Extracapsular parotidectomy

An alternative to a parotidectomy, a less invasive operation does exist referred to as a extracapsular parotidectomy. This is not an operation practiced by all surgeons!

The concept behind it in comparison with the traditional parotidectomy is that the facial nerve is not sought for prior to the removal of the tumour. The tumour is removed from the parotid gland alone, not with any parotid tissue.

The benefits include not so large an operation with potentially decreased complications

The problems associated with it include the incidental malignant tumour being found, poor margins/spillage on tumour removal (therefore risk of recurrence), the potential risk to a branch of the facial nerve deeper than the tumour.

I do not perform a extracapsular dissection. It is my feeling that this operation is suitable for very small localised superficial tumours. I also feel happier identifying the nerve at the start of the operation which anatomically is in a set position and I fell I perform a thourough operation for the patient with minimal risk of tumour spillage.

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