Pleomorphic adenoma surgery

Surgery is the mainstay of treatment for pleomorphic adenoma. There are two procedures superficial parotidectomy and total parotidectomy, the latter of which is the most commonly performed one due to its low incidence on recurrence of the tumor. The complications after surgery include facial nerve palsy, frey’s syndrome, trismus, haematoma or haemorrhage and wound infection. Recurrence do occur in pleomorphic adenoma sometimes.

• Surgical intervention is recommended for the management of pleomorphic adenoma.

Surgery is the mainstay of treatment for pleomorphic adenoma.There are two procedures:

• Superficial parotidectomy(Patey’s operation)^[1].
• Total parotidectomy, is the more frequently performed procedure due to the incidence of recurrence being lower.
• Care should be taken in order to preserve the facial nerve. ^[1]
• The tumors of the submandibular glands are treated with excision while preserving the adjacent nerves including the mandibular branch of the trigeminal nerve, the hypoglossal nerve, and the lingual nerve.
• When the tumor arises from the minor salivary glands, usually a 5 mm margin is to be obtained.
• Recurrence is also sometimes noticed after surgery.
• The main causes for recurrence are:^[2]
  • Incomplete excision
  • Intraoperative capsule rupture
  • Myxoid subtype
  • Presence of the satellite nodules and tumor extensions
• Adjuvant radiotherapy has been shown to be helpful in managing a recurrent pleomorphic adenoma in addition to surgery.^[3]

There aren’t any well established contraindications for the surgery of pleomorphic adenoma.

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