SURGICAL-MANAGEMENT OF 246 PREVIOUSLY UNTREATED PLEOMORPHIC ADENOMAS OF THE PAROTID-GLAND

Background Recent modifications of surgical technique may have influen ced outcome following parotidectomy. This retrospective study compares the results of the different surgical methods with regard to recurren ce rate and the effects on morbidity between 1974 and 1994. Methods A total of 246 primary surgical parotid procedures were performed on 245 patients for pleomorphic adenoma. These included 131 'partial' superf icial parotidectomies, 61 'total' superficial parotidectomies, 30 part ial superficial/deep lobe parotidectomies, eight total parotidectomies , and 16 'selective' deep lobe parotidectomies. In the recent past, th e posterior branch of the greater auricular nerve was preserved in the majority of patients. Eleven patients received postoperative radiothe rapy. Median follow-up was 95 months. Fourteen patients died without r ecurrent tumour. Results Two patients (0.8 per cent) developed local r ecurrence, both after total parotidectomy for a deep lobe tumour. No p atient experienced permanent facial nerve palsy. The incidence of gust atory sweating for partial superficial parotidectomy was 6.9 per cent (nine of 131) compared with 13.1 per cent (eight of 61) for total supe rficial parotidectomy. Conclusion Partial parotidectomy is an effectiv e treatment for the majority of pleomorphic adenomas; local recurrence is rare and morbidity is low. Prolonged follow-up is unnecessary.