the European Salivary Gland Society proposed the term “partial parotidectomy” as the procedure based on the dissection of the facial trunk and the removal of, at least, one of the parotid levels according to the ESGS proposal (Fig. 16.1) [2]. This definition is a little cumbersome as it excludes one of the other partial parotid resection techniques that has emerged in extracapsular dissection. The main differences with extracapsular dissection are that this method does neither include the intentional dissection of the facial nerve nor a cuff of normal parotid tissue.