Pleomorphic adenoma surgery

Pleomorphic adenoma Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Surgical intervention is not recommended for the management of [disease name].

OR

Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either [indication 1], [indication 2], and [indication 3]

OR

The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either [indication 1], [indication 2], and/or [indication 3].

OR

The feasibility of surgery depends on the stage of [malignancy] at diagnosis.

OR

Surgery is the mainstay of treatment for [disease or malignancy].

Indications

• Surgical intervention is not recommended for the management of [disease name].

OR

• Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either:
  • [Indication 1]
  • [Indication 2]
  • [Indication 3]
• The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either:
  • [Indication 1]
  • [Indication 2]
  • [Indication 3]

Surgery

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

• Superficial parotidectomy(Patey's operation).
• Total parotidectomy, being the more frequently performed procedure due to lower incidence of recurrence.

• Meticulous care shouldbe taken to preserve the facial nerve.
• The tumors of the submandibular glands are treated with simple excision procedure with preservation of adjacent nerve including the mandibular branch of the trigeminal nerve, the hypoglossal nerve, and the lingual nerve.
• When the tumor arises from the minor salivary glands, a five mm margin should be obtained.
• Recurrence is also noticed after surgery.
• The main causes for recurrence are:
  • Incomplete excision,
  • Intraoperative capsule rupture,
  • Myxoid subtype,
  • Presence of the satellite nodules and tumor extensions (pseudopodia),
  • Lack of the glandular tissue margin and the experience of the surgeon.