Sundarajan Karthik, Subagar A S, Arumugam Karthiga
Upgraded Institute of Otorhinolaryngology, Rajiv Gandhi Government General Hospital, Madras Medical College, Chennai, Tamil Nadu 600003 India.
Department of Otorhinolaryngology, Saveetha Medical college, Thandalam, Chennai, TamilNadu 602105 India.
Indian J Otolaryngol Head Neck Surg. 2024 Aug;76(4):3227-3233. doi: 10.1007/s12070-024-04650-7. Epub 2024 Apr 2.
The standard surgical procedure for treating the parotid gland's recurrent pleomorphic adenoma (RPA) is parotidectomy with facial nerve preservation (FN). Treatment of RPA remains challenging since controversies occur regarding recurrence, degree of revision surgery, postoperative radiation, and difficulty in conserving the FN. A retrospective review of patient's medical records treated for benign parotid neoplasms was conducted between 2017 and 2022 to identify individuals who underwent surgery for RPA. Demographic information, surgical intervention details, pre-and postoperative facial nerve function, histopathological analysis, and recurrence rates were collected. These variables were compared in patients with single recurrent tumors versus patients with multiple recurrent tumors. Twenty-one patients met the criteria, including 13 with a first recurrence, 7 with a second recurrence, and 1 with a third recurrence. Following surgery for multiple RPA, long-term FN outcomes were significantly worse ( = 0.005). There were no observable risk factors for tumor recurrence. The interval between the initial revision surgery and subsequent ones was drastically shortened. Our study suggests that the risk of permanent facial paralysis is greater with subsequent surgical procedures. Early detection of recurrence can aid in early re-operation.
治疗腮腺复发性多形性腺瘤(RPA)的标准外科手术是保留面神经(FN)的腮腺切除术。RPA的治疗仍然具有挑战性,因为在复发、翻修手术程度、术后放疗以及保留FN的难度方面存在争议。对2017年至2022年间接受良性腮腺肿瘤治疗的患者病历进行了回顾性研究,以确定接受RPA手术的个体。收集了人口统计学信息、手术干预细节、术前和术后面神经功能、组织病理学分析以及复发率。将单发复发性肿瘤患者与多发复发性肿瘤患者的这些变量进行了比较。21名患者符合标准,包括13例首次复发、7例第二次复发和1例第三次复发。多次RPA手术后,长期FN结果明显更差(=0.005)。没有可观察到的肿瘤复发风险因素。初次翻修手术与后续手术之间的间隔大幅缩短。我们的研究表明,后续手术导致永久性面瘫的风险更大。复发的早期检测有助于早期再次手术。