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Roh JL. Gland preservation with postauricular sulcus approach for benign parotid tumors. J Plast Reconstr Aesthet Surg 2024; 89:33-39. [PMID: 38128372 DOI: 10.1016/j.bjps.2023.11.050] [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: 09/27/2023] [Revised: 11/09/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023]
Abstract
Gland-preserving surgery has gained popularity for treating benign parotid tumors, offering potential benefits by preserving facial nerve function and salivary secretion while reducing complications. This study aims to evaluate the functional, cosmetic, and disease control outcomes of gland-preserving surgery via a postauricular sulcus incision. METHODS An observational longitudinal investigation encompassed 46 patients undergoing gland-preserving surgery for benign parotid tumors via the postauricular sulcus incision approach. Patient assessments included cosmetic contentment, functional repercussions, and disease management throughout the follow-up. RESULTS Predominantly, tumors were situated in the superficial lobe, with successful application observed in 8 instances (17%) within the deep lobe. Notably, no tumor recurrences were detected during the follow-up period. Postoperative pain remained minimal, accentuated by high patient satisfaction regarding the incision scar and facial symmetry. Furthermore, preservation of facial nerve functionality and salivary secretion was observed. CONCLUSION Gland-preserving surgery via the postauricular sulcus incision technique exemplifies advantageous functional and cosmetic outcomes when addressing benign parotid tumors. This approach presents a secure and efficient alternative, facilitating effective local management.
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Affiliation(s)
- Jong-Lyel Roh
- Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea; Department of Biomedical Science, General Graduate School, CHA University, Seongnam, Republic of Korea.
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Dong Y, Zhang J, Li Y, Huang W, Dang Y, Gong W, Shen X, Xu L. Endoscope-Assisted Resection of Benign Parotid Tumors via Concealed Post-Auricular Sulcus Incision. Laryngoscope 2023; 133:133-138. [PMID: 35460273 DOI: 10.1002/lary.30140] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 03/27/2022] [Accepted: 03/28/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To investigate the feasibility, safety, and effectiveness of endoscopic-assisted resection of benign parotid tumors via concealed post-auricular sulcus incision. METHODS Between October 2019 and March 2021, eligible patients with diagnosed benign parotid tumors were prospectively included and randomly assigned to two groups: the endoscope-assisted post-auricular sulcus incision group (endoscope group) and the conventional Blair "S" incision group (conventional group). RESULTS A total of 45 patients were finally included, including 24 subjects in the endoscope group and 21 subjects in the conventional group. No obvious differences were observed in basic information between these two groups of patients. The surgical incision length in endoscope group patients was 4.0 ± 0.4 cm, which was significantly shorter than that in conventional group patients, 10.3 ± 1.6 cm (p < 0.001). The total intraoperative blood loss, the first post-operative day drainage volume, the total post-operative drainage volume, and the total drainage days were all significantly lower in endoscope group patients than in conventional group patients (all p < 0.05). Among 3 months follow-ups, no local recurrence or residual tumor were found in both groups of patients, and there were none of them had permanent facial paralysis or parotid fistula. The self-evaluated appearance satisfaction VAS scores of endoscope group patients were all 0, which was significantly lower than that of conventional group patients, 4.7 ± 1.6 (p < 0.001). CONCLUSION Compared with the conventional Blair "S" incision surgery, the endoscope-assisted resection of the benign parotid tumors via concealed post-auricular sulcus incision was safe and effective and showed advantages of faster recovery and better self-assessments of appearance satisfaction. LEVEL OF EVIDENCE 2 Laryngoscope, 133:133-138, 2023.
