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Acta Otolaryngol. 2011 Jun;131(6):653-9. doi: 10.3109/00016489.2010.543148. Epub 2011 Jan 24.

Extracapsular dissection: minimally invasive surgery applied to patients with parotid pleomorphic adenoma.

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Department of Otolaryngology, Head and Neck Surgery, Higashiosaka City General Hospital, Osaka, Japan.



We performed extracapsular dissection (ECD) on 31 patients with pleomorphic adenoma, including 7 deep lobe cases. ECD is minimally invasive and has limited complications compared with other conventional parotidectomy procedures. This is the first report on performance of ECD in patients with deep lobe parotid pleomorphic adenomas. Surgeons who are capsule-conscious can perform ECD with good results.


Pleomorphic adenoma, the most common benign neoplasm occurring in the parotid gland, has a constant frequency of recurrence and facial paralysis in patients after surgery. ECD is one of the surgical procedures performed on patients with these tumors, but its validity is still unclear because of its similarity to enucleation.


We performed ECD in patients with untreated parotid neoplasms that were clinically diagnosed as benign before surgery. Of these, resected samples from 31 patients were histologically diagnosed as pleomorphic adenoma.


We achieved resection in patients with pleomorphic adenoma with no permanent facial paralysis or tumor recurrence, with a median follow-up time of 61 months (range 18-125 months).

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