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Mantsopoulos K, Gehrking M, Thimsen V, Sievert M, Mueller SK, Rupp R, Balk M, Gostian AO, Koch M, Iro H. Case-tailored indicated extracapsular dissection versus "one-size-fits-all" nerve dissection: Has the bet been won? Am J Otolaryngol 2024; 45:104260. [PMID: 38613928 DOI: 10.1016/j.amjoto.2024.104260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 03/17/2024] [Indexed: 04/15/2024]
Abstract
OBJECTIVE The aim of the study was to trace the development of surgical therapy in a large cohort, examine its changes at one single institution that has been specializing in salivary gland pathologies over the last 22 years, and to determine the extent to which a possible shift in the surgical therapy of parotid benign tumors towards less radical methods was correlated with a change in the incidence of facial palsy and Frey's syndrome. STUDY DESIGN Retrospective clinical study. METHODS A retrospective evaluation of the records of all patients treated for benign parotid tumors at a tertiary referral center between 2000 and 2022 was carried out. Surgical methods were classified into four groups: extracapsular dissection, partial superficial parotidectomy, superficial parotidectomy and complete parotidectomy. RESULTS A total of 4037 patients were included in the study. Our analysis demonstrated an increase in the total number of parotidectomies for benign lesions from 71 (2000) to 298 (2022), mostly due to the increase in extracapsular dissections (from 9 to 212). The increased performance of less radical surgery was associated with a significantly decreased incidence of perioperative complications. CONCLUSIONS Our study showed that the increased performance of less radical surgery was associated with better functional outcomes over the years.
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Affiliation(s)
- Konstantinos Mantsopoulos
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany.
| | - Mika Gehrking
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Vivian Thimsen
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Matti Sievert
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Sarina Katrin Mueller
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Robin Rupp
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Matthias Balk
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Antoniu-Oreste Gostian
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Michael Koch
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
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Yeom S, Lee DH, Lee JK, Lim SC. Growth rates over time of unoperated parotid benign tumors. Am J Otolaryngol 2024; 45:104183. [PMID: 38211399 DOI: 10.1016/j.amjoto.2023.104183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 12/06/2023] [Indexed: 01/13/2024]
Abstract
INTRODUCTION The treatment of parotid benign tumor is in principle surgery, but observation may be necessary in some cases. The purpose of this study was to investigate the growth rates over time of unoperated parotid benign tumors. METHODS We retrospectively reviewed the medical records of 63 patients with unoperated parotid benign tumors diagnosed at our institution between January 2010 and December 2022. RESULTS Forty-nine of the 63 patients had a Warthin tumor and 13 patients had a pleomorphic adenoma. On average, the unoperated parotid benign tumors grew 0.02 cm in length and 0.4 cm3 in volume per year. Compared to pleomorphic adenomas, Warthin tumors were more predominant in male patients and in those with a smoking history and a longer duration of smoking history; patients with Warthin tumors were also followed up longer (p < 0.05). However, the length and volume growth rates of unoperated Warthin tumors and pleomorphic adenomas did not significantly differ. CONCLUSION Surgery is the standard treatment for parotid benign tumors. However, small benign parotid tumors identified during preoperative examination can be observed through close follow-up, taking into account the patient's medical and general condition.
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Affiliation(s)
- Sujung Yeom
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School & Hwasun Hospital, Hwasun, South Korea
| | - Dong Hoon Lee
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School & Hwasun Hospital, Hwasun, South Korea.