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Affiliation(s)
- Yuke Dong
- Department of Otolaryngology, Head and Neck Surgery, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China
| | - Junbo Zhang
- Department of Otolaryngology, Head and Neck Surgery, Peking University First Hospital, Beijing, China
| | - Yujie Li
- Department of Otolaryngology, Head and Neck Surgery, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China
| | - Wei Huang
- Department of Otolaryngology, Head and Neck Surgery, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China
| | - Yanwei Dang
- Department of Otolaryngology, Head and Neck Surgery, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China
| | - Wendan Gong
- Department of Otolaryngology, Head and Neck Surgery, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China
| | - Xiao Shen
- Department of Otolaryngology, Head and Neck Surgery, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China
| | - Lianfang Xu
- Department of Otolaryngology, Head and Neck Surgery, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China
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Chen S, Zhao M, Wang D, Zhao Y, Qiu J, Liu Y. Endoscopic and Robotic Parotidectomy for the Treatment of Parotid Tumors: A Systematic Review and Meta-Analysis. Front Oncol 2021; 11:748885. [PMID: 34900694 PMCID: PMC8660082 DOI: 10.3389/fonc.2021.748885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 10/18/2021] [Indexed: 11/13/2022] Open
Abstract
Background The goal of this review was to introduce endoscopic/robotic parotidectomy (EP/RP) and compare EP/RP against conventional parotidectomy (CP) regarding the intraoperative and postoperative parameters in the treatment of parotid tumors. Methods A systematic literature search of medical databases (PubMed, Embase, and Cochrane Central Register of Controlled Trials) was performed from inception to November 2020 to generate relevant studies. Results A total of 13 eligible studies (572 patients) were included for systematic review, and 7 out of 13 comparable studies for the quantitative synthesis of outcomes. Patients who underwent EP were characterized by less intraoperative bleeding volume, shorter incision length, and higher satisfaction postoperatively (WMD, 95% CI, -42.80; - 58.23 to -27.37; p < 0.01; WMD, 95% CI, -5.64; -7.88 to -3.39; p < 0.01; SMD, 95% CI, 1.88; 1.46 to 2.31; p < 0.01, respectively). However, operative time and risk of facial palsy exhibited no significant differences (WMD, 95% CI, -11.17; -26.71 to 4.34; p = 0.16; OR, 95% CI,0.71; 0.39 to 1.32; p = 0.28, respectively). Conclusions Our findings suggest that the current evidence does not adequately support EP is equally safe and effective as CP. In certain selected cases, endoscopic technology has its unique advantages. For patients with strong cosmetic needs, endoscopic or robotic techniques may be an alternative through adequate preoperative evaluations. Systematic Review Registration International Prospective Register of Systematic Reviews, identifier CRD42020210299.
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Affiliation(s)
- Shanwen Chen
- Department of Otorhinolaryngology - Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Mei Zhao
- Oncology Department of Integrated Traditional Chinese and Western Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Dong Wang
- Department of Otorhinolaryngology - Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yi Zhao
- Department of Otorhinolaryngology - Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jianxin Qiu
- Department of Otorhinolaryngology - Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yehai Liu
- Department of Otorhinolaryngology - Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
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Yang X, Wang L, Shen Y, Guo B, Zheng ZW, Sun J. Feasibility of using the postauricular-groove approach without endoscopic assistant for excision of parotid tumors. Results from a series of 58 cases. J Craniomaxillofac Surg 2021; 50:449-455. [PMID: 35490146 DOI: 10.1016/j.jcms.2021.09.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 09/18/2021] [Accepted: 09/26/2021] [Indexed: 11/25/2022] Open
Abstract
The aim of the study was to evaluate the efficacy and preliminary outcomes of using a postauricular-groove approach without endoscopic assistance for the excision of parotid tumors. Patients who underwent parotidectomy using a postauricular-groove incision were selected for this study. For patients in which parotidectomy was difficult, namely, for tumors located in the deep lobe area, the parotid gland sternocleidomastoid space was fully utilized, and the tumor was resected from the posterior plane. A total of fifty-eight patients with parotid tumor were enrolled and divided into superior lobe group (n = 46) and deep lobe group (n = 12). The difference in operation time (94 vs 119 min) and postoperative drainage (20.18 vs 45.33 mL) was statistically significant between the tumors in the superficial and deep lobes. However, postoperative cosmetic VAS score was 10 (extremely satisfied) for all patients. The incidence of transient facial nerve paralysis was comparable (8.7% vs 16.7%), and all of them resolved spontaneously within 3 months. No recurrence of tumors was found in either group in the median follow-up interval of 26.45 months (range 22.2-35.3 months), which was comparable to the result using the conventional "S" approach. After making full use of the parotid gland sternocleidomastoid space, the postauricular-groove approach demonstrated satisfactory facial nerve protection, as well as easy maneuverability without the risk of surgical complications for tumors located in the deep lobe area. Importantly, the postauricular-groove approach showed excellent cosmetic outcomes for all patients and should be considered an alternative approach for parotidectomy of selected cases.
