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0:00
This is part two
of my talk on swellings
and lumps arising
in the salivary gland tissue.
It's Professor John Langdon
once again.
We'll start with management
of salivary gland neoplasms.
0:17
I'm not, in this talk,
talking very much about
management
of salivary gland diseases at all
because it's not your remit
but there are some important
background points to make.
This slide repeats
what I've labored previously
that the majority of tumors arise
in the parotid
and 75% of them are benign.
0:39
This slide is a specimen
of superficial parotidectomy,
and you're looking
at the deep aspect.
And you can see
at the edge of the specimen
is the normal healthy
parotid tissue
of the superficial lobe.
Within that, you can see
a benign pleomorphic adenoma
which is lobulated
and is not covered by normal
unaffected parotid tissue.
In other words, when you dissect
in the plane of the facial nerve,
more often than not,
the nerve is in direct contact
with the tumor.
1:21
This is the histology
of that specimen
showing one of the oscillations
or nodules arising
from the pleomorphic adenoma.
And you can see that the capsule
is deficient around
the actual nodule.
Now this means that
although we talk about
formal parotidectomy
with the dissection
of the facial nerve
as being the gold standard
for the management
of parotid tumors,
we kid ourselves
if we think
we're removing the tumor
with a cuff of unaffected tissue,
we're not.