Long-term Follow-up after Extracapsular Dissection of Parotid Pleomorphic Adenomas - A Retrospective Study

Area of Science:

• Otolaryngology
• Surgical Oncology
• Neurosurgery

Background:

• Parotid pleomorphic adenoma (PPA) is the most common benign salivary gland neoplasm.
• Extracapsular dissection (ED) is a conservative surgical alternative to superficial parotidectomy for reducing complications.
• Long-term follow-up data on ED for PPA is limited.

Purpose of the Study:

• To evaluate the long-term recurrence rate and complication incidence after extracapsular dissection (ED) for parotid pleomorphic adenoma (PPA).
• To assess the impact of ED on patient quality of life (QoL) and aesthetic satisfaction.
• To determine the suitability of ED as a primary surgical approach for selected PPAs.

Main Methods:

• Retrospective cohort study of 50 patients who underwent ED for superficial, mobile parotid lumps (<3 cm) with a histological diagnosis of PPA.
• Minimum 10-year follow-up including ultrasonography, clinical evaluation, and validated questionnaires (Parotidectomy Outcome Inventory-8).
• Analysis of clinical data, surgical reports, recurrence rates, complications, QoL, and aesthetic outcomes; statistical analysis with α=0.05.

Main Results:

• Low incidence and severity of complications were reported, leading to very good overall quality of life (mean 6.86/7) and high aesthetic satisfaction (mean 9.78/10).
• Complications and QoL were statistically related (P=0.02504, P=0.001859), but tumor size and location were not (P=0.8207, P=0.7586).
• No recurrences were detected after a mean follow-up of 12.5 years.

Conclusions:

• Extracapsular dissection (ED) is a safe and effective surgical technique for selected parotid pleomorphic adenomas (PPAs).
• ED provides excellent long-term oncological control and patient-reported outcomes, including high QoL and aesthetic satisfaction.
• ED should be considered the primary surgical approach for superficial, mobile PPAs without suspicion of malignancy due to its favorable long-term results.