Surgical treatment of salivary gland tumor

Abstract

The salivary glands are divided into two groups : the major glands （parotid, submandibular, sublingual） and minor glands. All salivary glands may be involved by tumor. In our hospital, salivary gland tumors occur much more commonly in the minor glands （minor glands: 72 ％, major glands: 28 ％）（palate: 53 ％, buccal mucosa:15 ％, lip: 13 ％, gingiva: 9 ％, tongue: 5 ％, oral floor: 5 ％）. In the major salivary glands, the majority of tumors occur in the parotid gland （parotid: 52 ％, submandibular: 43 ％, sublingual: 5 ％）. The majority of salivary glands tumors are benign （benign: 78 ％, malignant: 22 ％）. The pleomorphic adenoma is the most common salivary gland benign tumor. The mucoepidermoid carcinoma is the most common malignant salivary gland tumor.
The surgical approach adopted should remove the benign salivary gland tumor in its entirety with a surrounding cuff of normal tissue. In a superficial lobe pleomorphic adenoma of parotid gland, treatment is a superficial parotidectomy. In deep lobe case, a total parotidectomy is required. Benign submandibular gland tumor is excised with extracapsular dissection and excision of the submandibular gland. The malignant salivary gland tumor requires excision with wide margins and in continuity neck dissection. Most of patients who contract malignant salivary gland tumors need to have reconstructive operations （skin graft, local flap, free flap, nerve graft）.