| | - Joon Kyoo Lee
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School & Hwasun Hospital, Hwasun, South Korea
| | - Sang Chul Lim
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School & Hwasun Hospital, Hwasun, South Korea
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Fisher R, Ronen O. Cytologic diagnosis of parotid gland Warthin tumor: Systematic review and meta-analysis. Head Neck 2022; 44:2277-2287. [PMID: 35586869 PMCID: PMC9545504 DOI: 10.1002/hed.27099] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/02/2022] [Accepted: 05/05/2022] [Indexed: 12/02/2022] Open
Abstract
It is important to define the accuracy of fine‐needle aspiration cytology (FNAC) in the diagnosis of Warthin tumor (WT). This systematic review and meta‐analysis evaluated the accuracy of FNAC in the diagnosis of WT in the parotid gland and WT growth rate. For determination of FNAC accuracy, 17 studies, encompassing 1710 cases, were included. Pulled random model estimates of sensitivity, specificity, PPV, and NPV were 93.7% (95%CI: 92.1, 95.3), 97.9% (95%CI: 97, 98.9), 93.3% (95%CI: 91.5, 95.1), and 97.4% (95%CI: 96.4, 98.4), respectively. FNAC is highly reliable for the diagnosis of WT of the parotid. The high PPV value suggests that patients with a cytological diagnosis of WT of the parotid may be assigned to active surveillance.
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Affiliation(s)
- Roie Fisher
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Ohad Ronen
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.,Department of Otolaryngology - Head and Neck Surgery, Galilee Medical Center, Nahariya, Israel
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Mantsopoulos K, Bessas Z, Sievert M, Müller SK, Koch M, Agaimy A, Iro H. Frozen Section of Parotid Gland Tumours: The Head and Neck Pathologist as a Key Member of the Surgical Team. J Clin Med 2022; 11:jcm11051249. [PMID: 35268341 PMCID: PMC8911507 DOI: 10.3390/jcm11051249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 02/20/2022] [Accepted: 02/22/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction: The aim of this study was to evaluate the impact of subspecialised head and neck versus general surgical pathologists on the reliability of the histopathologic evaluation during intraoperative consultation. Materials and Methods: The medical records of all patients who underwent a parotidectomy with frozen section between 2006 and 2021 were retrospectively evaluated. The frozen section was evaluated for sensitivity, specificity, accuracy, and predictive value. Assessment by two groups of pathologists (subspecialised head and neck versus general surgical pathologists) was compared, and the nature or types of misdiagnoses compared with final diagnoses on paraffin sections were analysed for the two groups. Results: Our study sample was made up of 669 cases. The mean age of patients was 57.7 years (range: 10−94 years). Of these, 490 patients had a benign lesion (73.2%), whereas 179 patients had a malignant lesion (26.8%). Frozen section had an overall accuracy of 97.6%, sensitivity for malignancy was 91.1%, specificity was 100%, PPV was 100%, and the NPV was 96.8%. The exact histologic subtype in the group of malignant tumours was correctly identified in FS in 89.4% of cases. A comparison of head and neck pathologists versus general surgical pathologists revealed a highly statistically significant difference concerning both overall detection of malignancy (p < 0.001) as well as correct identification of the histologic subtype (p < 0.001). Conclusion: Involvement of subspecialised head and neck pathologists in the intraoperative consultation for salivary gland tumours results in a gain of 19.8% more sensitivity, underlining the importance of specialisation in salivary gland pathology for the optimisation of frozen section quality.
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Affiliation(s)
- Konstantinos Mantsopoulos
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (Z.B.); (M.S.); (S.K.M.); (M.K.); (H.I.)
- Correspondence: ; Tel.: +49-(0)-9131-8533156; Fax: +49-(0)-9131-8533833
| | - Zacharias Bessas
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (Z.B.); (M.S.); (S.K.M.); (M.K.); (H.I.)
| | - Matti Sievert
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (Z.B.); (M.S.); (S.K.M.); (M.K.); (H.I.)
| | - Sarina Katrin Müller
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (Z.B.); (M.S.); (S.K.M.); (M.K.); (H.I.)
| | - Michael Koch
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (Z.B.); (M.S.); (S.K.M.); (M.K.); (H.I.)
| | - Abbas Agaimy
- Institute of Pathology, Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany;
| | - Heinrich Iro
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (Z.B.); (M.S.); (S.K.M.); (M.K.); (H.I.)
