Management of Minor Salivary Tumours in Head and Neck

Minor salivary gland tumours are uncommon and account for only 2-4% of head and neck neoplasms. Mostly salivary gland tumours are benign. Most of minor salivary gland tumours begin in the palate, but also in the lips, tongue, mouth, throat, voice box, nose and sinuses. The most common benign tumours are mixed and Warthin's tumour and the most common minor salivary gland cancer are adenoid cystic carcinomas and adenocarcinomas. Among the main risk factors for salivary gland cancer is exposure to ionizing radiation. Fine needle aspiration biopsy is the most frequent procedure used for diagnosing salivary gland neoplasm. The aim of this article is to discuss the treatment methods and the particularities of surgery in salivary gland cancer. The treatment options and the extent of surgical resection are dictated by the stage of the cancer, by the tumour pathology and by the evidence of perineural spread. For the maxilla and infratemporal fossa, the functional results of the surgery may be achieved by reconstructing the defects with flaps (rotational flaps or free flaps). The main treatment for malignant salivary gland tumours is complete surgical removal of the tumour including a cuff of histologically normal tissue for adequate margins. The limitations of surgical edges can be completed with radiotherapy. Both radiotherapy and chemotherapy can be considered as an adjuvant for intermediate or high grades tumours. Aggressive follow-up of the patient is mandatory for salivary gland cancer. The treatment option for benign tumours is simple tumour excision.