6.3.4: 4. Clinical Evaluation- History and Examination
- Page ID
- 18310
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- Objectives
- Avoid unnecessary surgery for e.g. infective or non-neoplastic masses, lymphoma, unresectable tumour
- Do appropriate surgery
- Avoid embarking on surgery that is beyond the scope of a surgeon e.g. deep lobe tumour, tumour extending to the parapharyngeal space, tumour requiring neck dissection, or tumour requiring facial nerve reconstruction
- Malignant parotid tumours may have clinically benign features
- Consider lymphoma
- Past lymphoma
- HIV +ve
- Cervical / generalised lymphadenopathy
- Suspicious for malignancy
- Pain
- Rapid growth
- Neurological deficits
- Facial nerve: Facial twitching or weakness
- Trigeminal nerve
- Greater auricular nerve
- Skin invasion
- Muscle invasion….trismus
- Cervical nodes
- Prior skin/conjunctival cancer/melanoma
- Previous salivary cancer
- Previous radiation to salivary gland region