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Affiliation(s)
- Xin Yang
- Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Liang Wang
- Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yi Shen
- Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China.
| | - Bing Guo
- Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Zhi-Wei Zheng
- Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Jian Sun
- Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
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Khafif A, Niddal A, Azoulay O, Holostenco V, Masalha M. Parotidectomy via Individualized Mini-Blair Incision. ORL J Otorhinolaryngol Relat Spec 2020; 82:121-129. [PMID: 32097928 DOI: 10.1159/000505192] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 11/28/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND The modified Blair incision is the standard facial incision for the vast majority of parotid gland lesions. We utilize three types of incisions: "classic mini-Blair" for parotid body tumors, "cervical mini-Blair" for parotid tail tumors, and "vertical mini-Blair" for anterior parotid tumors. In this study, we describe the surgical and esthetic outcomes of these individually tailored incisions. METHODS Patients undergoing parotidectomy between 2011 and 2013 were included. The surgical outcomes and patients' satisfaction were assessed. RESULTS Of 122 patients, 89 were included. All patients completed a questionnaire assessing the postoperative course and patients' satisfaction regarding the surgery in general and the scar in particular. Among these patients, 78 (87%) had a benign pathology and 11 (13%) had malignant tumors. The tumors were located at the parotid body in 57 patients (64%), at the parotid tail in 19 (21%), at the deep lobe in 8 (9%), and at the anterior parotid gland in 5 (6%). All tumors were removed successfully with negative margins on pathology. No inadvertent permanent facial nerve paralysis occurred. The median operation time was 72 min (23-211). The average patient scores of satisfaction with the surgical scar and with the surgery were 9.54 and 9.72, respectively. CONCLUSIONS Individualized mini-Blair incision is feasible for benign as well as selected malignant parotid tumors.
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Affiliation(s)
- Avi Khafif
- Department of Otolaryngology - Head and Neck Surgery, Assuta Medical Center, Ben Gurion University in Beer Sheva, Tel Aviv, Israel
| | - Assadi Niddal
- Department of Otolaryngology - Head and Neck Surgery, Assuta Medical Center, Ben Gurion University in Beer Sheva, Tel Aviv, Israel
| | - Ofer Azoulay
- Department of Otolaryngology - Head and Neck Surgery, Assuta Medical Center, Ben Gurion University in Beer Sheva, Tel Aviv, Israel
| | - Victoria Holostenco
- Department of Otolaryngology - Head and Neck Surgery, Assuta Medical Center, Ben Gurion University in Beer Sheva, Tel Aviv, Israel
| | - Muhamed Masalha
- Department of Otolaryngology - Head and Neck Surgery, Assuta Medical Center, Ben Gurion University in Beer Sheva, Tel Aviv, Israel, .,Department of Otolaryngology - Head and Neck Surgery, Emeq Medical Center, Technion University in Haifa, Afula, Israel,
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Li T, Liu Y, Wang Q, Qin Y, Gao W, Li Q, Schiferle E, Xiao S. Parotidectomy by an endoscopic‐assisted postauricular‐groove approach. Head Neck 2019; 41:2851-2859. [PMID: 30869186 DOI: 10.1002/hed.25720] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 01/24/2019] [Accepted: 02/05/2019] [Indexed: 11/07/2022] Open
