Superficial parotidectomy is the biopsy procedure of choice for all parotid neoplasm's as well as therapeutic choice for small low-grade malignancies. The key to successful parotid surgery is identification of the facial nerve. It is usually done under general anesthesia (GA).The main focus in this procedure is to remove entire superficial parotid gland along with a disease and at the same time preventing any iatrogenic injury to facial nerve and its peripheral branches which supplies over the face. We present three cases of superficial parotidectomies done under local anesthesia technique. The objectives of these reports are to discuss the clinical presentation, diagnosis and management of these growths surgically under local as an alternative method or when it is desired under some special circumstances and the merits. This technique may avoid the use of facial nerve monitor.

Pleomorphic adenoma is the most common salivary gland tumor. It possesses epithelial and myoepithelial elements with mucoid, myxoid, or chondroid tissue in a mucopolysaccharide stroma. Pleomorphic adenoma of submandibular gland is generally seen in middle aged women. It presents as a solitary, well defined, painless slowly growing benign tumor but can turn malignant. USG, FNAC and CT scan help in establishing diagnosis, extent and tumor’s relation with surrounding structures. Surgical excision is treatment of choice because of chances of malignant transformation.Our case was a young male who presented with right sided upper neck swelling for four months. It was painless, progressive and without any pressure symptoms. On examination, a 3 x 2 cm, globular swelling was seen in the right submandibular region. It was firm, non tender, mobile and ballotable on bidigital palpation. USG neck revealed a 2.1 x 2.7 x 3.1 cm well defined hypoechoic lesion in right submandibular gland. FNAC reported a pleomorphic adenoma.Gland was excised under general anaesthesia. Skin incision was given 2 cm below right mandible. Subplatysmal flaps were raised. Gland was excised in totality with precise dissection, preserving marginal mandibular nerve. Histopathological examination reported a final diagnosis of Pleomorphic Adenoma of right submandibular gland.

Branchial cysts although common, should be managed with great precision because of their proximity to vital neurovascular structures. This case series illustrates how tricky can branchial cysts get, especially during dissection. The third case report demonstrates how branchial cysts can be misdiagnosed with other lesions, thus delaying treatment.

Cystic Hygroma although common in children, can also present in adults. It should be managed with great precision because of its proximity to vital anatomy. This case report discusses a rare presentation of a 52 years old adult presenting with cystic hygroma. It illustrates how difficult can cystic hygroma get, especially during dissection. In this case, careful delineation of structures was done to excise the mass without injury to surrounding nerves and vessels. Cystic hygromas do not resolve spontaneously and surgical excision is the treatment of choice in such cases.