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Partial superficial parotidectomy for pleomorphic adenoma of the parotid gland

Bhattacharya A, Singh M, Shah A, Varghese LL

BMJ Case Rep, 2021 Jun 14;14(6).

PMID: 34127499 DOI: 10.1136/bcr-2020-238759

Pleomorphic adenoma, otherwise called as benign mixed tumour, is the most common salivary gland tumour which accounts for 60% of all benign salivary gland tumours. The clinical, radiological and histopathological presentations are varied. The tumour occurs in diverse anatomical sites and can consist of epithelial and mesenchymal components. In this case report, the patient reported with an asymptomatic swelling on the face. CT scan with contrast was advised. The clinical, roentgenographic findings and Fine Needle Aspiration Cytology were indicative of pleomorphic adenoma of the parotid gland. Treatment included partial superficial parotidectomy under general anaesthesia using the modified Blair's incision. The facial nerve was not involved. Part of the gland along with the tumour was resected completely superficial to the facial nerve with a margin of normal tissue all around. Histopathologic examination of tissue specimen confirmed the lesion as pleomorphic adenoma. The patient was asymptomatic at 6-month follow-up.

Matched MeSH terms: Parotid Gland/surgery

Fulltext Parotid mass: a 5-year review of parotid surgery

Chew YK, Noorizan Y, Khir A, Brito-Mutunayagam S

Med J Malaysia, 2007 Dec;62(5):388-9.

PMID: 18705472

This study is to analyze the incidence of facial nerve paralysis after parotidectomy and the type of pathologic condition involved in Hospital Pakar Sultanah Fatimah, Muar between 2002 and 2006. There were 20 parotidectomies done on 20 patients over this period of time. Fourteen were done for tumour and six for inflammatory conditions. The pathology involved were pleomorphic adenoma 9 (45%) cases, Kimura disease 2 (10%) cases, carcinoma 5 (25%) cases and inflammatory condition 4 (20%) cases. Out of 20 parotidectomies done (13 for superficial and 7 for total), 4 (20%) patients had complication of facial nerve paralysis, 2 Malignant tumour, 1 benign tumor and 1 was inflammatory condition. In conclusion, preservation of the facial nerve and its function, wherever possible, is very important to reduce social and functional morbidity.

Matched MeSH terms: Parotid Gland/surgery*

Benign parotid lesions: is near total parotidectomy justified?

Arshad AR

Ann Acad Med Singap, 2006 Dec;35(12):889-91.

PMID: 17219001

INTRODUCTION: Benign tumours of the parotid gland constitute about 80% of parotid tumours. The most common benign tumour of the parotid gland is pleomorphic adenoma. Other conditions, like Kimura's disease, may mimic a tumour when they present as a parotid mass. Various modes of treatment have been advocated for the treatment of benign parotid lesions, ranging from enucleation to near-total parotidectomy.

MATERIAL AND METHODS: This is an audit of an 18-year period where 173 lesions of the parotid gland (34 malignant and 139 benign lesions) were treated by the author.

RESULTS: There were 139 benign lesions, of which 123 were benign tumours and 16 non-tumour conditions. Fourteen cases of recurrent pleomorphic adenoma of parotid that had been treated elsewhere were also operated on. Near-total parotidectomy was performed on all these cases with benign lesions.

CONCLUSIONS: There has been no recurrence in all the patients who was treated this way. Near-total parotidectomy should be considered when there is a need to treat benign parotid swellings.

Matched MeSH terms: Parotid Gland/surgery*

Fulltext An audit of parotidectomy in Singapore: a review of 31 cases

Hwang SY, Brett RH

Med J Malaysia, 2003 Jun;58(2):273-8.

PMID: 14569749

A series of 31 consecutive parotidectomies was evaluated. FNAC could differentiate tumour from non tumour in 72.8% of cases. For actual histology, FNAC was correct in 66.6%. Frozen section was correct in differentiating between benign, malignant and inflammatory conditions in all cases. Eighty-eight percent of frozen section histology concurred with final histology. The immediate postoperative period had 13 cases of facial nerve dysfunction, but only 3 cases had residual weakness. The branch most commonly affected was the mandibular branch (92.3%). Two patients had Frey's syndrome and one had a traumatic neuroma. FNAC and CT scans improve preoperative planning, providing histological evidence and the extent of the lesion.

Matched MeSH terms: Parotid Gland/surgery*

Fulltext A review of parotid tumours and their management: a ten-year-experience

Shashinder S, Tang IP, Velayutham P, Prepageran N, Gopala KG, Kuljit S, et al.

Med J Malaysia, 2009 Mar;64(1):31-3.

PMID: 19852317 MyJurnal

To review the demographics, management and outcome of patients undergoing parotidectomy at a tertiary center. A total of 76 patients who underwent parotidectomies from January 1996 to December 2005 at the ORL department of our center were reviewed. All clinical, operative, postoperative, histology data were gathered and reviewed. Fine-needle aspiration cytology (FNAC) was diagnostic in 90% of patients with a sensitivity of 76% and specificity of 96%. Twenty-one patients had malignant tumours and the rest had benign or inflammatory lesions. There were a total of 48 superficial and 28 total parotidectomies performed. Facial nerve palsy occurred in 30 (39%) patients with 4% permanent palsy and 35% temporary palsy. The recurrence rate of pleomorphic adenoma was 2.6%. FNAC and CT scan were performed prior to the surgery were useful guidance in planning the operation but clinical judgment is more important. The most common surgery performed was superficial parotidectomy and the most common cause was due to pleomorphic adenoma. The incidence of complications and recurrence of tumour are comparable to other international studies. Prior knowledge of anatomy and careful planning is needed to decrease the incidence of facial nerve palsy.

Matched MeSH terms: Parotid Gland/surgery*

Fulltext Parotid swellings: report of 110 consecutive cases

Arshad AR

Med J Malaysia, 1998 Dec;53(4):417-22.

PMID: 10971987

Parotid swellings are uncommon. Over a twelve-year period, 110 cases of parotid swellings were treated at the Department of Plastic Surgery, Hospital Kuala Lumpur, of which 97 cases were histologically proven to be parotid tumours. 75% of these tumours were benign tumours, and 80% of the benign tumours were pleomorphic adenomas. Among the malignant tumours, 6 cases were adenoid cystic carcinoma and 5 were carcinoma ex-pleomorphic adenoma. There were equal number of male to female patients, with an age range of 14 to 83 years. There is a positive correlation between the final histological diagnosis and FNAC results in 74% of cases. Surgical treatment of choice for benign parotid tumours was near-total parotidectomy whilst for malignant tumours was total radical parotidectomy with sural nerve graft.

Matched MeSH terms: Parotid Gland/surgery*

Metastatic Pleomorphic Adenoma in the infratemporal fossa and neck following total parotidectomy after 30 years

Wong DKC, Muhamad NS, Sobri SS, Amin WAM, Yusof Z

Med J Malaysia, 2019 04;74(2):85-86.

PMID: 31079134

Metastasising pleomorphic adenoma is rare and may occur years after surgical excision of a pleomorphic adenoma (PA). We present a 61-year-old woman with a right infratemporal PA with metastases to the cervical lymph nodes after 30 years following a total parotidectomy. She was treated successfully with a resection of the tumour with combined neck and mandibulotomy approach along with postoperative radiotherapy given subsequently.

Matched MeSH terms: Parotid Gland/surgery*

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