Affiliation(s)
- Tiancheng Li
- Department of Otorhinolaryngology-Head and Neck Surgery, Peking University First Hospital, Beijing, China
| | - Yuhe Liu
- Department of Otorhinolaryngology-Head and Neck Surgery, Peking University First Hospital, Beijing, China
| | - Quangui Wang
- Department of Otorhinolaryngology-Head and Neck Surgery, Peking University First Hospital, Beijing, China
| | - Yong Qin
- Department of Otorhinolaryngology-Head and Neck Surgery, Peking University First Hospital, Beijing, China
| | - Weihua Gao
- Department of Otorhinolaryngology-Head and Neck Surgery, Peking University First Hospital, Beijing, China
| | - Qian Li
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
| | - Erik Schiferle
- Center for Cancer Research, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Shuifang Xiao
- Department of Otorhinolaryngology-Head and Neck Surgery, Peking University First Hospital, Beijing, China
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7
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Endoscope-assisted extracapsular dissection of benign parotid tumors through a single cephaloauricular furrow incision versus a conventional approach. Surg Endosc 2016; 31:3203-3209. [DOI: 10.1007/s00464-016-5345-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 11/09/2016] [Indexed: 10/20/2022]
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Minimally invasive video-assisted submandibular sialadenectomy: surgical technique and results from two institutions. Surg Endosc 2015; 30:3314-20. [PMID: 26487240 DOI: 10.1007/s00464-015-4604-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 09/26/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Submandibular gland excision is traditionally performed using a transcervical approach. However, innovative surgical trials have recently been conducted to investigate techniques that can prevent or reduce visible scarring and nerve injury. The aim of the present study was to evaluate the feasibility of a new approach to submandibular gland excision that is based on the use of a minimally invasive video-assisted technique and an ultrasound scalpel in an endoscopic neck surgery program with a low annual flow of procedures. METHODS We retrospectively studied 15 patients with submandibular gland disease who underwent minimally invasive video-assisted submandibular sialadenectomy performed by two surgeons at two institutions. Eight patients had proximally located salivary calculi, three had chronic sialadenitis, and four had benign neoplasms. All dissections were carried out by a single-port gasless approach, using the Miccoli technique, involving endoscope magnification and an ultrasonic scalpel. RESULTS All 15 submandibular gland resections were performed successfully, with no conversions to conventional open resection. The operative time ranged from 45 to 125 min (median 84 min). A total of 67 % of patients were discharged the day after surgery, and the maximum length of stay was 3 days. One patient experienced postoperative bleeding, and one experienced postoperative infection. There was no neural injury. The incision scar healed well in all cases, and all patients reported excellent cosmetic results. CONCLUSIONS Endoscopic submandibular gland resection using a minimally invasive video-assisted technique, endoscopic magnification, and ultrasonic scalpel was feasible and resulted in excellent surgical outcomes.
