Cancer of the parotid gland: role of 7th nerve preservation.

Most neoplasms arising in the parotid gland are benign. Patients with cancer of the parotid gland usually present with normal facial nerve function. In these patients, findings at the time of surgery will guide the management of the facial nerve, with most surgeons preserving the nerve unless it is adherent to, or imbedded in, a malignant tumor. In cases where the margins of resection are close to the facial nerve, adjuvant radiotherapy administered postoperatively has significantly improved local control of disease. The minority of patients with parotid cancer who present with facial nerve palsy has a poor prognosis despite extensive surgical resection including the facial nerve.