ABSTRACT
Extracapsular dissection (ECD) is an example of the general move towards more minimally invasive procedures. The reputation for pleomorphic adenomas having a propensity to recur is largely undeserved. The reason for this is that in the 1930s, when the high incidence of recurrence was noticed, these lesions were thought to be hamartomas and not true neoplasms. They were called pathological adenomas. ECD is only appropriate for benign tumours of the parotid gland. It has no application in the submandibular gland because the morbidity of submandibular ECD and submandibular gland removal are the same. Every effort should be taken to avoid inadvertent ECD of a salivary malignancy. The patient’s neck is extended as it makes the parotid gland more prominent; this can be done by placing a small pack beneath the nape of neck. The key to ECD is finding a safe plane in which to dissect.
