PAROTID PLEOMORPHIC ADENOMAS AND THEIR RE CURRENCES

Even today, a wide variety of techniques are performed in parotid pleo morphic adenoma surgery, ranging from enucleation to total parotidecto my. This study reports the results of our experiences. Among a total o f 587 surgically treated parotid lesions at the Homburg/Saar Universit y ENT Department from 1968 through 1991, 205 were parotid pleomorphic adenomas. Among these, 166 patients received primary surgery at our de partment. Twenty-one enucleations led to 3 recurrent tumors (14%), whi le 108 superficial parotidectomies had 3 recurrences (2.8%). Fifteen e xtended superficial parotidectomies also produced 3 recurrences (20%) and 22 total parotidectomies had one recurrent case (4.5%). The overal l recurrence rate was 6%, but increased to 8.3% in 5 years, 9.5% in 10 years and 12.5% in 15 years follow-up. The ''true'' overall recurrenc e rate after 10 years was estimated to be between 9.5 and 20% and that for lateral parotidectomies between 4.4 and 13%. Patients younger tha n 30 years of age at the time of primary surgery developed a tumor rec urrence in 17% of all cases. The overall recurrence rate following sec ondary surgery was 13%. Clinical findings and surgical techniques for resections of pleomorphic adenomas and their recurrences are discussed . Segmental parotidectomy is the preferred treatment, but may have to be changed locally to enucleation in some cases in order to preserve t he facial nerve.