Recurrent Parotid Pleomorphic Adenomas: Our Clinical Experience

Area of Science:

• Otolaryngology
• Head and Neck Surgery
• Oncology

Background:

• Pleomorphic adenoma is the most common benign salivary gland tumor.
• Recurrence can occur after initial surgical resection, necessitating revision surgery.
• Management of recurrent tumors presents unique challenges, including potential facial nerve involvement.

Purpose of the Study:

• To present clinical, surgical, and follow-up data for patients treated for recurrent parotid pleomorphic adenoma.
• To discuss findings in the context of current literature on recurrent parotid tumors.
• To evaluate the efficacy of revision surgery for recurrent pleomorphic adenoma.

Main Methods:

• Retrospective analysis of 11 patients undergoing revision surgery for recurrent pleomorphic adenoma.
• Evaluation of clinical and radiological features, surgical techniques, and facial nerve management.
• Assessment of follow-up periods and recurrence rates.

Main Results:

• The study included 11 patients (7 female, 4 male; average age 45).
• Revision surgeries included superficial parotidectomy (6 patients) and total conservative parotidectomy with facial nerve preservation (5 patients).
• Two patients required facial nerve branch sacrifice due to tumor involvement; one received adjuvant radiotherapy for lymphatic vessel involvement. No recurrences were observed during a mean follow-up of 9.1 years.

Conclusions:

• Careful preoperative planning is crucial for recurrent parotid pleomorphic adenoma, considering tumor size, location, multicentricity, and facial nerve involvement.
• Surgical goals include achieving tumor-free margins, with facial nerve sacrifice reserved for cases of direct involvement.
• Regular postoperative follow-up is essential for early detection of any potential recurrences.