PURPOSE: Surgical treatment of benign parotid tumors has developed in the direction of less invasive procedures in recent years and has raised great debate about the best surgical approach. Aim of this article is to analyse anatomical and other factors that are important in selection of the appropriate surgical technique in treatment of benign parotid tumors. Furthermore, to discuss the risk of complications and recurrent disease according to selected operation. Finally, to define patient selection criteria to facilitate decision making in parotid surgery and become a guide for younger surgeons. METHODS: Literature review and authors' personal opinions based on their surgical experience. RESULTS: All possible surgical techniques for benign parotid surgery with advantages and disadvantages are being described. An algorithm with anatomical and other criteria influencing decision making in benign parotid surgery is presented. CONCLUSION: Surgeons nowadays have many options to choose from for benign parotid surgery. ECD is one of the many surgical techniques available in parotid surgery and can achieve excellent results with proper training and if used for proper indications. PSP is mainly indicated in large tumors of the caudal part of the PG (ESGS level II). SP represents a universal solution in parotid surgery and should be the first technique young surgeons learn. TP has only few but important indications in benign parotid surgery. Surgeons need to carefully consider the patient and his/her preoperative imaging as well as her or his own special expertise to select the most appropriate surgical technique.

1st Department of ORL Head and Neck Surgery Aristotle University AHEPA Hospital Thessaloniki Greece

Department of Otorhinolaryngology and Head and Neck Surgery 1st Faculty of Medicine Charles University Motol University Hospital 5 Uvalu 84 150 06 Prague 5 Czech Republic

Department of Otorhinolaryngology and Head and Neck Surgery LMU Klinikum Marchioninistr 15 81377 Munich Germany

Department of Otorhinolaryngology and Head and Neck Surgery University Hospital Augsburg Sauerbruchstraße 6 86179 Augsburg Germany

Department of Otorhinolaryngology and Head and Neck Surgery University Hospital Ioannina Leof Stavrou Niarchou 455 00 Ioannina Greece

Department of Otorhinolaryngology and Head and Neck Surgery University Hospital Regensburg Franz Josef Strauss Allee 11 93053 Regensburg Germany

Department of Otorhinolaryngology Head and Neck Surgery Faculty of Medicine University of Freiburg Freiburg Germany

Department of Otorhinolaryngology Head and Neck Surgery Jena University Hospital Jena Germany

Department of Otorhinolaryngology Universitätsklinikum Hamburg Eppendorf Martinistr 52 20246 Hamburg Germany

Multidisciplinary Salivary Gland Society Geneva Switzerland

Otorhinolaryngology Head and Neck Surgery and Department of Oncology Section Head and Neck Oncology University Hospitals Leuven KU Leuven Louvain Belgium

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Utility of fine-needle aspiration biopsy (FNAB) in parotid pleomorphic adenoma diagnosis and management

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