Surgical techniques in the treatment of pleomorphic adenoma of the parotidgland: Our experience and review of literature

This paper presents a retrospective study carried out on a sample of 100 pa tients affected by pleomorphic adenoma of the parotid gland and treated at the Department of Maxillofacial Surgery at the University of Rome "La Sapie nza" between January 1, 1989 and December 31,1997. For the diagnosis of thi s neoformation, cytological tests were performed on material taken from the neoformation using fine needle aspiration and ultrasound scan. In some sel ected cases, a CT examination of the head and neck with medium contrast or Nuclear Magnetic Resonance (NMR) was carried out. This study sets out to ex amine the most suitable treatment to be followed for the removal of the ple omorphic adenoma of the parotid gland. In 56 cases the patients underwent a superficial, conservative parotidectom y. Forty one patients had a total parotidectomy with the facial nerve left intact and one patient had a total parotidectomy where the marginal mandibu lar nerve of the facial nerve was damaged. The remaining two patients invol ved in the study were suffering from a recurrent pleomorphic adenoma and in these two cases a total parotidectomy was performed where the facial nerve was killed. The removal of the cranial nerve VII in these patients proved necessary because the nerve fibers had adhered to the surrounding scar tiss ue of the tumor, either after previous surgery or due to repeated chronic p hlogosis of the gland.