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Current Trends and Controversies in the Management of Warthin Tumor of the Parotid Gland. Diagnostics (Basel) 2021; 11:diagnostics11081467. [PMID: 34441400 PMCID: PMC8391156 DOI: 10.3390/diagnostics11081467] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/07/2021] [Accepted: 08/10/2021] [Indexed: 12/27/2022] Open
Abstract
Purpose: To review the current options in the management of Warthin tumors (WTs) and to propose a working management protocol. Methods: A systematic literature search was conducted using PubMed and ScienceDirect database. A total of 141 publications were selected and have been included in this review. Publications were selected based on relevance, scientific evidence, and actuality. Results: The importance of parotid WTs is increasing due to its rising incidence in many countries, becoming the most frequently encountered benign parotid tumor in certain parts of the world. In the past, all WTs were treated with surgery, but because of their slow growth rate, often minimal clinical symptoms, and the advanced age of many patients, active observation has gradually become more widely used. In order to decide on active surveillance, the diagnosis of WT must be reliable, and clinical, imaging, and cytological data should be concordant. There are four clear indications for upfront surgery: uncertain diagnosis; cosmetic problems; clinical complaints, such as pain, ulceration, or recurrent infection; and the patient’s wish to have the tumor removed. In the remaining cases, surgery can be elective. Active surveillance is often suggested as the first approach, with surgery being considered if the tumor progresses and/or causes clinical complaints. The extent of surgery is another controversial topic, and the current trend is to minimize the resection using partial parotidectomies and extracapsular dissections when possible. Recently, non-surgical options such as microwave ablation, radiofrequency ablation, and ultrasound-guided ethanol sclerotherapy have been proposed for selected cases. Conclusions: The management of WT is gradually shifting from superficial or total parotidectomy to more conservative approaches, with more limited resections, and to active surveillance in an increasing number of patients. Additionally, non-surgical treatments are emerging, but their role needs to be defined in future studies.
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Fíková A, Kuchař M, Kalfeřt D, Dostálová L, Balko J, Zábrodský M, Plzák J. Experience with follow-up strategy in selected patients with Warthin tumour diagnosed by ultrasound-guided fine-needle aspiration biopsy (FNAB). Eur Arch Otorhinolaryngol 2021; 279:2049-2055. [PMID: 34212241 DOI: 10.1007/s00405-021-06959-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 06/24/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Warthin tumour (WT) management options comprise surgery or follow-up. The purpose of this study was to asses our experience with the follow-up strategy in selected patients with an ultrasound-guided fine-needle aspiration biopsy (FNAB) showing WT. METHODS We performed a retrospective analysis of patients diagnosed with WT using FNAB between 1.1.2006 and 31.12.2019. Patients were divided into three groups according to the therapeutic approach-immediate surgery, follow-up or surgery and follow-up. RESULTS 323 patients were diagnosed with WT and met the study's inclusion criteria (154 women, 47.7% and 169 men, 52.3%). 192 patients were operated right after the diagnosis, 109 patients were observed with their first detected tumour and 22 patients had parotid WT surgery and were in the wait-and-scan protocol with a contralateral tumour, recurrence or both. The growth rate (GR) of observed WT was highly variable (mean GR 1.0 mm/year (5%), median GR 0.8 mm (9%), range - 19.7 to +20.0 mm/year). From 131 patients in the follow-up group, 19 patients underwent surgery and definitive histology revealed 17 WTs and 2 adenocarcinomas. However, these 2 patients had changes in sonographic findings at their next control. The mean observation time was 44.7 months (range 12-138 months) in patients followed exclusively at our institution and 50.9 months (range 12-110 months) in patients observed in cooperation with an otorhinolaryngologist at the patients' place of residence. CONCLUSION Ultrasound-guided FNAB is an accurate and simple method in WT diagnosis and based on its result a follow-up strategy can be chosen for selected patients with WT.
