What are the current indications for total parotidectomy?

Rodrigo Arrangoiz MS, MD, FACS, FSSO
  • Intraparotid lymph node metastases from an extraparotid tumor, usually skin neoplasms (e.g., basal cell carcinoma, melanoma, squamous cell carcinoma, Merkel cell carcinoma, etc.)
    • Regardless of the lobe in which the metastasis is found, but strictly necessary in those located in the deep lobe
  • Intraparotid lymph node metastasis from a primary tumor of the parotid gland:
    • Regardless of the lobe in which the metastasis is identified, but strictly necessary in those located in the deep lobe
  • Primary parotid gland tumor with metastasis to regional cervical nodes [N+]
  • High-grade malignant primary tumor of the parotid gland with known high risk of regional lymph node metastasis
  • Malignant primary tumor of the deep lobe of the parotid gland
  • Benign primary tumor of the superficial lobe with extension to the deep lobe:
    • The latter scenario is usually managed, in most cases, by superficial parotidectomy associated with a partial excision of the deep lobe
  • Benign primary tumor of the deep lobe requiring a superficial parotidectomy “of necessity” for excision (in other words, those in which it is not possible to perform a deep parotidectomy while preserving the superficial lobe)
  • Malignant primary tumor of the parotid gland with invasion of surrounding soft tissues
  • Primary tumor of the parotid gland with a high rate of multifocality (to ensure complete removal, e.g., oncocytomas).
  • Bibliography:
  1. Olsen KD, Moore EJ. (2014) Deep lobe parotidectomy: clinical rationale in the management of primary and metastatic cancer. Eur Arch Otorhinolaryngol. 271(5):1181-5.
  2. Olsen KD, Quer M, de Bree R, Vander Poorten V, Rinaldo A, Ferlito A. (2017) Deep lobe parotidectomy-why, when, and how? Eur Arch Otorhinolaryngol. 274(12):4073-4078.
  3. Thom JJ, Moore EJ, Price DL, Kasperbauer JL, Starkman SJ, Olsen KD. (2014) The Role of Total Parotidectomy for Metastatic Cutaneous Squamous Cell Carcinoma and Malignant Melanoma. JAMA Otolaryngol Head Neck Surg. 140(6):548-54.
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Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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