An Institutional Review of Recurrent Pleomorphic Adenoma of the Parotid Gland. Journal Article

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Authors: Brar, G; Smith, S; Block, A; Borrowdale, R; Marzo, SJ; Thorpe, E; Leonetti, J
Article Title: An Institutional Review of Recurrent Pleomorphic Adenoma of the Parotid Gland.
Abstract: OBJECTIVE: Surgical resection is standard treatment for pleomorphic adenoma (PA) of the parotid gland. A small number (2-5%) of these tumors recur. Recurrence usually necessitates re-operation, which is technically challenging and puts the facial nerve (FN) at risk. The aim of this study is to characterize the recurrent parotid PA population and compare outcomes after surgery for singly recurrent and multiply recurrent tumors. METHODS: This study was a retrospective chart review of patients at a single tertiary care academic medical center who underwent operations for recurrent PA of the parotid gland between 2007 and 2020. Demographic data, details of surgical interventions, pre-and post-operative FN function, and recurrence rates were studied. These factors were compared between patients with singly and multiply recurrent tumors. RESULTS: Thirty-eight patients met criteria: 4 patients presented for primary PA and subsequently recurred, 26 with a first recurrence, 7 with a second recurrence, and 1 with a fourth recurrence. Multiply recurrent PAs were more likely to require at least partial nerve sacrifice at the time of reoperation (p=0.0092). Significantly worse long-term FN outcomes were seen following surgery for multiply recurrent PA (p=0.008). There was no significant difference between the rate of re-recurrence following first revision surgery versus 2nd-4th revision surgery. Time to re-operation was significantly shorter between the first and second revision surgery than between the primary surgery and first revision (p=0.0017). CONCLUSION: Surgery for recurrent PA incurs high risk to the FN, and this risk appears to increase in the setting of multiple recurrences.
Journal Title: Ear, nose, throat journal
ISSN: 1942-7522; 0145-5613
Publisher: Unknown  
Date Published: 2022