Objective: To investigate the clinicopathologic characterstics and management of parotid pleomorphic adenomas closely abutting the facial nerve.
Methods: Twenty cases (21 sides) of pleomorphic adenoma in the parotid gland were surgically treated in Peking University School and Hospital of Stomatology from September 2000 to August 2010. During the operation, the facial nerve was found to be closely abutted the tumor. The nerve was carefully dissected and preserved and the tumor was removed with the parotid gland. The capsular structure of the tumor in the location where the facial nerve closely abutted was examined histopathologically. The patients were followed after the treatment.
Results: Complete capsule could be seen in the location of the tumor closely abutting the facial nerve. Very thin but complete capsule was shown in 5 cases and infiltrated tumor nodule within the capsule could be found in 3 cases. No recurrence of tumor occurred in the 20 sides without tumor spillage during the operation, while recurrence of tumor occurred in one patient with tumor spillage.
Conclusion: There was thin but complete capsule in the location where facial nerve closely abutting the parotid pleomorphic adenoma, careful dissection and preservation of facial nerve was reliable. Avoiding spillage of the tumor during the operation was the key point to prevent the seeding recurrence of the tumor.