The management of parotid neoplasms.

In recent years, the management of parotid gland neoplasms has changed considerably, to include a more aggressive surgical approach and multimodality therapy. An organized approach to surgical management and the rationale for postoperative irradiation for selected tumors are presented. A review of several studies supporting the efficacy of postoperative irradiation is included. The principles of palliative management of adenoidcystic carcinoma are unlike those for most other malignancies, and include repeated use of limited procedures to control local and regional disease over extended periods of time, and delayed treatment of distant disease until the patient becomes symptomatic.