Fig. 263.—Mixed Tumour of Parotid.
Fig. 264.—Mixed Tumour of the Parotid of over twenty years' duration.
Although usually benign, these tumours may, after lasting for years, take on malignant characters, growing rapidly, implicating adjacent lymph glands, and showing a marked tendency to recur after removal.
The treatment consists in shelling out the tumour, care being taken to avoid injuring the facial nerve or the parotid duct by making the incision and the subsequent cuts in the dissection run parallel to them. If the tumour is removed early and completely, recurrence is the exception.
Sarcoma and carcinoma are rare. They are very malignant, grow rapidly, infiltrate surrounding parts, including the skin, and infect the adjacent lymph glands. There is severe neuralgic pain, and paralysis from involvement of the facial nerve is an early symptom.
The treatment consists in excising the whole of the parotid gland with the tumour, no attempt being made to conserve the facial nerve or other structures traversing it. Recourse should be had to the use of radium both before and after operation, otherwise recurrence is all but inevitable.
The submaxillary and sublingual glands may be the seat of the same varieties of tumour as the parotid. These glands are particularly liable to become invaded along with the adjacent lymph glands in epithelioma of the tongue and floor of the mouth.