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Yan Y, Chen X. Endoscopic Resection for Benign Parotid Tumor Through a Cosmetic Retroauricular Incision with Water Sac Establishing Operative Space: A New Approach. J Laparoendosc Adv Surg Tech A 2015; 25:508-13. [PMID: 25973985 DOI: 10.1089/lap.2015.0046] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Yuyan Yan
- Department of Pathology, Affiliated Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Xiaohong Chen
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
- Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otolaryngology, Beijing, People's Republic of China
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Li SY, Hsu CH, Chen MK. Minimally invasive endoscope-assisted trans-oral excision of huge parapharyngeal space tumors. Auris Nasus Larynx 2015; 42:179-82. [DOI: 10.1016/j.anl.2014.10.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 10/12/2014] [Accepted: 10/21/2014] [Indexed: 11/24/2022]
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Chen J, Chen W, Zhang J, He F, Zhu Z, Tang S, Wang Y. Modified Endoscope-Assisted Partial-Superficial Parotidectomy through a Retroauricular Incision. ORL J Otorhinolaryngol Relat Spec 2014; 76:121-6. [DOI: 10.1159/000362605] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Accepted: 03/31/2014] [Indexed: 11/19/2022]
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12
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Exclusively endoscopic resection of nasopharyngeal adenocarcinoma. Clin Exp Otorhinolaryngol 2013; 6:263-5. [PMID: 24353869 PMCID: PMC3863678 DOI: 10.3342/ceo.2013.6.4.263] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2010] [Revised: 08/24/2010] [Accepted: 09/07/2010] [Indexed: 12/04/2022] Open
Abstract
We reported two patients with nasopharyngeal adenocarcinoma resected by using the exclusively endoscopic approach. Case reports and a review of the world literature concerning nasopharyngeal adenocarcinoma. The tumors were resected successfully via the exclusively endoscopic approach and no conversions to the conventional approach were necessary. The two patients were followed up for 26 and 18 months respectively, and no recurrence was noted without postoperative chemotherapy or radiotherapy. To the best of our knowledge, this is the first report of endoscopic resection of nasopharyngeal adenocarcinoma. Our experience revealed that not only for the early recurrent nasopharyngeal carcinoma, the exclusively endoscopic nasopharyngectomy can be expanded for the resection of selected nasopharyngeal adenocarcinoma.
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Li B, Zhang L, Zhao Z, Shen G, Wang X. Minimally invasive endoscopic resection of benign tumours of the accessory parotid gland: an updated approach. Br J Oral Maxillofac Surg 2013; 51:342-6. [DOI: 10.1016/j.bjoms.2012.07.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2012] [Accepted: 07/25/2012] [Indexed: 11/26/2022]
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Borumandi F, George KS, Cascarini L. Parotid surgery for benign tumours. Oral Maxillofac Surg 2012; 16:285-290. [PMID: 22847039 DOI: 10.1007/s10006-012-0352-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Accepted: 07/25/2012] [Indexed: 06/01/2023]
Abstract
PURPOSE The majority of parotid tumours are benign, making parotid surgery a compromise between adequate tumour excision and preservation of function and facial harmony. Besides the traditional superficial or total parotidectomy, less invasive techniques have been described with similar recurrent rates. The aim of this review is to assess the evidence in the published literature and to summarise the advantages and disadvantages of the available techniques. METHODS A systematic search in Pubmed for studies on surgery of benign parotid tumours (BPTs) published between January 2000 and January 2012 was conducted. Case series with a clear description of the surgical technique and a minimum number of 10 patients were included. RESULTS Four hundred sixty-three articles were found, 49 abstracts reviewed and 37 case series were selected for this review. The surgical techniques for benign parotid tumours can largely be grouped into facial nerve dissecting (superficial parotidectomy, partial superficial parotidectomy and total parotidectomy) and non-nerve dissecting techniques (extracapsular dissection). With all of the currently used techniques, a low recurrence (<3 %) with a low incidence of permanent facial nerve morbidity (0.2-4 %) can be achieved. The tumour-facial nerve interface and pseudopodia are areas at risk for positive margins. CONCLUSION There is currently no agreement in the literature about the extent of surgery for BPTs to obtain an adequate margin. The tumour nerve interface is the predetermined area at risk for tumour spillage and positive margin. A prolonged follow-up is recommended. Further long-term randomised clinical trials are required to address the question of the extent of the excision in benign parotid surgery.
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Affiliation(s)
- Farzad Borumandi
- Department of Oral and Maxillofacial Surgery, Northwick Park Hospital, North West London Hospitals NHS Trust, Watford Road, Harrow, London, HA1 3UJ, UK.
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Yuen APW. Aesthetic consideration of parotidectomy - post-aural approach and extended sternomastoid flap: how we do it. Clin Otolaryngol 2010; 35:231-4. [PMID: 20636747 DOI: 10.1111/j.1749-4486.2010.02108.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- A P-W Yuen
- Hong Kong Head & Neck Ear Nose Throat Surgery Centre, Hong Kong, China.
