Surgical treatment of recurrent pleomorphic adenoma of the parotid gland: A clinical analysis of 52 patients
Article first published online: 30 MAR 2001
Copyright © 2001 John Wiley & Sons, Inc.
Head & Neck
Volume 23, Issue 4, pages 311–316, April 2001
How to Cite
Glas, A. S., Vermey, A., Hollema, H., Robinson, P. H., Roodenburg, J. L.N., Nap, R. E. and Plukker, J. Th. M. (2001), Surgical treatment of recurrent pleomorphic adenoma of the parotid gland: A clinical analysis of 52 patients. Head Neck, 23: 311–316. doi: 10.1002/hed.1036
- Issue published online: 30 MAR 2001
- Article first published online: 30 MAR 2001
- Manuscript Accepted: 21 AUG 2000
- recurrent parotid gland adenoma;
- nerve reconstruction
Surgical management of recurrent pleomorphic adenoma of the parotid gland has a considerable risk of facial nerve injury and a high re-recurrence rate. To obtain more insight into this issue we evaluated our experiences.
Medical records and histologic material of all these patients (31 women and 21 men), who had been treated from 1976–1995 were reviewed. Median interval between initial treatment and commencement of recurrences was 3 (0.8–18) years. Last surgery consisted of parotidectomy in 48 patients (92%), including 19 (40%) total procedures and wide local excision with involved skin in four patients.
At a median follow-up of 9 years, eight patients (8/52; 15%) had re-recurrences develop, including 4 of 21 patients (19%) after a previous parotidectomy (group I) and 4 of 31 patients (13%) without prior parotidectomy (group II). The chance of re-recurrence in a group of patients with a minimal follow-up of 10 years after salvage surgery was 17% (4 of 24). The risk of a new relapse was, respectively, 4% and 8% at 1 and 5 years after treatment of recurrent disease. Acceptable N.VII function was preserved in 45 of the 49 (92%) nerves at risk. The risk of N.VII injuy was higher and more serious in group I (29% vs 10% in group II). The function of four of the five (80%) reconstructed zygomaticotemporal branches of the N.VII was adequate.
Surgical treatment of recurrent pleomorphic adenoma of the parotid gland, usually consisting of a parotidectomy with wide extent and eventually facial nerve reconstruction, demonstrates favorable results with acceptable morbidity. The risk of new relapse and N.VII injury was higher after previous parotidectomy. © 2001 John Wiley & Sons, Inc. Head Neck 23: 311–316, 2001.