Extracapsular dissection: Minimally invasive surgery applied to patients with parotid pleomorphic adenoma

Abstract

Conclusions: We performed extracapsular dissection (ECD) on 31 patients with pleomorphic adenoma, including 7 deep lobe cases. ECD is minimally invasive and has limited complications compared with other conventional parotidectomy procedures. This is the first report on performance of ECD in patients with deep lobe parotid pleomorphic adenomas. Surgeons who are capsule-conscious can perform ECD with good results. Objective: Pleomorphic adenoma, the most common benign neoplasm occurring in the parotid gland, has a constant frequency of recurrence and facial paralysis in patients after surgery. ECD is one of the surgical procedures performed on patients with these tumors, but its validity is still unclear because of its similarity to enucleation. Methods: We performed ECD in patients with untreated parotid neoplasms that were clinically diagnosed as benign before surgery. Of these, resected samples from 31 patients were histologically diagnosed as pleomorphic adenoma. Results: We achieved resection in patients with pleomorphic adenoma with no permanent facial paralysis or tumor recurrence, with a median follow-up time of 61 months (range 18–125 months).

Keywords::

• Parotidectomy
• deep parotid lobe
• facial paralysis
• enucleation

Acknowledgments

Mrs Masako Okui, a chief technician of Higashiosaka City General Hospital Department of Clinical Laboratory, is gratefully acknowledged for clinical advice on parotid ultrasonography.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.