Pleomorphic adenoma of the parotid: formal parotidectomy or limited surgery?
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.


METHODS
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.
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital, Freiburgstrasse, 3010 Bern, Switzerland. peter.zbaeren@insel.ch
Peter
P
Zbären
Vincent
V
Vander Poorten
Robert L
RL
Witt
Julia A
JA
Woolgar
Ashok R
AR
Shaha
Asterios
A
Triantafyllou
Robert P
RP
Takes
Alessandra
A
Rinaldo
Alfio
A
Ferlito
D008949:Adenoma, Pleomorphic / Q000175:diagnosis / Q000601:surgery*; D002277:Carcinoma / Q000473:pathology; D002471:Cell Transformation, Neoplastic / Q000473:pathology; D004210:Dissection; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D010306:Parotid Gland / Q000601:surgery*; D010307:Parotid Neoplasms / Q000175:diagnosis / Q000601:surgery*