Basic concepts in surgery of the parotid glands.

Surgeons who operate successfully upon patients with non-neoplastic or neoplastic disease of the parotid gland must have special graduate training in this type of surgery. The anatomical nature of the gland, the facial nerve, and surrounding anatomical structures combined with disease all tend to enhance surgical difficulties inherently present. The well trained surgeon is usually successful in avoiding many surgical difficulties. Wound exposure and identification of the facial nerve are discussed at length. Patients undergoing multiple operations fall into a special category since the surgeon who performs the re-operation or re-operations has the responsibility of not only curing the pathological disorder but in addition must be the "protector" of the facial nerve. Early and late surgical complications are discussed with reference to recognition, prevention, and treatment.