Facial Nerve in Recurrent Benign Pleomorphic Adenoma

Conley, John; Clȧirmont, Albert A.

doi:10.1001/archotol.1979.00790170017004

Cited by 60 publications

(28 citation statements)

References 9 publications

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“…In these cases, direct nerve reconstruction should be considered. Some authors such as Conley 24,28 even advise radical parotidectomy with nerve reconstruction in all cases. Primary transplantation with sural nerve graft offers good results.…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of recurrent pleomorphic adenoma of the parotid gland: A clinical analysis of 52 patients

et al. 2001

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Section: Discussionmentioning

confidence: 99%

Surgical treatment of recurrent pleomorphic adenoma of the parotid gland: A clinical analysis of 52 patients

et al. 2001

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“…Another concern following tumor recurrence relates to a facial nerve that is closely adherent to a tumor. Sacrifice of the facial nerve with microsurgical nerve grafting has been reported to occur in 14-30% of patients with RPA [2,14] .…”

Section: Surgical Morbidity: Prevalence and Preventionmentioning

confidence: 99%

Recurrent Benign Salivary Gland Neoplasms

Witt¹,

Nicolai²

2016

Salivary Gland Neoplasms

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The most important causes of recurrence of benign pleomorphic adenoma are enucleation with intraoperative spillage and incomplete tumor excision in association with characteristic histologic findings for the lesion (incomplete pseudocapsule and the presence of pseudopodia). Most recurrent pleomorphic adenomas (RPAs) are multinodular. MRI is the imaging method of choice for their assessment. Nerve integrity monitoring may reduce morbidity of RPA surgery. Although treatment of RPA must be individualized, total parotidectomy is generally recommended given the multicentricity of the lesions. However, surgery alone may be inadequate for controlling RPA over the long term. There is growing evidence from retrospective series that postoperative radiotherapy results in significantly better local control. A high percentage of RPAs are incurable. All patients should therefore be informed about the possibility of needing multiple treatment procedures, with possible impairment of facial nerve function, and radiation therapy for RPA. Reappearance of Warthin tumor is a metachronous occurrence of a new focus or residual incomplete excision of all primary multicentric foci of Warthin tumor. Selected cases can be observed. Conservative surgical management can include partial superficial parotidectomy or extracapsular dissection. Not uncommonly, other major and minor salivary gland neoplasms, including myoepithelioma, basal cell adenoma, oncocytoma, canalicular adenoma, cystadenoma, and ductal papilloma, follow an indolent course after surgical resection, with rare cases of recurrence.

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“…Surgery for recurrent pleomor¬ phic adenoma presents a high risk of injury to the facial nerve requiring formal identification to achieve resec¬ tion with preservation of facial nerve function. 4. Recurrent tumor presents a sig¬ nificant risk of malignant degenera¬ tion, even though preceeding tumor histology does not appear to be predic¬ tive of this development.…”

Section: When Recurrent Tumor or Scar Ismentioning

confidence: 99%

Surgical Treatment of Recurrent Pleomorphic Adenoma of the Parotid Gland

Niparko¹,

Beauchamp²,

Krause³

et al. 1986

Archives of Otolaryngology - Head and Neck Surgery

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of the parotid gland warrant consideration because of the potential for facial nerve injury occurring with surgical treatment and the risk of malignant conversion. Forty-eight cases of recurrent pleomorphic adenoma treated at the University of Michigan, Ann Arbor, between 1935 and 1975 were retrospectively analyzed. The results of surgical procedures for recurrence were determined with respect to tumor control and resultant facial nerve function. Malignant conversion developed in three (6%) of 48 cases. The results of this study underscore the importance of adequate surgical excision of initial recurrences as well as primary tumors to prevent tumor recidivism. Tumor control rates and facial nerve preservation are enhanced with formal parotidectomy for recurrent tumor when feasible. In cases in which facial nerve identification and dissection is not possible, en bloc total parotidectomy offers effective, though not absolute, control of extensive recurrence.Advances in surgical techniques -¿A-have markedly diminished the recurrence rate previously associated with surgical excision of pleomorphic adenoma of the parotid gland. Factors responsible for the recurrence of pleo¬ morphic adenoma have received extensive review over the past 50 years. While intraoperative tumor rupture and seeding, tumor multicentricity, metachronous tumor develop¬ ment, and histologie evidence of cap¬ sular penetration or hypercellularity are mentioned as factors possibly related to the development of recur¬ rence, clinical behavior of pleomor¬ phic adenomas is most closely corre¬ lated with the adequacy of surgical treatment. Rates of recurrence follow¬ ing primary surgery for pleomorphic adenoma of the parotid gland have been reported to be as high as 44%, this being attributed to inadequate surgical excision.1 Subsequent reports suggested that formal parotidectomy was associated with lower rates of recurrence than was simple excision,2 and comparisons of large groups treated within the same institution revealed a fourfold greater rate of recurrence from simple excision as compared with formal parotidectomy, whether superficial or total, with facial nerve preservation.3 Recent reports have documented that a surgi¬ cal treatment policy of formal paroti¬ dectomy for primary pleomorphic adenoma leads to recurrence rates that approach zero,46 and many sur¬ geons have adopted this policy. None¬

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Facial Nerve in Recurrent Benign Pleomorphic Adenoma

Cited by 60 publications

References 9 publications

Surgical treatment of recurrent pleomorphic adenoma of the parotid gland: A clinical analysis of 52 patients

Surgical treatment of recurrent pleomorphic adenoma of the parotid gland: A clinical analysis of 52 patients

Recurrent Benign Salivary Gland Neoplasms

Surgical Treatment of Recurrent Pleomorphic Adenoma of the Parotid Gland

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