Advertisement

Pleomorphic adenoma of the parotid gland: a 13-year experience of consequent management by lateral or total parotidectomy

  • Orlando Guntinas-LichiusEmail author
  • Carsten Kick
  • J. Peter Klussmann
  • Markus Jungehuelsing
  • Eberhard Stennert
Miscellaneous

Abstract

Optimal surgical management of parotid pleomorphic adenoma is important because of a considerable risk of tumour recurrence and complications. Our series of primary surgery cases with standardised parotidectomy technique in a university hospital were evaluated. Medical records of 295 patients treated from 1987 to 1999 were reviewed, and 171 patients answered a questionnaire about long-term sequelae. Sixty-two patients reporting major complications were re-examined in the hospital. At a mean follow-up of 8 years, one patient (0.6%) re-appeared with a recurrence. Twenty-four percent left the hospital with a partial and 3% with a complete paresis. Only 5% developed a permanent partial paresis, whereas a permanent total paresis was not seen. Half of the patients indicated gustatory sweating, but treatment was required in only 6%. Other major permanent complications were not seen. Treatment of pleomorphic adenoma by standardised parotidectomy in a university hospital demonstrates favourable results with low perioperative and long-term morbidity, as well as minimal risk of tumour relapse.

Keywords

Outcome Parotid Parotidectomy Pleomorphic adenoma Salivary gland 

References

  1. 1.
    Bradley PJ (2001) Recurrent salivary gland pleomorphic adenoma: etiology, management, and results. Curr Opin Otolaryngol Head Neck Surg 9:100–108CrossRefGoogle Scholar
  2. 2.
    Fee WE Jr, Goffinet DR, Calcaterra TC (1978) Recurrent mixed tumours of the parotid gland—results of surgical therapy. Laryngoscope 88:265–273PubMedGoogle Scholar
  3. 3.
    Hancock BD (1999) Clinically benign parotid tumours: local dissection as an alternative to superficial parotidectomy in selected cases. Ann R Coll Surg Engl 81:299–301PubMedGoogle Scholar
  4. 4.
    Helmus C (1997) Subtotal parotidectomy: a 10-year review (1985 to 1994). Laryngoscope 107:1024–1027PubMedGoogle Scholar
  5. 5.
    Helmus C (1999) Conservative vs superficial parotidectomy for benign lesions of the parotid tail [comment]. Arch Otolaryngol Head Neck Surg 125:1166–1167Google Scholar
  6. 6.
    Henriksson G, Westrin KM, Carlsoo B, Silfversward C (1998) Recurrent primary pleomorphic adenomas of salivary gland origin: intrasurgical rupture, histopathologic features, and pseudopodia. Cancer 82:617–620CrossRefPubMedGoogle Scholar
  7. 7.
    Krolls SO, Boyers RC (1972) Mixed tumours of salivary glands. Long-term follow-up. Cancer 30:276–281PubMedGoogle Scholar
  8. 8.
    Laccourreye H, Laccourreye O, Cauchois R, Jouffre V, Menard M, Brasnu D (1994) Total conservative parotidectomy for primary benign pleomorphic adenoma of the parotid gland: a 25-year experience with 229 patients. Laryngoscope 104:1487–1494PubMedGoogle Scholar
  9. 9.
    Laskawi R, Schott T, Mirzaie-Petri M, Schroeder M (1996) Surgical management of pleomorphic adenomas of the parotid gland: a follow-up study of three methods. J Oral Maxillofac Surg 54:1176–1179PubMedGoogle Scholar
  10. 10.
    McGurk M, Renehan A, Gleave EN, Hancock BD (1996) Clinical significance of the tumour capsule in the treatment of parotid pleomorphic adenomas. Br J Surg 83:1747–1749PubMedGoogle Scholar
  11. 11.
    Minor V (1928) Ein neues Verfahren zu der klinischen Untersuchung der Schweißabsonderung. Dt Z Nervenheilk 101:302–309Google Scholar
  12. 12.
    Myssiorek D (1999) Removal of the inferior half of the superficial lobe is sufficient to treat pleomorphic adenoma in the tail of the parotid gland [see comments]. Arch Otolaryngol Head Neck Surg 125:1164–1165PubMedGoogle Scholar
  13. 13.
    Naeim F, Forsberg MI, Waisman J, Coulson WF (1976) Mixed tumours of the salivary glands. Growth pattern and recurrence. Arch Pathol Lab Med 100:271–275Google Scholar
  14. 14.
    Natvig K, Soberg R (1994) Relationship of intraoperative rupture of pleomorphic adenomas to recurrence: an 11–25 year follow-up study. Head Neck 16:213–217PubMedGoogle Scholar
  15. 15.
    Patey D, Thackeray AC (1957) The treatment of parotid tumours in the light of a pathological study of parotidectomy material. Br J Surg 45:477–487Google Scholar
  16. 16.
    Sittel C, Stennert E (2001) Prognostic value of electromyography in acute peripheral facial nerve palsy. Otol Neurotol 22:100–104PubMedGoogle Scholar
  17. 17.
    Sood S, Quraishi MS, Jennings CR, Bradley PJ (1999) Frey's syndrome following parotidectomy: prevention using a rotation sternocleidomastoid muscle flap. Clin Otolaryngol 24:365–368CrossRefPubMedGoogle Scholar
  18. 18.
    Stennert E, Guntinas-Lichius O, Klussmann JP, Arnold G (2001) Histopathology of pleomorphic adenoma in the parotid gland: a prospective unselected series of 100 cases. Laryngoscope 111:2195–2200PubMedGoogle Scholar
  19. 19.
    Touquet R, Mackenzie IJ, Carruth JA (1990) Management of the parotid pleomorphic adenoma, the problem of exposing tumour tissue at operation. The logical pursuit of treatment policies. Br J Oral Maxillofac Surg 28:404–408PubMedGoogle Scholar
  20. 20.
    Webb AJ, Eveson JW (2001) Pleomorphic adenomas of the major salivary glands: a study of the capsular form in relation to surgical management. Clin Otolaryngol 26:134–142CrossRefPubMedGoogle Scholar
  21. 21.
    Witt RL (1998) Facial nerve monitoring in parotid surgery: the standard of care? Otolaryngol Head Neck Surg 119:468–470Google Scholar
  22. 22.
    Witt RL (1999) Facial nerve function after partial superficial parotidectomy: an 11-year review (1987–1997). Otolaryngol Head Neck Surg 121:210–213PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Orlando Guntinas-Lichius
    • 1
    Email author
  • Carsten Kick
    • 1
  • J. Peter Klussmann
    • 1
  • Markus Jungehuelsing
    • 1
  • Eberhard Stennert
    • 1
  1. 1.Department of Otorhinolaryngology, Head and Neck SurgeryUniversity of CologneCologneGermany

Personalised recommendations