title: Recurrent pleomorphic adenoma of the parotid gland.
abstract: BACKGROUND
  Surgery of recurrent pleomorphic adenoma presents an increased risk of facial nerve injury and a considerable re-recurrence rate.
  
  
  METHODS
  A series of 33 patients with first recurrence of pleomorphic adenoma of the parotid gland was analyzed. The data were derived from medical records as well as from interviews and clinical examinations of all living patients. Histologic material of the initial and recurrent tumor were reviewed.
  
  
  RESULTS
  Multifocal recurrence and carcinoma in pleomorphic adenoma were observed in 73% and 9% of patients, respectively. The incidence of permanent partial facial nerve injury after surgery was 23% in patients with initial enucleation and 14% in those with initial superficial parotidectomy (including 1 patient with facial nerve resection and 1 patient with a partial facial paresis before recurrence surgery). A subsequent recurrence occurred in 6 patients, all with initial enucleation after a mean time interval of 9 years.
  
  
  CONCLUSIONS
  The preservation of the facial nerve was possible in all but 1 patient treated for the first recurrence with a relatively low rate of permanent partial facial paresis because of the use of the operating microscope and facial nerve monitor. To evaluate the re-recurrence rate, a follow-up of at least 10 years is necessary.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital, University of Berne, CH-3010 Berne, Switzerland. peter.zbaeren@insel.ch
authors.forename: Peter
authors.initials: P
authors.lastname: Zbären
authors.forename: Isabelle
authors.initials: I
authors.lastname: Tschumi
authors.forename: Michel
authors.initials: M
authors.lastname: Nuyens
authors.forename: Edouard
authors.initials: E
authors.lastname: Stauffer
mesh_terms: D008949:Adenoma, Pleomorphic / Q000473:pathology* / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D020220:Facial Nerve Injuries / Q000209:etiology / Q000517:prevention & control; D005158:Facial Paralysis / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010306:Parotid Gland / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D012468:Salivary Gland Neoplasms / Q000473:pathology* / Q000601:surgery*