Extracapsular Dissection in Pleomorphic Adenomas of the Parotid Gland: Results After 13 Years of Follow-up.
Adenoma, Pleomorphic
/ surgery
Adolescent
Adult
Aged
Aged, 80 and over
Facial Nerve Injuries
/ epidemiology
Female
Follow-Up Studies
Humans
Male
Middle Aged
Neoplasm Recurrence, Local
/ epidemiology
Parotid Gland
/ pathology
Parotid Neoplasms
/ surgery
Retrospective Studies
Treatment Outcome
Young Adult
Parotid pleomorphic adenoma
extracapsular dissection
facial nerve dissection
limited surgery
recurrence
Journal
The Laryngoscope
ISSN: 1531-4995
Titre abrégé: Laryngoscope
Pays: United States
ID NLM: 8607378
Informations de publication
Date de publication:
02 2021
02 2021
Historique:
received:
22
12
2019
revised:
17
03
2020
accepted:
01
04
2020
pubmed:
13
5
2020
medline:
29
1
2021
entrez:
13
5
2020
Statut:
ppublish
Résumé
To assess long-term results after the treatment of parotid pleomorphic adenomas (PPAs) using different surgical techniques and focusing on recurrence rates and the risk of adverse effects. Retrospective analysis. Retrospective analysis of 182 patients treated exclusively for PPAs at a tertiary referral center between 2000 and 2004. Thorough follow-up examinations over a mean period of 13 years were possible in 53.8% (n = 98/182). Tumors were categorized according to the European Salivary Gland Society (ESGS) system to improve the comparison of outcomes. After different surgical resection strategies, recurrence rates, postoperative facial nerve paresis (FNP), and incidence of Frey's syndrome were assessed. The follow-up period included clinical examinations and imaging of every patient in the treating department. Of 182 patients, extracapsular dissection (ED) was performed in 29.7%, and other surgical modalities (OSMs), including facial nerve dissection, in 70.3%. After the long-term follow-up, 98% of all the patients (n = 96/98) were recurrence free. When recurrence rates were compared, no significant differences were noted (P < .331). ED resulted in significantly lower FNP rates compared to OSMs (P < .001). FNP rates significantly increased with size and location of the tumors according to ESGS categories (temporary and permanent FNP, P = .04). Surgical invasiveness corresponded to a significant increase in the incidence of Frey's syndrome (P < .001). ED was associated with the lowest complication rates, but not with a higher risk of recurrence, when compared with OSM in the long-term course. As ED can be performed in the majority of PPAs, it can be regarded as the treatment of choice whenever possible. 4 Laryngoscope, 131:E445-E451, 2021.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
E445-E451Informations de copyright
© 2020 The Authors. The Laryngoscope published by Wiley Periodicals, Inc. on behalf of The American Laryngological, Rhinological and Otological Society, Inc.
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