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Affiliation(s)
- Alžběta Fíková
- Department of Otorhinolaryngology and Head and Neck Surgery 1st Faculty of Medicine, Charles University, Faculty Hospital Motol, Postgraduate Medical School, V Úvalu 84, 150 06, Prague, Czech Republic.
| | - Martin Kuchař
- Department of Otorhinolaryngology and Head and Neck Surgery 1st Faculty of Medicine, Charles University, Faculty Hospital Motol, Postgraduate Medical School, V Úvalu 84, 150 06, Prague, Czech Republic
| | - David Kalfeřt
- Department of Otorhinolaryngology and Head and Neck Surgery 1st Faculty of Medicine, Charles University, Faculty Hospital Motol, Postgraduate Medical School, V Úvalu 84, 150 06, Prague, Czech Republic
| | - Lucie Dostálová
- Department of Otorhinolaryngology and Head and Neck Surgery 1st Faculty of Medicine, Charles University, Faculty Hospital Motol, Postgraduate Medical School, V Úvalu 84, 150 06, Prague, Czech Republic
| | - Jan Balko
- Department of Pathology and Molecular Medicine 2nd Faculty of Medicine, Charles University, Faculty Hospital Motol, V Úvalu 84, 15006, Prague, Czech Republic
| | - Michal Zábrodský
- Department of Otorhinolaryngology and Head and Neck Surgery 1st Faculty of Medicine, Charles University, Faculty Hospital Motol, Postgraduate Medical School, V Úvalu 84, 150 06, Prague, Czech Republic
| | - Jan Plzák
- Department of Otorhinolaryngology and Head and Neck Surgery 1st Faculty of Medicine, Charles University, Faculty Hospital Motol, Postgraduate Medical School, V Úvalu 84, 150 06, Prague, Czech Republic
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Berner F, Koch M, Müller SK, Schapher M, Grundtner P, Iro H, Mantsopoulos K. Investigation of Sonographic Criteria for Reliable Identification of T1-T2 Low-Grade Malignant Tumors of the Parotid Gland. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:471-477. [PMID: 33309444 DOI: 10.1016/j.ultrasmedbio.2020.11.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 09/01/2020] [Accepted: 11/16/2020] [Indexed: 06/12/2023]
Abstract
The aim of this study was to investigate sonographic findings of low-grade malignant tumors of the parotid gland. The sonographic findings of all patients treated for T1-T2 low-grade carcinomas of the parotid gland between 2003 and 2018 were retrospectively examined and compared with those of patients with pleomorphic adenomas for the following parameters: definition of tumor margins, echotexture, echogenicity, shape and vascularization. Statistical analysis was performed using the χ2 test. A p value of <0.05 was considered statistically significant. A total of 310 patients (62 with T1-T2 low-grade malignant tumors, 248 with pleomorphic adenomas) were evaluated. Our analysis detected a statistically significant difference in the definition of margins, echotexture, echogenicity and shape. Furthermore, we could detect a specific pattern (anechoic islets in a small hypoechoic lesion with distal enhancement) appearing far more frequently in low-grade malignant lesions. It seems that there is still potential to reduce the incidence of the false working hypothesis "benign lesion" on imaging of low-grade malignant tumors.
