Pleomorphic adenoma: extracapsular dissection versus partial superficial parotidectomy with facial nerve dissection.

BACKGROUND

To determine if Extracapsular Dissection (ECD) versus Partial Superficial Parotidectomy (PSP) differ in terms of tumor recurrence and transient and permanent facial nerve dysfunction. ECD does not dissect the facial nerve. PSP dissects the facial nerve and provides a 1-2 cm margin around the tumor.

METHODS

A 38-year Ovid Medline search (1970-2008) and an historical review with statistical analysis of published manuscripts were performed.

RESULTS

Tumor recurrence occurred in 36/1183 (3.0%) ECD cases and 1/340 (0.3%) PSP cases; (p < 0.05). Permanent facial nerve dysfunction occurred in 22/1202 (1.8%) ECD cases and 2/924 (0.2%) PSP cases; (p < 0.05). Transient facial nerve dysfunction occurred in 112/1036 (11.8%) ECD cases and 142/793 (17.9%) PSP cases; (p < 0.05%).

CONCLUSIONS

Historical review with statistical analysis of published series demonstrate a significantly higher rate of recurrent pleomorphic adenoma and permanent facial nerve dysfunction and a lower rate of transient facial nerve dysfunction with ECD compared to PSP.