Partial Parotidectomy Outcomes for Pleomorphic Adenoma: 15-Year Academic Center Experience.

Abstract

To evaluate long-term tumor control and functional outcomes of partial parotidectomy for primary pleomorphic adenoma of the parotid gland in a large single-surgeon cohort at an academic tertiary care center. All patients who underwent parotidectomy for pleomorphic adenoma performed by the primary author (D.G.D.) between January 2004 and December 2018 at a single academic institution were retrospectively reviewed. Demographic data, tumor characteristics, operative details, facial nerve outcomes, and recurrence rates were analyzed. Follow-up extended through January 2026 to allow long-term outcome assessment. A total of 363 patients underwent parotidectomy for pleomorphic adenoma during the study period. The mean patient age was 58.1 years. Postoperative facial nerve weakness was uncommon, with short-term paresis occurring in 5.2% of patients and long-term weakness in 1.4%. Among the 290 patients with documented tumor location relative to the facial nerve, short-term facial nerve paresis occurred more frequently in tumors located deep to the nerve compared with superficial tumors (11.3% vs. 1.6%, p = 0.0006). However, rates of long-term facial nerve dysfunction were similar between the groups (1.2% vs. 0.5%, p = 0.556). Mean operative time was 132 min (SD 91 min). A trainee was involved in all cases, and continuous facial nerve monitoring was rarely used. Tumor recurrence occurred in 0.6% of patients over an average follow-up of 10 years. Partial parotidectomy demonstrated excellent tumor control and low rates of facial nerve dysfunction. These findings support its safety and effectiveness for primary pleomorphic adenoma management in an academic training environment.