A CLINICAL STUDY OF PLEOMORPHIC ADENOMA IN SALIVARY GLANDS

타액선 다형성선종 환자의 임상적 연구

  • Kim, Jong-Ryoul (Department of Oral & Maxillofacial Surgery, College of Dentistry, Busan National University) ;
  • Park, Bong-Wook (Department of Dentistry, College of Medicine, Gyeongsang National University) ;
  • Byun, June-Ho (Department of Dentistry, College of Medicine, Gyeongsang National University) ;
  • Kim, Yong-Deok (Department of Oral & Maxillofacial Surgery, College of Dentistry, Busan National University) ;
  • Shin, Sang-Hoon (Department of Oral & Maxillofacial Surgery, College of Dentistry, Busan National University) ;
  • Kim, Uk-Kyu (Department of Oral & Maxillofacial Surgery, College of Dentistry, Busan National University) ;
  • Chung, In-Kyo (Department of Oral & Maxillofacial Surgery, College of Dentistry, Busan National University)
  • 김종렬 (부산대학교 치과대학 구강악안면외과학교실) ;
  • 박봉욱 (경상대학교 의과대학 치과학교실) ;
  • 변준호 (경상대학교 의과대학 치과학교실) ;
  • 김용덕 (부산대학교 치과대학 구강악안면외과학교실) ;
  • 신상훈 (부산대학교 치과대학 구강악안면외과학교실) ;
  • 김욱규 (부산대학교 치과대학 구강악안면외과학교실) ;
  • 정인교 (부산대학교 치과대학 구강악안면외과학교실)
  • Published : 2005.04.30

Abstract

The pleomorphic adenoma is well recognized as the most common salivary neoplasm. We examined 49 patients who had received surgical excision of the pleomorphic adenoma from 1989 to 1998 with over 5 years follow-up period. We retrospectively evaluated the patients' age, sex, chief complaints, surgical methods, and recurrence or complication rates after analysis of one's clinical and surgical records. The results are as follows : 1. There were 15 cases in parotid gland, 23 cases in palate, 8 cases in submandibular gland, and 3 cases in cheek. The ratio of male to female was 1 : 1.13. The mean age was 44. The tumor of submandibular gland occurred in more younger age than that of other salivary gland. 2. In 15 patients of parotid pleomorphic adenoma, there was 1 case(6.7%, 1/15) of recurrence. That was transformed into the malignant pleomorphic adenoma after 4 years of first surgery. We performed superficial parotidectomy of 9 cases(56.2%, 9/16), total parotidectomy of 6 cases(37.5%, 6/16), and radical parotidectomy of 1 case(6.3%, 1/16). 3. We used the rotational Sternocleidomastoid muscular flap to cover the exposed facial nerve in 12 cases(75%) after parotidectomy(7 cases of superficial parotidectomy and 5 cases of total parotidectomy). We could see 3 cases(18.7%) of facial nerve palsy and 1 case(6.3%) of Frey's syndrome after parotidectomy. We examined Frey's syndrome in only 1 case which was not used SCM muscular flap after parotidectomy. 4. In 23 patients of palatal pleomorphic adenoma, there were 2 cases(8.7%) of recurrence. In recurrence cases, We performed re-excision after 4 and 5 years of first surgery, respectively. We preserved partial thin overlying palatal mucosa during tumor excision in 5 cases(20%), which were proved as benign mixed tumor in preoperative biopsy. That mucosa-preserved cases had thick palatal mucosa, did not show mucosa ulceration and revealed well encapsulated lesions in preoperative CT. 5. In palatal tumors, we could see the 13 cases(52%) of bony invasion in preoperative CT views and the 4 cases(16%) of oro-nasal fistula after tumor excision. In two cases of recurrence, one(20%, 1/5) was in palatal mucosa-preserved group and the other(5.5%, 1/18) was in palatal mucosa-excised group. 6. We excised tumors with submandibular glands in the all cases of submandibular pleomorphic adenoma. There was no specific complication or recurrence in these cases. 7. After excision of the cheek pleomorphic adenomas, we could not see any complication or recurrence.

Keywords

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