Clinical Outcomes and Complications of Parotidectomy for Pleomorphic Adenoma Tumour

Objective: To evaluate the clinical and surgical outcomes in patients treated for pleomorphic adenoma (PA) of the parotid gland. Methods: This retrospective study covered 100 PA cases from 2000 to 2018, all confirmed by histopathology and with at least 24 months of follow-up. Statistical analysis was performed using Student’s t-test, Pearson’s Chi-square test, and Fisher’s exact test, with a significance level of 0.05. Results: The average patient age was 42±12 years, with an even sex ratio. Parotid swelling was the main symptom (94%), with an average tumor size of 2.5cm. Most tumors were in the superficial lobe (94 cases), and there were 3 bilateral cases. Surgical approaches included superficial exofacial parotidectomy (55 cases), total parotidectomy (25 cases), partial exofacial parotidectomy (14 cases), and enucleation (6 cases). Complications occurred in 49 patients, with postoperative facial paralysis (FP) being the most common (20%). Total parotidectomy had a higher transient FP rate (24%) compared to exofacial parotidectomy (11%). Four recurrences were noted, mainly after enucleation or exofacial parotidectomy. Statistical analysis showed significant associations: exofacial parotidectomy had the highest complication rate (47%) and was linked to permanent FP (p=0.02). Total parotidectomy was associated with Frey’s syndrome (p=0.01), partial exofacial parotidectomy with salivary fistula (p<0.001), and enucleation with tumor recurrence (p<0.001). Conclusions: Superficial exofacial parotidectomy is common but associated with complications. Total parotidectomy is linked to Frey’s syndrome, while partial exofacial parotidectomy and enucleation have specific risks of salivary fistula and recurrence. Careful selection of surgical technique is crucial to minimize complications and recurrence.