Parotid pleomorphic adenomas: Factors influencing surgical techniques, morbidity, and long-term outcome relative to the new ESGS classification in a retrospective study

Schapher M, Koch M, Agaimy A, Goncalves M, Mantsopoulos K, Iro H (2019)

Publication Type: Journal article

Publication year: 2019

Journal

Journal of Cranio-Maxillofacial Surgery Elsevier

DOI: 10.1016/j.jcms.2019.06.009

Abstract

Purpose: To assess long-term results after treatment of parotid pleomorphic adenomas (PPAs) with different surgical techniques, standardized according to the European Salivary Gland Society (ESGS) classification system. Methods: We analyzed ESGS categories, occurrence of facial nerve paresis (FNP), Frey's syndrome, histopathology, and recurrences. Surgical modalities were compared, differentiating techniques with and without facial nerve dissection. A strict protocol ensured a postoperative follow-up-period of more than 7 years. Results: 205 patients were included. A complete follow-up was possible in 138 patients, 77 of whom underwent extracapsular dissection (ED) and 61 of whom had other surgical modalities (OSMs). ESGS categories correlated with the extent of surgery, significantly with the risk for FNP and Frey's syndrome, but not with recurrences. Recurrences did not differ significantly between ED and OSMs, whereas the risks for FNP (p < 0.001 each) and Frey's syndrome (p = 0.000) were significantly higher after OSMs in comparison with ED. Young women with a stroma-rich (myxoid) tumor subtype appear to have the greatest risk for recurrences. Conclusion: ED is the treatment of choice for PPAs, if possible, resulting in similar recurrence rates but significantly fewer comorbidities in comparison with more extensive surgery. After the treatment of PPAs, a long-term follow-up is needed, including imaging.

Authors with CRIS profile

Mirco Schapher Department of Otorhinolaryngology – Head and Neck Surgery Abbas Agaimy Lehrstuhl für Allgemeine Pathologie und Pathologische Anatomie Miguel Goncalves Department of Otorhinolaryngology – Head and Neck Surgery Konstantinos Mantsopoulos Department of Otorhinolaryngology – Head and Neck Surgery Heinrich Iro Lehrstuhl für Hals-, Nasen- und Ohrenheilkunde

How to cite

APA:

Schapher, M., Koch, M., Agaimy, A., Goncalves, M., Mantsopoulos, K., & Iro, H. (2019). Parotid pleomorphic adenomas: Factors influencing surgical techniques, morbidity, and long-term outcome relative to the new ESGS classification in a retrospective study. Journal of Cranio-Maxillofacial Surgery. https://dx.doi.org/10.1016/j.jcms.2019.06.009

MLA:

Schapher, Mirco, et al. "Parotid pleomorphic adenomas: Factors influencing surgical techniques, morbidity, and long-term outcome relative to the new ESGS classification in a retrospective study." Journal of Cranio-Maxillofacial Surgery (2019).

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