eRadiograph Volume 7: Imaging of Oral Cavity | Page 229

parotid gland. Very rarely may other neoplasms metastasize to the intraparotid lymph
nodes.
On imaging it is difficult to differentiate between benign enlarged lymph nodes and
neoplastic.
Staging of parotid neoplasmsTNM staging
T1- Less than 2 cm
T2- Between 2 and 4 cm
T3- Larger than 4 cm or those that demonstrate extra glandular or extraparenchymal
extension.
T4A- Moderately advanced disease (potentially resectable) Skin invasion, mandible,
external auditory canal, facial nerve.
T4 B- Very advanced local disease skull base and/ or pterygoid plates invasion and/or
encases the internal carotid artery.
N0- No neck nodes
N1- Ipsilateral nodes less than 3 cm
N2A- Single ipsilateral node between 3 and 6 cm
N2B - Multiple ipsilateral nodes not more than 6 cm
N2C- Bilateral/ contralateral nodes not more than 6 cm

M0 - No distant metastases
M1- Distant metastases
Treatment of most parotid lesions is by surgery. It is important to preserve the facial
nerve, therefore the facial nerve should be traced, any extension to deep lobe be
identified prior to surgery. Benign lesions in the superficial gland are treated by

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Parotid Space

N3- Metastases in nodes greater than 6 cm