Parotid function after selective deep lobe parotidectomy.

Selective deep lobe parotidectomy is a demanding technique, but it preserves healthy glandular tissue, improves cosmetic results and minimises the incidence of Frey's syndrome. We have evaluated postoperative function of the superficial lobe of the parotid after selective resection of the deep lobe. Fourteen patients who each had a mass involving the deep lobe of the parotid were selected from 127 patients with tumours of the parotid gland who were seen and treated between January 2001 and March 2004. Of the 14, 12 matched the study criteria. The preoperative diagnosis was made using both computed tomography (CT) and ultrasound or fine needle aspiration cytology, and the diagnosis was confirmed by histological analysis. All cases were treated by the same surgeon. At 6 months follow-up all patients had a House-Brackmann test, iodine starch test, and scintigraphy of both parotid glands. After scintigraphy the maximum uptake value and function of the gland were evaluated with the concentration index (CI) and the CI percentage ratio. The concentration function of the gland in the resected side of the study group had a mean (S.D.) CI index of 5.5 (3.6) and a CI percentage ratio of 84%. Selective deep lobe parotidectomy has the following advantages: it minimises the impact of treatment on the facial contour, it does not increase postoperative morbidity and it preserves the function of the gland.