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Abstract
Part II this article reviewed the current state of the art in head and neck oncology. These include very important and stimulating new areas of interest including the marked acceptance of chemoradiation in favor of surgery in patients with cancer of the head and neck. The concept of HPV as a cause of cancer of the oropharynx is relatively new and very important in the epidemiology of these tumors. New modalities such as PET CT scanning and robotic surgery are discussed and appear to be very important in management of cancer of the head and neck. Endoscopic endonasal skull base surgery is another new high technology contribution to the field of head and neck surgery as is the use of endoscopic assisted thyroid surgery. These and other new concepts are discussed in this manuscript.
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Removal of frontal sinus keratoma solely via endoscopic sinus surgery. The Journal of Laryngology & Otology 2010; 124:1116-9. [PMID: 20602851 DOI: 10.1017/s002221511000157x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES To present a patient with a frontal sinus keratoma removed solely via endoscopic sinus surgery, including presentation of characteristic computed tomography and magnetic resonance images; to discuss the differential diagnosis of this condition; and to report the current knowledge on and treatment of frontal sinus keratoma. CASE REPORT A 53-year-old man presented to our department with a 10-month history of rhinorrhoea and postnasal drip. After computed tomography and magnetic resonance imaging studies, the patient underwent surgery utilising a modified Lothrop procedure. An extensive soft tissue lesion was removed from the frontal sinus. Histological examination revealed a lamellated cluster of keratinous material. The pathological diagnosis was keratoma of the frontal sinus. There was no recurrence of keratoma over a two-year follow-up period. CONCLUSIONS Following review of the English language literature, we believe this case report to represent the first successful application of a modified endoscopic Lothrop procedure for resection of an extensive frontal sinus keratoma. Thus, the applications of endoscopic sinus surgery may be expanded to include frontal sinus keratoma removal.
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Sun W, Xu YD, Zheng YQ, Liu X, Zeng L, Liu W, Huang X. Endoscope-assisted partial-superficial parotidectomy through two small skin incisions. Acta Otolaryngol 2009; 129:1493-7. [PMID: 19922103 DOI: 10.3109/00016480902791694] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION Endoscope-assisted partial-superficial parotidectomy is a feasible method for treatment of benign parotid superficial lobe tumors located at the anterior or the inferior of the auricular lobule. The main advantage of this procedure is that the small operative scar resulted in improved cosmetic results. OBJECTIVES This study evaluated the feasibility of endoscope-assisted partial parotidectomy through two small skin incisions. PATIENTS AND METHODS Thirty cases with benign parotid superficial lobe tumors with a diameter < 30 mm located at the anterior or the inferior of the auricular lobule underwent endoscope-assisted partial-superficial parotidectomy via retrograde approach through two small skin incisions. RESULTS All 30 operations were successfully performed endoscopically. All the patients were satisfied with the cosmetic results. Only three patients had transient facial paresis and recovered in 1-2 months. The endoscopic surgery lasted for 106.48+/-12.62 min. There was no tumor recurrence during the follow-up after 26-50 months.
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Affiliation(s)
- Wei Sun
- Department of Otorhinolaryngology & Head and Neck Surgery, 2nd Affiliated Hospital of Sun Yat-Sen University, Guangzhou, PR China
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Hsu AK, Kutler DI. Indications, techniques, and complications of major salivary gland extirpation. Oral Maxillofac Surg Clin North Am 2009; 21:313-21. [PMID: 19608047 DOI: 10.1016/j.coms.2009.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This article reviews major salivary gland anatomy and the differential diagnosis of salivary gland disease. The surgical technique for parotid and submandibular gland excision is described in detail. Possible complications and their management are also discussed, followed by a brief literature review of new surgical techniques.
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Affiliation(s)
- Amy K Hsu
- Department of Otorhinolaryngology, Head and Neck Surgery, New York Presbyterian Hospital, Weill Medical College of Cornell University, 1305 York Avenue, New York, NY 10021, USA
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