Surgical Techniques in the Treatment of Pleomorphic Adenoma of the Parotid Gland: Our Experience and Review of Literature

Abstract

This paper presents a retrospective study carried out on a sample of 100 patients affected by pleomorphic adenoma of the parotid gland and treated at the Department of Maxillofacial Surgery at the University of Rome "La Sapienza" between January 1, 1989 and December 31, 1997. For the diagnosis of this neoformation, cytological tests were performed on material taken from the neoformation using fine needle aspiration and ultrasound scan. In some selected cases, a CT examination of the head and neck with medium contrast or Nuclear Magnetic Resonance (NMR) was carried out. This study sets out to examine the most suitable treatment to be followed for the removal of the pleomorphic adenoma of the parotid gland. In 56 cases the patients underwent a superficial, conservative parotidectomy. Forty one patients had a total parotidectomy with the facial nerve left intact and one patient had a total parotidectomy where the marginal mandibular nerve of the facial nerve was damaged. The remaining two patients involved in the study were suffering from a recurrent pleomorphic adenoma and in these two cases a total parotidectomy was performed where the facial nerve was killed. The removal of the cranial nerve VII in these patients proved necessary because the nerve fibers had adhered to the surrounding scar tissue of the tumor, either after previous surgery or due to repeated chronic phlogosis of the gland.

WITHDRAWN: Comparison of the effect of total conservative parotidectomy versus superficial parotidectomy in management of benign parotid gland tumor: A systematic review

“…Five studies (Martis, 1983;Corcione and Califano, 1990;Federspil et al, 1994;Van Hee et al, 1996;Marchesi et al, 2006) were judged to be at high risk of bias and 8 studies (Debets and Munting, 1992;Laskawi et al, 1996;Leverstein et al, 1997;Rehberg et al, 1998;Valentini et al, 2001;Guntinas-Lichius et al, 2004;Zernial et al, 2007;Riad et al, 2011) were considered at moderate risk of bias.…”

“…A total of 1291 patients were enrolled in 8 studies (Corcione and Califano, 1990;Laskawi et al, 1996;Leverstein et al, 1997;Rehberg et al, 1998;Valentini et al, 2001;Guntinas-Lichius et al, 2004;Marchesi et al, 2006;Zernial et al, 2007). The total number of patients in the SP group was 1003 and in the TCP group was 288.…”

Microsurgical dissection of facial nerve in parotidectomy: a discussion of techniques and long-term results

“…Ward (12), Woods (13), Aljamo (14), Mehle (9), and Valentini (15) have reported that superficial parotidectomy and/or total parotidectomy with preservation of the facial nerve is the gold standard for excision of parotid tumors. However, in their studies, they report a number of post-operative complications related to facial nerve injury.…”

Multicentric recurrent parotid pleomorphic adenoma in a child

“…In our case, recurrences occurred 7 and 14 years after the initial surgical treatment. The treatment of recurrences is complicated and technically difficult because of the fibrosis, adhesions, and changes in anatomic references that increase the risk of facial nerve lesions (14).…”