Quadrant Parotidectomy Versus Superficial Parotidectomy for Treatment of Pleomorphic Adenoma
Pleomorphic adenoma is notorious of its propensity to local recurrence due to the
microscopic extracapsular extension of the tumor. Superficial parotidectomy (SP) is the
standard treatment. Extracapsular dissection (ED) has been proposed to minimize the risk of
facial nerve palsy. However, the oncologic safety of ED is controversial in the literature.
We propose quadrant parotidectomy (QP) which is less radical than SP and less conservative
than ED. QP entails dissection overlying one primary division of the facial nerve leaving
the other division undisturbed while the resection safety margin is still generous.
Surgery for pleomorphic adenoma is a compromise between radicality and facial nerve
morbidity. Risk of local recurrence is imprecisely described in the literature and is
universally regarded as infrequent and remote. Many studies did not report recurrent cases.
Thus, Facial nerve injury is the main concern of parotid surgeons and is considered the
primary end point of this study.
Allocation: Randomized, Endpoint Classification: Safety Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment
Incidence of facial nerve palsy
using clinical neurological examination
at six months after surgery
Osama Hussein, MD, PhD
Egypt: Ministry of Higher Education