Pleomorphic adenoma of an unusual size in the deep lobe of the parotid gland

The role of trans-oral digital pressure in the removal of large dumbbell shaped tumor from deep lobe of parotid gland

A 44-year-old male patient, a cardiothoracic surgeon by profession, presented with a tumor arising from the deep lobe of the right parotid gland. Investigations confirmed its para-pharyngeal location and its dumbbell shape. A total conservative parotidectomy was performed preserving full function of the facial nerve. The case is presented because of the unique technique used for this procedure.

Stylomandibular tenotomy in the transcervical removal of large benign parapharyngeal tumours

We used a simple modification of the transcervical approach in a selected group of nine patients with large benign parapharyngeal space tumours, all of whom met the following inclusion criteria: The tumour was benign on fine needle aspiration, the encapsulated tumour was not attached to skull base or great vessels in the parapharyngeal space on imaging. Adequate exposure was achieved by just dividing the stylomandibular ligament and retracting the mandible anteriorly. It was possible to remove the tumours successfully and safely in all nine patients without the need for mandibulotomy or superficial parotidectomy. In seven cases, the tumour crossed the midline. There were no major perioperative neurological or vascular complications. On subsequent follow up, there were no clinical or radiological signs of residual or recurrent tumour.