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Head and Neck Surgery

(367) Partial Superficial Parotidectomy: A 22-Year Experience with 151 Patients

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time
Has Audio
Disclosure(s):
Aniya Keaton: No relevant relationships to disclose.
Ali M. Hawa, MD: No relevant relationships to disclose.


Introduction: There has been controversy regarding the extent of resection in the management of pleomorphic adenomas. Over the last few decades, the pendulum of optimal surgical management has shifted from an aggressive approach to a more conservative approach. The primary aim of this study was to evaluate the efficacy and post-operative outcomes of partial superficial parotidectomy (PSP) for the management of pleomorphic adenomas.

Methods: Retrospective chart review of patients who underwent PSP was performed. Variables included demographics, pre-operative facial nerve function, operative techniques, postoperative course/facial nerve function, complications, and recurrence.

Results: 151 adults who underwent PSP for pleomorphic adenoma from July 2000 to March 2022 were identified. Mean age was 55 years with females representing 74% of the cohort. Mean tumor size at the time of presentation was 1.8 (1.3 – 2.3) cm. Baseline facial nerve function was excellent for most patients (House-Brackmann I, n = 146, 97%). Most patients underwent a superficial inferior parotidectomy (ESGS 2, n = 133, 88%). Modified Blair incision (n = 105, 77%) was the most utilized incision. Intraoperatively, the facial nerve was identified in 149 (99%) patients. The main trunk was identified in 126 (85%) patients. No patients had tumor spillage. Only two patients required parotid bed reconstruction. The most common complication was ear numbness (n=126, 60%). Postoperatively, 112 patients were House-Brackmann grade I at both preoperative and postoperative assessment, 8 went from grade I to II, 2 went from grade II to I, and 1 went from grade VI to II (Bell’s palsy that resolve to grade II following surgery). The mean follow up was 7.4 months (SD 19.6). No patients had a recurrence.

Conclusions: Partial superficial parotidectomy, in our experience, is efficacious in the management of pleomorphic adenomas with preservation of facial nerve function and minimal post-operative complications/recurrence.