Total parotidectomy--a routine treatment for parotid gland swellings?

The results of 25 years of quasi-routine total parotidectomy performance are shown. At the Department of Otolaryngology of the University of Florence, 582 patients were treated as follows: on 527 occasions by total parotidectomy with facial nerve preservation; 24 occasions by lateral lobectomy; 27 occasions by total parotidectomy with removal of the whole facial nerve; four times by enucleo-resection of the disease. Benign tumours were 378; primary and metastatic malignant tumours--100; non tumoral lesions--104. The benign tumours follow-up showed three recurrences only (two pleomorphic adenomas--one of them proved to be an adenoid-cystic carcinoma, and one monomorphic adenoma, which also proved to be an adenoid-cystic carcinoma), respectively 6, 6 and 8 years later. The malignant tumours were also treated by total parotidectomy with adequate management both of the facial nerve and the neck lymph nodes. The results thoroughly justify the nerve preservation, when preserved.