Results of extracapsular dissection of pleomorphic adenoma of parotid gland

Piekarski, Janusz; Nejc, Dariusz; Szymczak, Wiesław; Wroński, Konrad; Jeziorski, Arkadiusz

doi:10.1016/j.joms.2004.01.025

Cited by 65 publications

(63 citation statements)

References 29 publications

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“…the rate of recurrence comparing ECD and superficial parotidectomy was 4.5 versus 3.6 % [37], and in a further series of 156 patients followed for a mean of 3 years and 8 months, there were no published cases of recurrence [39 • ]. Against this pattern, there are isolated reports of increased rate of recurrence of up to 8 % with ECD [40]. In this series, an explanation was given by the principal author (personal communication) for the higher rate of recurrence.…”

Section: Recurrence Risk For Bmtmentioning

confidence: 73%

The Role of Extracapsular Dissection for Benign Parotid Tumors

Witt

Iro

McGurk

2014

Curr Otorhinolaryngol Rep

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Surgical treatment of benign parotid tumors has been debated for decades. Extracapsular dissection (ECD) differs markedly from classic surgical approaches to the parotid neoplasm because facial nerve dissection is not performed. ECD, its advantages, disadvantages, indications, and contra-indications for benign tumors with an emphasis on benign mixed tumor will be comprehensively explored in this chapter. Factors noted to favor this approach include mobility of the tumor within the gland, a thin covering of capsule and glandular tissue, and a tumor large enough to allow digital manipulation during dissection. Imaging, fine needle aspiration cytology, and neuromonitoring play a heightened role in ECD. Recurrence and permanent facial nerve dysfunction with ECD are not higher in high volume centers performed by experienced surgeons. Transient facial nerve dysfunction, Frey's syndrome, sensory deficits, and sialocele are lower with ECD. Devastating adverse outcomes of permanent facial nerve dysfunction and recurrence should be considered by the occasional and inexperienced parotid surgeon.

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Section: Recurrence Risk For Bmtmentioning

confidence: 73%

The Role of Extracapsular Dissection for Benign Parotid Tumors

Witt

Iro

McGurk

2014

Curr Otorhinolaryngol Rep

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“…This series also demonstrates that the technique is transferable from specialist centres after appropriate training. PIEKARSKI et al 13 thought the technique should not be practised by surgeons in training before their skills had been developed through classical parotidectomy procedures.…”

Section: Discussionmentioning

confidence: 99%

Extra-capsular dissection for benign parotid tumours

Shehata

2010

International Journal of Oral and Maxillofacial Surgery

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“…[1][2][3][4] Pleomorphic adenoma is most common in middle age and in women, 5 and although rare in children, it remains the most common solid parotid mass in the pediatric population. [6][7][8][9] These tumors arise directly from salivary gland tissue and consist of epithelial and mesenchymal cells; the latter can give rise to osseous, cartilaginous, hyaline, and myxoid elements, hence the name "mixed tumor."…”

Section: Discussionmentioning

confidence: 99%

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2012

J Neurol Surg Rep

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A 53-year-old man presented to the emergency department with a 7-day history of right ear fullness, otalgia, and hearing loss. He had recently been treated with antibiotics for sinusitis at an outside hospital but his symptoms failed to resolve. He denied vertigo, dizziness, otorrhea, or tinnitus. Physical examination demonstrated a mass behind an intact right eardrum, and tuning fork evidence of a conductive hearing loss. The remainder of his cranial nerve examination was normal, with the exception of the long-standing HouseBrackmann Grade VI/VI right facial nerve paralysis. Audiogram demonstrated a right moderate conductive hearing loss with flat (Type B) tympanogram. The left side was normal.The patient had a right parotid pleomorphic adenoma 35 years ago, which was treated by enucleation. He presented with several subcutaneous nodules 7 years after the initial treatment, which were treated by total parotidectomy. During surgery the facial nerve was sacrificed due to tumor encasement. Pathology confirmed recurrent pleomorphic adenoma. Postoperatively the tumor bed was treated with external beam radiotherapy. After this he remained asymptomatic for nearly 30 years.Magnetic resonance imaging of the head confirmed a large, irregular, heterogeneous, and variably enhancing mass in the right mastoid with extension medially along the floor of the posterior fossa measuring $5 Â 5 Â 5 cm (►Fig. 1). The mass eroded through the mastoid laterally and inferiorly into the upper cervical soft tissues. The superior portions of the mastoid were opacified with enhancement, suggesting tumor infiltration. The mass extended inferiorly into the parapharyngeal space and extrinsically compressed the right sigmoid sinus displacing it medially. In addition, a 1 Â 1 cm enhancing nodule in the right cerebellum medial to the cystic lesion was observed. The differential diagnosis at this point included carcinoma ex AbstractPleomorphic adenoma, also known as benign mixed tumor, is the most common tumor affecting the parotid gland and can reach massive size; however, intracranial invasion is rare. Recurrence of pleomorphic adenoma after excision is a well-known phenomenon and can present decades after resection of the primary tumor. Here we present the case of a 53-year-old man who presented to our clinic with ear fullness, otalgia, and hearing loss 30 years after undergoing total parotidectomy and external beam radiotherapy for pleomorphic adenoma. Magnetic resonance imaging revealed a massive transcranial tumor invading the mastoid cavity, the dura of the posterior fossa, the fallopian and semicircular canals, the jugular foramen, the lateral infratemporal fossa skull base, the sigmoid and transverse sinuses, and the superior parapharyngeal region. Gross examination and histopathological studies confirmed that the mass was a recurrent pleomorphic adenoma. Here we discuss the features of recurrent pleomorphic adenoma and review the current literature.

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Results of extracapsular dissection of pleomorphic adenoma of parotid gland

Cited by 65 publications

References 29 publications

The Role of Extracapsular Dissection for Benign Parotid Tumors

The Role of Extracapsular Dissection for Benign Parotid Tumors

Extra-capsular dissection for benign parotid tumours

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