Survey of opinions on the management of pleomorphic adenoma among United Kingdom oral and maxillofacial surgeons.
ABSTRACT This study aims to highlight the current points of view regarding the management of pleomorphic adenomas among oral and maxillofacial surgeons in the United Kingdom.
A questionnaire was drafted and sent to all the consultant members of the British Society of Oral Maxillofacial Surgery (n=263). The survey evaluated the surgical experience of the surgeon, the preferred surgical treatment of a newly diagnosed 3 cm diameter pleomorphic adenoma in the superficial lobe of the parotid gland in an adult and a child, and the treatment options of pleomorphic salivary adenoma (PSA) with the four following scenarios: (i) PSA with complete excision or incomplete excision; (ii) PSA with carcinoma in situ (atypical pleomorphic adenoma) with complete excision or incomplete excision; (iii) PSA with non-invasive malignant transformation with complete or incomplete excision; and (iv) carcinoma in PSA with complete or incomplete excision. The initial response was low so two reminders were sent to increase the rate of response.
The final response rate was 67%. The results showed that there was no significant difference in the opinions of the respondents regarding treatment of pleomorphic adenoma in both adults and children. Seventy-five (56.4%) of 133 surgeons were treated the multinodular recurrence in older patients with surgery combined with radiotherapy. One-hundred and five (78.9%) surgeons were treated older patients with solitary recurrence with surgery alone. There was a consensus on complete excision for the treatment of carcinoma in situ (atypical pleomorphic adenoma) or PSA with non-invasive malignant transformation.
This survey shows that superficial parotidectomy is the standard treatment method for primary pleomorphic adenoma in children and adults. Surgery combined with radiotherapy is the preferred option in the case of multinodular recurrence, and surgery alone is recommended in the case of a solitary recurrence.