BACKGROUND: Optimal surgery for pleomorphic adenoma of the parotid is controversial. In the present review, we discuss the advantages and disadvantages of the various approaches after addressing the surgical pathology of the parotid pleomorphic adenoma capsule and its influence on surgery. DATA SOURCES: PubMed literature searches were performed to identify original studies. CONCLUSIONS: Almost all pleomorphic adenomas can be effectively treated by formal parotidectomy, but the procedure is not mandatory. Extracapsular dissection is a minimal margin surgery; therefore, in the hands of a novice or occasional parotid surgeon, it may result in higher rates of recurrence. Partial superficial parotidectomy may be a good compromise. The tumor is removed with a greater cuff of healthy parotid tissue than in extracapsular dissection. This may minimize the recurrence rate. On the other hand, the removal of healthy parotid tissue compared with formal parotidectomy is limited, thus minimizing complications such as facial nerve dysfunction and Frey syndrome.
BACKGROUND: Optimal surgery for pleomorphic adenoma of the parotid is controversial. In the present review, we discuss the advantages and disadvantages of the various approaches after addressing the surgical pathology of the parotid pleomorphic adenoma capsule and its influence on surgery. DATA SOURCES: PubMed literature searches were performed to identify original studies. CONCLUSIONS: Almost all pleomorphic adenomas can be effectively treated by formal parotidectomy, but the procedure is not mandatory. Extracapsular dissection is a minimal margin surgery; therefore, in the hands of a novice or occasional parotid surgeon, it may result in higher rates of recurrence. Partial superficial parotidectomy may be a good compromise. The tumor is removed with a greater cuff of healthy parotid tissue than in extracapsular dissection. This may minimize the recurrence rate. On the other hand, the removal of healthy parotid tissue compared with formal parotidectomy is limited, thus minimizing complications such as facial nerve dysfunction and Frey syndrome.
Authors: Miquel Quer; Vincent Vander Poorten; Robert P Takes; Carl E Silver; Carsten C Boedeker; Remco de Bree; Alessandra Rinaldo; Alvaro Sanabria; Ashok R Shaha; Albert Pujol; Peter Zbären; Alfio Ferlito Journal: Eur Arch Otorhinolaryngol Date: 2017-06-21 Impact factor: 2.503
Authors: Asterios Triantafyllou; Lester D R Thompson; Kenneth O Devaney; Diana Bell; Jennifer L Hunt; Alessandra Rinaldo; Vincent Vander Poorten; Alfio Ferlito Journal: Head Neck Pathol Date: 2014-11-08
Authors: Georgios Psychogios; Christopher Bohr; Jannis Constantinidis; Martin Canis; Vincent Vander Poorten; Jan Plzak; Andreas Knopf; Christian Betz; Orlando Guntinas-Lichius; Johannes Zenk Journal: Eur Arch Otorhinolaryngol Date: 2020-08-04 Impact factor: 2.503