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General considerations for treatment

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Some points of consideration in the treatment of salivary gland malignancy include:

  • tumours in the parotid region should be removed by complete local excision - superficial parotidectomy
  • tumours in the submandibular region require that the entire submandibular triangle be cleared
  • complete excision is usually sufficient for localised, low-grade malignancy
  • post-operative radiotherapy should be administered for high-grade malignancy and for incomplete excision
  • clinically involved lymph nodes should be removed by an appropriate neck dissection, but prophylactic neck dissection is unneccessary except possibly for submandibular cancers
  • radical surgery is not usually performed when distant metastases are present, except for adenoid cystic carcinoma
  • the facial nerve should be preserved unless it is paralysed or found to be invaded by tumour. If it must be divided, it can be reconstructed using a nerve graft, e.g. sural nerve. Such grafts are effective in about 60% of cases but complete recovery may take up to 2 years.

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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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