A 77-year-old man with a left facial mass presented to the surgical suites for consultation. He had been followed previously by his local ear, nose, and throat surgeon. Over the last 6 years, he had undergone 4 fine-needle aspirations (FNAs) to rule out malignancy. Each time, cytologic analysis showed inflammatory cells involving the parotid salivary gland. His last FNA demonstrated adenocarcinoma. On examination, the patient was a stout man with a wide face. His lips and chin on the left side drooped....