[Sixty-two cases report of surgical treatment of parotid pleomorphic adenoma].
OBJECTIVE: To define the most appropriate surgical modality for parotid pleomorphic adenoma (PPA). METHODS: Sixty-two cases with PPA who underwent surgical treatment from January 1996 and December 2003 were reviewed retrospectively. The course of disease before treatment, tumor size, surgical modality, post-operative histopathological findings, recurrence and the complications were analyzed. RESULTS: There have been no recurrence in all 44 patients operated by superficial parotidectomy (SP), in all 16 patients operated by partial superficial parotidectomy plus partial deep parotidectomy (PSP + PDP), and in all 2 cases operated by total parotidectomy (TP). Pathological findings showed that in 6 cases (10%) the capsule of PPA was incomplete in focal areas and leaded to instances of positive margins, and in 28 cases (45%) the proliferation and mitosis were found in tumor cells with capsule invasion. 2 cases (4.5%) treated by SP had transient facial nerve dysfunction, while none of the 16 cases treated by PSP + PDP had facial nerve dysfunction. Frey syndrome occurred in 8 cases (18%) treated by SP, in 2 cases (13%) treated by PSP + PDP and in all 2 cases (13%) treated by total parotidectomy. The total rate of Frey syndrome in all 62 cases was 19.3%. CONCLUSIONS: For the superficial PPA smaller than 4 cm, surgical procedure of PSP + PDP is as efficacy as SP, with relatively lower rates of complications like facial nerve dysfunction and Frey syndrome.