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Affiliation(s)
- Ferdinand Berner
- Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Michael Koch
- Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | | | - Mirco Schapher
- Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Philipp Grundtner
- Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Heinrich Iro
- Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
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Mantsopoulos K, Koch M, Fauck V, Schinz K, Schapher M, Constantinidis J, Rösler W, Iro H. Primary parotid gland lymphoma: pitfalls in the use of ultrasound imaging by a great pretender. Int J Oral Maxillofac Surg 2020; 50:573-578. [PMID: 32938567 DOI: 10.1016/j.ijom.2020.08.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 06/23/2020] [Accepted: 08/19/2020] [Indexed: 12/17/2022]
Abstract
The aim of this study was to highlight several misleading imaging and clinical aspects of parotid gland lymphoma, taking our personal experience and relevant literature reports into consideration. The records of all patients diagnosed with lymphoma in the parotid gland between 2005 and 2017 were examined retrospectively. Sixty-seven patients were included in this study. The mean age was 61.4 years. The most frequent histological entities were marginal zone B-cell lymphoma (31.3%) and follicular lymphoma (28.4%). The tumour was stage I in 35 cases (52.2%), stage II in 13 cases (19.4%), stage III in 11 cases (16.4%), and stage IV in eight cases (11.9%). B symptoms were seen in only three patients (4.5%). The diagnosis was made after parotidectomy in 51 cases (76.1%), by core needle biopsy in 14 cases (20.9%), and by means of open biopsy in the remaining two cases (3.0%). Parotid gland lymphoma represents a diagnostically challenging, multifaceted entity that can easily mimic both benign and malignant conditions. This entity should be included in the differential diagnosis of almost all types of parotid lesion, as it seems to play the role of a great pretender.
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Affiliation(s)
- K Mantsopoulos
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany.
| | - M Koch
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - V Fauck
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - K Schinz
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - M Schapher
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - J Constantinidis
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Thessaloniki, Greece
| | - W Rösler
- Department of Haematology-Oncology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - H Iro
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
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Psychogios G, Bohr C, Constantinidis J, Canis M, Vander Poorten V, Plzak J, Knopf A, Betz C, Guntinas-Lichius O, Zenk J. Review of surgical techniques and guide for decision making in the treatment of benign parotid tumors. Eur Arch Otorhinolaryngol 2020; 278:15-29. [DOI: 10.1007/s00405-020-06250-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 07/27/2020] [Indexed: 12/13/2022]
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Pleomorphic adenoma compared with cystadenolymphoma of the parotid gland: which is more common? Br J Oral Maxillofac Surg 2020; 58:361-363. [DOI: 10.1016/j.bjoms.2019.12.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 12/31/2019] [Indexed: 01/11/2023]
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Mantsopoulos K, Bär B, Iro H. [Is dissection of the facial nerve avoidable during surgery for benign parotid tumors? : Parotid surgery without facial nerve dissection]. HNO 2020; 68:205-207. [PMID: 32060568 DOI: 10.1007/s00106-020-00821-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- K Mantsopoulos
- Hals-Nasen-Ohren-Klinik, Kopf- und Halschirurgie, Universitätsklinikum Erlangen-Nürnberg, Waldstraße 1, 91054, Erlangen, Deutschland.
| | - B Bär
- Hals-Nasen-Ohren-Klinik, Kopf- und Halschirurgie, Universitätsklinikum Erlangen-Nürnberg, Waldstraße 1, 91054, Erlangen, Deutschland
| | - H Iro
- Hals-Nasen-Ohren-Klinik, Kopf- und Halschirurgie, Universitätsklinikum Erlangen-Nürnberg, Waldstraße 1, 91054, Erlangen, Deutschland
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Bär B, Mantsopoulos K, Iro H. Paradigm shift in surgery for benign parotid tumors: 19 years of experience with almost 3000 cases. Laryngoscope 2019; 130:1941-1946. [DOI: 10.1002/lary.28454] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 10/01/2019] [Accepted: 11/17/2019] [Indexed: 12/11/2022]
Affiliation(s)
- Bianca Bär
- Department of Otorhinolaryngology, Head and Neck Surgery University of Erlangen–Nuremberg Erlangen Germany
| | - Konstantinos Mantsopoulos
- Department of Otorhinolaryngology, Head and Neck Surgery University of Erlangen–Nuremberg Erlangen Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology, Head and Neck Surgery University of Erlangen–Nuremberg Erlangen Germany
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Does increasing the incidence of extracapsular dissection for benign tumors of the parotid correlate with an increased need for revision surgery? Oral Oncol 2019; 94:111-114. [DOI: 10.1016/j.oraloncology.2019.05.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 05/22/2019] [Accepted: 05/25/2019] [Indexed: 12/27/2022]
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