[Clinical features of accessory parotid gland tumors]

Endoscope-assisted resection of nonneoplastic space-occupying lesion in oral and maxillofacial areas

Endoscope-assisted oral and maxillofacial surgeries have been applied to the resection of tumors with minimal invasion and good cosmetic outcomes. However, with regard to endoscope-assisted resection of nonneoplastic space-occupying lesion (NSOL) in oral and maxillofacial areas which differ from tumors in treatment, there are no systematic reports. Therefore the advantages and limitations of the endoscopy-assisted approach (EAA) in resection of NSOL remain unclear. In this novel study we describe endoscope technique for resection of NSOL in face and submandibular areas and compare the feasibility and effectiveness of EAA with external approach (EA). Eleven patients underwent EAA and 20 patients underwent EA procedures. The perioperative and postoperative outcomes of the patients were evaluated. The resection of NSOL with EAA was completed successfully with a shorter hospitalization duration, less bleeding, a smaller incison and better satisfaction with appearance than with the EA procedure (P < 0.01). Our study showed that endoscope-assisted resection of NSOL is technically safe, feasible and practicable. Good cosmetic results with minimal invasion can be achieved with this new technique and therefore this may be a promising new standard procedure in oral and maxillofacial areas.

Evaluation of usefulness of fine-needle aspiration cytology in the diagnosis of tumours of the accessory parotid gland: a preliminary analysis of a case series in Japan

CONCLUSION

The accuracy and sensitivity of fine-needle aspiration cytology (FNAC) in this analysis were not satisfactory, and the false-negative rate seemed to be higher than for parotid tumours. The possibility of low-grade malignancy should be considered in the surgical treatment of accessory parotid gland (APG) tumours, even if the preoperative results of FNAC suggest that the tumour is benign.

OBJECTIVES

Little is known about the usefulness of FNAC in the preoperative evaluation of APG tumours, probably due to the paucity of APG tumour cases. We examined the usefulness of FNAC in the detection of malignant APG tumours.

METHODS

We conducted a retrospective analysis of 3 cases from our hospital, along with 18 previously reported Japanese cases. We compared the preoperative FNAC results with postoperative histopathological diagnoses of APG tumours and evaluated the accuracy, sensitivity, specificity and false-negative rates of FNAC in detecting malignant APG tumours.

RESULTS

There were four false-negative cases (19.0%), three of mucoepidermoid carcinomas and one of malignant lymphoma. One false-positive result was noted in the case of a myoepithelioma, which was cytologically diagnosed as suspected adenoid cystic carcinoma. The accuracy, sensitivity and specificity of FNAC in detecting malignant tumours were 76.2%, 60.0% and 90.9%, respectively.