Parotidectomy for benign tumors is undergoing constant evolution. The potential for recurrence and malignant transformation of pleomorphic adenomas creates complexities that have forced head and neck surgeons to undertake more comprehensive parotid surgery with facial nerve dissection. This approach carries inherent morbidities, including facial nerve injury, Frey syndrome, and facial asymmetry, that have to be addressed. Extracapsular dissection is compared with conventional superficial parotidectomy; surgical histologic findings are discussed as well as outcome data. More novel approaches are discussed as well. This article provides a systematic approach to benign parotid tumor surgery.
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