Document Detail

Current management of benign parotid tumors--the role of limited superficial parotidectomy.
MedLine Citation:
PMID:  14603455     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Parotid tumors are mostly benign, but their evaluation and treatment require a thorough knowledge of the relevant anatomy and pathology. Surgical treatment of benign tumors is aimed at complete removal of the mass with facial nerve preservation. The aim of this study was to evaluate the results of treatment of benign parotid neoplasms when surgery entailed limited superficial parotidectomy. METHODS: All patients with benign parotid tumors treated by the author from 1988 to 2002 were reviewed. Data had been prospectively accessioned onto the computerized database of the Department of Head and Neck Surgery, RPAH. Limited superficial parotidectomy was carried out in all previously untreated patients with tumors superficial to the plane of the facial nerve. Median follow-up time was 6 years (range, 1-14 years). RESULTS: A total of 363 parotidectomies was carried out on 355 patients, 29 of whom (8%) were previously treated. Tumors arose deep to the plane of the facial nerve in 40 patients (11%), and, of these, 16 occupied the parapharyngeal space. Pleomorphic adenoma (70%) and Warthin's tumors (15%) were the most common pathologic types. Temporary postoperative facial weakness occurred after 98 operations (27%). Facial weakness was permanent in 2.5% of patients (9 cases) who had normal preoperative function; however, in this group the facial nerve was intentionally resected in 2 patients, 3 others had had previous surgery, and 1 had a deep lobe tumor. Tumor recurrence developed in three patients (0.8%), two of whom had been previously treated. CONCLUSION: Complete superficial parotidectomy is unnecessary in the treatment of benign localized parotid tumors. Limited parotidectomy is associated with very low rates of morbidity and recurrence. Preoperative investigations should be used selectively; however, the author recommends routine (or at least liberal) use of fine-needle aspiration biopsy.
Christopher J O'Brien
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Head & neck     Volume:  25     ISSN:  1043-3074     ISO Abbreviation:  Head Neck     Publication Date:  2003 Nov 
Date Detail:
Created Date:  2003-11-06     Completed Date:  2004-03-09     Revised Date:  2006-10-05    
Medline Journal Info:
Nlm Unique ID:  8902541     Medline TA:  Head Neck     Country:  United States    
Other Details:
Languages:  eng     Pagination:  946-52     Citation Subset:  IM    
Copyright Information:
Copyright 2003 Wiley Periodicals, Inc.
Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital Medical Centre, 100 Carillon Avenue, Newtown, NSW 2042, Australia.
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MeSH Terms
Adenolymphoma / radiography,  surgery
Adenoma, Pleomorphic / radiography,  surgery*
Magnetic Resonance Imaging
Oral Surgical Procedures / methods*
Parotid Gland / radiography,  surgery*
Parotid Neoplasms / radiography,  surgery*
Tomography, X-Ray Computed

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