Clinicopathologic Factors in Selection of Surgical Procedure in Parotid Tumor Surgery -A Retrospective Review of 245 Cases-

Korean Journal of Head & Neck Oncology 2003;19(2):137-141.
Published online November 30, 2003.

Woon Won Kim;Sang Hyo Kim

이하선 종양 수술술식 선택에 있어 임상병리학적 요인 245예의 후향적 분석

김운원;김상효

Abstract

Introduction: A routine superficial parotidectomy with facial nerve dissection in parotid tumor surgery often results in facial dysfunction, Frey syndrome and defect in operation site. Formal facial nerve dissection has been a recommended procedure, because pleomorphic adenoma is a commonly recurrent tumor in case of inadequate surgical management, however it can not be always reasonable in aspect of postoperative sequelae. Patients and Methods: Through retrospective review of 245 cases parotidectomies and follow up for more than three years, clinicophathologic factors influencing to the selection of surgical procedure were considered to be age, sex, and preoperative pathology confirmed by preoperative MRI and FNA.
Results
Five categories were established as follow for surgical decision in parotid tumor surgery. Category 1. Superficial lobe adenoma -- Superficial parotidectomy -- 124 Category 2. Deep lobe adenoma -- Deep parotidectomy -- 39 Category 3. Non pleomorphic adenoma -- Tumorectomy 1.5cm adenoma in young female -- Tumorectomy -- 25 Category 4. Recurrent multicentric tumor -- Parotidectomy+RT -- 9 Category 5. Parotid cancer; Parotidectomy + UND (RND) + RT -- 48 ; CORE (Composite Regional Ear Resection) -- 2
Conclusion
Surgical morbidity and recurrence rate could be minimized by individualizing the surgical procedure according to the category principle based on the clincopathologic features.

Key Words: Parotid tumor, Parotidectomy, Clinicopathologic factors