Deep lobe parotidectomy: clinical rationale in the management of primary and metastatic cancer.

Deep lobe parotidectomy is an important management approach for highgrade primary parotid cancers that metastasize to the deep lobe nodes and for cancers that metastasizes to the deep parotid from a site outside the parotid. This paper reviews the rationale for deep lobe parotidectomy with facial nerve preservation for these parotid cancers. Deep lobe parotid involvement was reviewed in 27 patients. Twelve patients had primary parotid tumors that metastasized to the deep lobe, and 15 had tumors outside the parotid that metastasized to deep parotid nodes. Deep lobe parotidectomy should be considered in patients with a highgrade primary parotid tumor, a cancer that metastasizes to a superficial intraparotid node, or a primary parotid malignancy that metastasizes to a superficial parotid node or a neck node.