Parotidectomy for deep lobe pleomorphic adenomas is associated with higher rates of complications and recurrence

Head Neck. 2024 Nov;46(11):2853-2860. doi: 10.1002/hed.27840. Epub 2024 Jun 8.

Abstract

Background: Pleomorphic adenoma (PA) is a common parotid tumor, yet due to the relative rarity of deep lobe PA (DLPA), there is a paucity of information about its clinical presentation and surgical outcomes.

Methods: We reviewed the charts of patients with previously untreated parotid PA between the years 1990 and 2015. Clinical parameters and surgical outcomes were compared between superficial lobe PA (SLPA) and DLPA.

Results: The cohort comprised 147 cases of DLPA and 222 cases of SLPA. DLPA were larger (median 2.6 cm vs. 2.0 cm, p < 0.001), more often discovered incidentally on imaging (33%, n = 48) and had unique presentations (pharyngeal mass, dysphagia, otalgia). Postsurgical complications were more frequently observed in DLPA (41% vs. 30% in SLPA, p = 0.025), mainly transient facial nerve weakness. DLPA also showed higher recurrence rates (n = 6, 4.1% vs. n = 1, 0.4%, p = 0.016).

Conclusions: Parotidectomy for DLPA carries a higher risk of complications and recurrence compared to SLPA.

Keywords: benign mixed tumor; major salivary glands; parapharyngeal space; surgery; symptoms.

MeSH terms

  • Adenoma, Pleomorphic* / pathology
  • Adenoma, Pleomorphic* / surgery
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local*
  • Parotid Gland / surgery
  • Parotid Neoplasms* / pathology
  • Parotid Neoplasms* / surgery
  • Postoperative Complications* / epidemiology
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult