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Narang E, Tyagi S, Jain N, Singh J. Collaural fistula: Our experience. Trop Doct 2023; 53:517-519. [PMID: 37331986 DOI: 10.1177/00494755231181424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Branchial cleft anomalies are congenital, arising from the first to the fourth pharyngeal clefts. The most common is a second arch anomaly. As it is congenital, it presents at birth though may become symptomatic later. The spectrum of anomalies includes sinus, cyst, or fistula formation or a combination of these. Here we present a case series based on first cleft anomalies. The principles of management include early diagnosis, excision of any fistulous tract, and prevention of injury to the facial nerve.
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Affiliation(s)
- Ekta Narang
- Assistant Professor, Chacha Nehru Bal Chikitsalya, Geeta Colony, New Delhi, India
| | - Sonali Tyagi
- Senior Resident, Chacha Nehru Bal Chikitsalya, Geeta Colony, New Delhi, India
| | - Neha Jain
- Assistant Professor, Chacha Nehru Bal Chikitsalya, Geeta Colony, New Delhi, India
| | - Jyoti Singh
- Senior Resident, Chacha Nehru Bal Chikitsalya, Geeta Colony, New Delhi, India
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2
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Murugan RS, Maniam R, Dhanasekarapandiyan V, Hariharan G. Characteristics, Surgical Management, and Outcomes of Parotid Gland Masses in the Pediatric Age Group: A Single Tertiary Institute Experience. J Indian Assoc Pediatr Surg 2023; 28:415-420. [PMID: 37842213 PMCID: PMC10569271 DOI: 10.4103/jiaps.jiaps_100_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 06/19/2023] [Accepted: 07/13/2023] [Indexed: 10/17/2023] Open
Abstract
Context Parotid gland lesions in children requiring surgical management are not common. Neoplastic lesions of the parotid glands are also less common. Parotid tumors in children have different characteristics from those that occur in adults. When they occur in the pediatric age group, malignancy has to be ruled out. Subjects and Methods This is a retrospective study of children who presented to our institute, a tertiary care referral hospital for children <12 years, with parotid swellings during the 5-year period between April 2018 and March 2023. The children who underwent surgical management for parotid lesions, in the form of parotidectomy, were included in the study. Children who were treated by nonoperative management were excluded from the study. Results Twelve children were included. Of the 12 children, three (25.0%) children had malignancy, four (33.33%) children had benign tumors, three (25.0%) children had vascular malformations, and the remaining two (16.67%) children had inflammatory etiology. All children underwent superficial/total parotidectomy, depending on the involvement of superficial and/or deep lobe. Of the three malignant parotid tumors, two were of mucoepidermoid carcinoma and one was myoepithelial carcinoma. One of the children with mucoepidermoid carcinoma had recurrence. Conclusions Facial nerve-sparing parotidectomy is the treatment for neoplastic and inflammatory lesions. Initially, lymphovascular tumors were treated aggressively with parotidectomy. Neck node dissection should be performed only in children with fine-needle aspiration cytology-confirmed nodal metastases during primary surgery. Adjuvant treatment may be required in selected cases.
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Affiliation(s)
- Raghunath Sambandam Murugan
- Department of Paediatric Surgery, Institute of Child Health and Hospital for Children, Madras Medical College, Chennai, Tamil Nadu, India
| | - Raghul Maniam
- Department of Paediatric Surgery, Institute of Child Health and Hospital for Children, Madras Medical College, Chennai, Tamil Nadu, India
| | - Vembar Dhanasekarapandiyan
- Department of Paediatric Surgery, Institute of Child Health and Hospital for Children, Madras Medical College, Chennai, Tamil Nadu, India
| | - G. Hariharan
- Department of Paediatric Surgery, Institute of Child Health and Hospital for Children, Madras Medical College, Chennai, Tamil Nadu, India
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3
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Grasso M, Fusconi M, Cialente F, de Soccio G, Ralli M, Minni A, Agolli G, de Vincentiis M, Remacle M, Petrone P, Di Maria D, D’Andrea V, Greco A. Rupture of the Pleomorphic Adenoma of the Parotid Gland: What to Know before, during and after Surgery. J Clin Med 2021; 10:jcm10225368. [PMID: 34830650 PMCID: PMC8624875 DOI: 10.3390/jcm10225368] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/15/2021] [Accepted: 11/15/2021] [Indexed: 11/17/2022] Open
Abstract
Background: We assessed the cases of intraoperative spillage of primary pleomorphic adenomas (PPAs) of the parotid gland in the literature, comparing them with our own cases. We aim to explain how the surgeon should manage a spillage during surgery (i.e., how to avoid spreading the contents that are coming out of the tumor). We also aim to investigate whether or not spillage is linked to a higher rate of PPA recurrence. Methods: We collected surgical and pathological reports, taking data on capsular ruptures and the spillage of tumors. Results: Intraoperative tumor spillage and tumor rupture occurred in 34/202 cases. There were three recurrences after a mean of 3.7 years (mean follow-up duration: 10.3 years). One recurrence happened to a patient who had an intraoperative tumor spillage, and two more recurrences happened to patients who did not have spillage. Conclusion: We believe that the real number of the events of spillage is underestimated and underreported by surgeons. Capsular rupture must always be avoided, and secure resection margins must always be pursued, independent of the type of parotidectomy being performed. Features that increase the risk of recurrence are an intraoperative rupture and the presence of satellite nodules (as recorded in the pathologist’s report). In these cases, patients need a longer follow-up period.
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Affiliation(s)
- Michele Grasso
- Department of Sense Organs, Sapienza University of Rome, 00161 Rome, Italy; (M.F.); (F.C.); (G.d.S.); (M.R.); (A.M.); (G.A.); (A.G.)
- Correspondence:
| | - Massimo Fusconi
- Department of Sense Organs, Sapienza University of Rome, 00161 Rome, Italy; (M.F.); (F.C.); (G.d.S.); (M.R.); (A.M.); (G.A.); (A.G.)
| | - Fabrizio Cialente
- Department of Sense Organs, Sapienza University of Rome, 00161 Rome, Italy; (M.F.); (F.C.); (G.d.S.); (M.R.); (A.M.); (G.A.); (A.G.)
| | - Giulia de Soccio
- Department of Sense Organs, Sapienza University of Rome, 00161 Rome, Italy; (M.F.); (F.C.); (G.d.S.); (M.R.); (A.M.); (G.A.); (A.G.)
| | - Massimo Ralli
- Department of Sense Organs, Sapienza University of Rome, 00161 Rome, Italy; (M.F.); (F.C.); (G.d.S.); (M.R.); (A.M.); (G.A.); (A.G.)
| | - Antonio Minni
- Department of Sense Organs, Sapienza University of Rome, 00161 Rome, Italy; (M.F.); (F.C.); (G.d.S.); (M.R.); (A.M.); (G.A.); (A.G.)
| | - Griselda Agolli
- Department of Sense Organs, Sapienza University of Rome, 00161 Rome, Italy; (M.F.); (F.C.); (G.d.S.); (M.R.); (A.M.); (G.A.); (A.G.)
| | - Marco de Vincentiis
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy;
| | - Marc Remacle
- Department of Otorhinolaryngology Head and Neck Surgery, CHL-Eich, Rue d’Eich 78, 1111 Luxembourg, Luxembourg;
| | - Paolo Petrone
- Department of Otolaryngology, Head and Neck Surgery, “Di Venere” Hospital, 70121 Bari, Italy;
| | - Domenico Di Maria
- Department of Otolaryngology, Head and Neck Surgery, “San Pio” Hospital, 82100 Benevento, Italy;
| | - Vito D’Andrea
- Department of Surgical Sciences, “Sapienza” University of Rome, Viale Regina Elena 324, 00161 Rome, Italy;
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, 00161 Rome, Italy; (M.F.); (F.C.); (G.d.S.); (M.R.); (A.M.); (G.A.); (A.G.)
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4
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Loke WL, Rahimi S, Brennan PA. An update on extracapsular dissection for the management of parotid gland pleomorphic adenoma. J Oral Pathol Med 2021; 51:219-222. [PMID: 34697837 DOI: 10.1111/jop.13251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/04/2021] [Accepted: 10/12/2021] [Indexed: 11/29/2022]
Abstract
Superficial parotidectomy has been the gold standard for surgical removal of benign mobile parotid gland tumours. The comparatively newer technique of extracapsular dissection, which involves careful dissection of the tumour itself without the need for formal gland excision, has gained popularity in recent years. Tumours can be removed via smaller incision, and the technique reduces the risk of Frey's syndrome (gustatory sweating) and hollowing at the site of surgery. The risk of facial nerve damage can also be lower with extracapsular dissection. If done carefully, the incidence of tumour recurrence, particularly for pleomorphic adenomas, is comparable with formal parotidectomy. We provide a brief update overview of the current evidence for extracapsular dissection in the treatment of benign parotid tumours and include several meta-analyses which provide evidence for the safety of the technique. We have also included our audited results of over 100 recent extracapsular dissections, with 0% incidence of permanent facial nerve weakness, reported Frey's syndrome and recurrence rates over the last 5 years.
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Affiliation(s)
- Wee Lee Loke
- Maxillofacial Unit, Queen Alexandra Hospital, Portsmouth, UK
| | - Siavash Rahimi
- Department of Histopathology, IDI-IRCCS, Rome, Italy.,School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, UK
| | - Peter A Brennan
- Maxillofacial Unit, Queen Alexandra Hospital, Portsmouth, UK
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5
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Saripalli RRK, Alluri LSC, Jakkula A, Yadavilli SS. Extracapsular Dissection for Small Benign Tumors of Parotid Gland: A Case Report on Contemporary Technique. Cureus 2021; 13:e17007. [PMID: 34540408 PMCID: PMC8423323 DOI: 10.7759/cureus.17007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2021] [Indexed: 11/30/2022] Open
Abstract
Salivary gland tumor looms as painless enlarging mass which may embrace in both major or minor glands. Pleomorphic adenoma (PA) accord about 40-70% of all salivary gland tumors, where Warthin tumor, basal cell adenoma (BCA), adenoid cystic carcinoma (ACC), and sebaceous tumors have a strong predilection for major salivary gland. However, polymorphous low-grade adenocarcinoma (PLGA) has a marked predilection for the minor salivary gland. We present a case of PA in a 26-year-old male patient that has been successfully managed by extracapsular dissection (ECD) without any post-operative complications.
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Affiliation(s)
| | | | - Ananthnag Jakkula
- Department of Oral and Maxillofacial Surgery, GSL Dental College & Hospital, Rajahmundry, IND
| | - Sai Sarat Yadavilli
- Department of Oral and Maxillofacial Surgery, St. Joseph Dental College, Eluru, IND
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6
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Jain A, Sudharshan M, Vijayakumar C, Kumbhar U, Nelamangala Ramakrishnaiah VP. Colossal Parotid Tumors: A Diagnostic and Surgical Challenge. Cureus 2021; 13:e14539. [PMID: 34017654 PMCID: PMC8129954 DOI: 10.7759/cureus.14539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Tumors of the salivary glands constitute 3% of all head and neck tumors. The parotid gland (PG) is the most common site involved in 85% of cases. PG tumors' size varies from a few millimeters to several centimeters and is about 2-6 cm on average. However, because of insidious growth and asymptomatic nature, untreated tumors of the PG can attain large size. Pleomorphic adenoma (PA), as large as 33 cm in size or 26.5 kg in weight, has been reported in the literature. Similarly, untreated Warthin’s tumor (WT) rarely becomes giant, size up to 20 cm is reported. Giant PG tumors are commonly symptomatic and have a rare tendency to become malignant. We are reporting two giant PG tumors with different histopathological diagnoses, PA and WT of size 15x15 cm and 10x8 cm, respectively. Therefore, with a size of 10 cm, our case is the second-largest WT reported in the literature. Both the giant PG tumors were present for 15-20 years, and mild pain and discomfort were the only symptoms. We had the differential preoperative tissue diagnosis in fine-needle aspiration cytology (FNAC) because of varying consistency. Contrast-enhanced computed tomography (CECT) and magnetic resonance imaging (MRI) of the neck were done for these cases for preoperative planning. Compared to the former, the latter was more informative about nerve involvement preoperatively. Both the patients underwent superficial parotidectomy, and meticulous dissection was done to identify and safeguard the facial nerve and its branches. We had a challenge in closing the flaps, which was achieved with an acceptable cosmetic outcome. Both the patients were discharged in stable condition with minimal facial nerve weakness.
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Affiliation(s)
- Ankit Jain
- Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, IND
| | - Mahalingam Sudharshan
- Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, IND
| | - Chellappa Vijayakumar
- Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, IND
| | - Uday Kumbhar
- Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, IND
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7
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Sardar S, Dutta M, Dutta S, Das S, Sinha R. Do Benign Mass Lesions in the Superficial Lobe of Parotid Gland Influence Landmark-Based Search for Facial Nerve Trunk At Surgery? Medeni Med J 2021; 36:36-43. [PMID: 33828888 PMCID: PMC8020187 DOI: 10.5222/mmj.2021.43067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 02/28/2021] [Indexed: 11/19/2022] Open
Abstract
Objective To assess the influence of benign mass lesions in the superficial lobe of parotid on the known anatomic landmarks for identifying the facial nerve trunk. Method Patients with unilateral biopsy-proven benign mass lesions in the superficial parotid were selected for this observational study. During superficial/partial superficial parotidectomy, distance of the facial nerve trunk from each landmark was assessed using spring calliper and correlated with the lesion’s volume (measured from the pre-operative imaging). At least two identifiers among tragal pointer (TP), posterior belly of digastric muscle (PBDM) and tympanomastoid suture (TMS) were considered. Results The study involved 32 patients. The lesions mostly involved the parotid tail (50%) and pretragal region (34.3%), and constituted of pleomorphic adenoma (~66%) and Warthin’s tumor (~9%), the rest being various cysts and hamartomas. TP was universally uncovered, while PBDM and TMS were exposed in 26 and 25 patients, respectively. Average distances between the facial nerve trunk and TP, PBDM and TMS were 12.79 mm (SD=2.33), 9.78 mm (SD=1.21) and 7.58 mm (SD=1.33), respectively. Correlation coefficients between the lesion’s volume and the distance of facial nerve from a given landmark were -0.11, 0.04 and -0.16 for TP, PBDM and TMS, respectively. Conclusion TP was the most easily available landmark on surgical dissection, while PBDM was the most consistent and the least variable when volumetric data of the benign mass lesions in the superficial lobe of parotid were considered as a factor influencing the distance from the facial nerve trunk.
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Affiliation(s)
- Subhadip Sardar
- R. G. Kar Medical College and Hospital, Department of Otorhinolaryngology and Head-Neck Surgery, West Bengal, India
| | - Mainak Dutta
- Kolkata Medical College and Hospital, Department of Otorhinolaryngology - Head and neck Surgery, West Bengal, India
| | - Sirshak Dutta
- Raigunj Government Medical College and Hospital, Department of Otorhinolaryngology- Head and neck Surgery, West Bengal, India
| | - Saumik Das
- North Bengal Medical College and Hospital, Department of Otorhinolaryngology- Head and Neck Surgery, West Bengal, India
| | - Ramanuj Sinha
- Kolkata Medical College and Hospital, Department of Otorhinolaryngology - Head and neck Surgery, West Bengal, India
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8
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Mantsopoulos K, Iro AK, Sievert M, Müller SK, Agaimy A, Schapher M, Koch M, Iro H. Is extracapsular dissection for pleomorphic adenoma rather a euphemism for enucleation that jeopardises the intactness of the capsule? Br J Oral Maxillofac Surg 2021; 59:1204-1208. [PMID: 34274171 DOI: 10.1016/j.bjoms.2021.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/04/2021] [Indexed: 02/07/2023]
Abstract
The aim of this study was to compare several surgical modalities with respect to the incidence of positive margins and focal capsular exposure of pleomorphic adenoma of the parotid gland. The clinical records and histopathological findings of all patients who underwent parotidectomy for pleomorphic adenoma between 2006 and 2020 were retrospectively evaluated (n = 845). The lesion was removed by extracapsular dissection in 577 cases (68%) and facial nerve dissection in 268 (32%). Our analysis did not reveal a statistically significant difference between the examined modalities regarding positive margins (p=0.648) or capsular exposure (p=0.112). Recurrences were detected in 7/845 cases (0.82%) with a mean (range) follow-up time of 82.3 (6-183) months. The choice of surgical method does not seem to have a significant effect on the incidence of positive margins, or on the capsular exposure of a pleomorphic adenoma.
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Affiliation(s)
- K Mantsopoulos
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.
| | - A-K Iro
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - M Sievert
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - S K Müller
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - A Agaimy
- Institute of Pathology, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - M Schapher
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - M Koch
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - H Iro
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
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9
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Suzuki M, Nakaegawa Y, Kobayashi T, Kawase T, Ikeda M, Murono S. Indications for partial superficial parotidectomy for benign parotid gland tumors using the retrograde approach. Fukushima J Med Sci 2020; 66:73-77. [PMID: 32507800 PMCID: PMC7470754 DOI: 10.5387/fms.2020-06] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
A recent systematic review and meta-analysis suggest that retrograde parotidectomy is a safe procedure with no significant difference in facial nerve paralysis rates when compared to anterograde parotidectomy. The aim of the current study was to establish indications for partial superficial parotidectomy using the retrograde approach. To this end, the two surgical techniques were compared in terms of postoperative facial nerve paralysis, tumor size, location of the tumor, and surgical time. For tumor diameters of 30 mm or less, mean surgical time in the retrograde parotidectomy group was significantly shorter than in the anterograde parotidectomy group (p < 0.05). Our study indicates that retrograde parotidectomy may be more effective than anterograde parotidectomy for partial superficial parotidectomy for benign parotid tumors of 30 mm or less.
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Affiliation(s)
- Masahiro Suzuki
- Department of Otolaryngology, Fukushima Medical University School of Medicine
| | - Yuta Nakaegawa
- Department of Otolaryngology, Fukushima Medical University School of Medicine
| | - Tetsuro Kobayashi
- Department of Otolaryngology, Fukushima Medical University School of Medicine
| | - Tomotaka Kawase
- Department of Otolaryngology, Fukushima Medical University School of Medicine
| | - Masakazu Ikeda
- Department of Otolaryngology, Fukushima Medical University School of Medicine
| | - Shigeyuki Murono
- Department of Otolaryngology, Fukushima Medical University School of Medicine
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10
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Abstract
Background: Retrospective analysis of extracapsular dissection (ECD) and superficial parotidectomy (SP).Aims/objectives: Comparing the outcomes of ECD and SP in surgery of benign parotid masses.Material and methods: Total of 136 patients included in the study. The inclusion criteria were pathologically proven benign FNA biopsy, lack of deep lobe invasion and single tumour diameter lower than 4 cm, absence of radiologically and clinically malignant lesion and facial paralysis at the time of diagnosis.Objectives: Drain volumes and seroma presence, clinical evaluation of face nerve function; signs of infective complications were collected from patients' clinic chart. Complications and recurrence rates were obtained from follow-up forms.Results: The mean follow-up period was 42.53 ± 14.88 months. In SP group, three patients with disease recurrence were found, 8 (10.2%) had early facial nerve paralysis (grade 2 and 3) and 11 (14.1%) had Frey's syndrome. No postoperative complication, early facial paralysis and recurrence were observed in ECD group.Conclusion and significance: ECD procedure was found to be as successful as SP in the selected patient group in approach to the pathologically proven and single benign parotid masses with similar recurrence and lower complication rates compared to the SP.
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Affiliation(s)
- Kerem Ozturk
- Otolaryngology Department, Ege University School of Medicine, Izmir, Turkey
| | - Arin Ozturk
- Otolaryngology Department, Ege University School of Medicine, Izmir, Turkey
| | - Goksel Turhal
- Otolaryngology Department, Ege University School of Medicine, Izmir, Turkey
| | - Isa Kaya
- Otolaryngology Department, Ege University School of Medicine, Izmir, Turkey
| | - Serdar Akyildiz
- Otolaryngology Department, Ege University School of Medicine, Izmir, Turkey
| | - Umit Uluoz
- Otolaryngology Department, Ege University School of Medicine, Izmir, Turkey
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Cheng PC, Lo WC, Chang CM, Huang TW, Cheng PW, Liao LJ. The outcome and decision-making of extracapsular dissection for benign superficial lobe parotid tumours: Our experience in 144 patients. Clin Otolaryngol 2019; 45:151-155. [PMID: 31755650 DOI: 10.1111/coa.13480] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 10/24/2019] [Accepted: 11/17/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Ping-Chia Cheng
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan (R.O.C.)
| | - Wu-Chia Lo
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan (R.O.C.)
| | - Chih-Ming Chang
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan (R.O.C.).,Department of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan (R.O.C.)
| | - Tsung-Wei Huang
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan (R.O.C.).,Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan (R.O.C.)
| | - Po-Wen Cheng
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan (R.O.C.)
| | - Li-Jen Liao
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan (R.O.C.).,Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan (R.O.C.).,Medical Engineering Office, Far Eastern Memorial Hospital, New Taipei City, Taiwan (R.O.C.)
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12
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Bonavolontà P, Dell'Aversana Orabona G, Maglitto F, Abbate V, Committeri U, Salzano G, Improta G, Iaconetta G, Califano L. Postoperative complications after removal of pleomorphic adenoma from the parotid gland: A long-term follow up of 297 patients from 2002 to 2016 and a review of publications. Br J Oral Maxillofac Surg 2019; 57:998-1002. [PMID: 31500918 DOI: 10.1016/j.bjoms.2019.08.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 08/13/2019] [Indexed: 11/28/2022]
Abstract
Pleomorphic adenomas are rounded, lumpy, capsulated lesions that are more common in women. They are typically benign, but can be associated with malignancy in a minority of cases (such as carcinoma ex pleomorphic adenoma), between 3% - 12% of the time, according to available data. The purpose of our study was to evaluate clinical outcomes in patients with benign parotid gland tumours after extracapsular dissection (ECD) or superficial parotidectomy (SP). We made a retrospective study of 297 patients who had had benign tumours of the parotid gland, and had been referred to our department from 2002 - 2016 to have either procedure. We measured the statistical differences between the two techniques (evaluated recurrence rate and complications) with the chi squared test. The chosen level of statistical significance was p<0.05. Median (range) follow-up time was 43 months (25-168) months. Haematoma and hypoaesthesia were significantly more common after SP than after ECD (8.9% compared with 7.7%, and 16.8% compared with 5.6%, respectively). Transient facial nerve injury, Frey syndrome, and facial paralysis were significantly more common after SP than after ECD (23.6% compared with 1.5%, 6.7% compared with 1% and 6,7% compared with 0%, respectively). ECD had the advantage of reduced operating time, lower morbidity and lower recurrence rate, and could be considered the treatment of choice for pleomorphic adenoma of the parotid gland up (to 3cm) which are mobile and sited in the superficial lobe of the parotid gland.
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Affiliation(s)
- Paola Bonavolontà
- Department Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples, Italy.
| | - Giovanni Dell'Aversana Orabona
- Department Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples, Italy
| | - Fabio Maglitto
- Department Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples, Italy
| | - Vincenzo Abbate
- Department Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples, Italy
| | - Umberto Committeri
- Department Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples, Italy.
| | - Giovanni Salzano
- Department Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples, Italy
| | - Giovanni Improta
- Department of Public Health, Federico II University of Naples, Naples, Italy
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13
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Zhang M, Jia ZY, Liu SY, Zhao YZ, Qu PF, Chen B. [Partial superficial parotidectomy versus superficial parotidectomy for treatment of parotid benign tumors: evidence-based medicine analysis]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2019; 33:875-882. [PMID: 31446709 DOI: 10.13201/j.issn.1001-1781.2019.09.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Indexed: 11/12/2022]
Abstract
Objective:The aim of this study is to systematically assess the postoperative outcomes of partial superficial parotidectomy(PSP) and superficial parotidectomy(SP) by systematic literature review and Meta-analysis, and to provide a theoretical basis for the selection of the appropriate surgical approach in clinical process. Method:Relevant studies that compared the outcomes of PSP and SP for the parotid benign tumors were searched in Pubmed, CNKI and Wanfangdata databases, and Meta-analysis was performed using software RevMan 5.0. Result:24 studies were selected for the Meta-analysis. A total of 2 795 participants were included in those studies, of whom 1 301 underwent PSP and 1 494 underwent SP. The recurrence rates for PSP and SP were 1.14%(10 of 874) and 0.6%(6 of 993), respectively. There were no statistically significant difference in recurrence rate between PSP and SP. The rates of transient facial nerve paresis for PSP and SP were 11.60%(122 of 1 052) and 27.37%(350 of 1 279), respectively. The rates of permanent facial nerve paralysis for PSP and SP were 1.04%(6 of 579) and 4.46%(31 of 695), respectively. The incidences of Frey's syndrome in PSP group and SP group were 9.20%(95 of 1 033) and 30.32%(409 of 1 349), respectively. The rate of salivary fistulafor PSP and SP were 5.38%(37 of 688) and 11.25%(65 of 578). PSP could reduce the risk for complications compared with SP. Conclusion:This systematic review with meta-analysis suggests that PSP has a similar recurrence rate as SP, but PSP can significantly reduce the postoperativecomplications.
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Affiliation(s)
- M Zhang
- Medical College of Zhangjiakou University,Zhangjiakou,075000,China
| | - Z Y Jia
- Department of Oraland Maxillofacial Surgery,the Second Hospital of Hebei Medical University
| | - S Y Liu
- Department of Obstetrics and Gynecology,Women and Children Health Care Hospital of Donggang,Rizhao
| | - Y Z Zhao
- Department of Oraland Maxillofacial Surgery,the Second Hospital of Hebei Medical University
| | - P F Qu
- Department of Oraland Maxillofacial Surgery,the Second Hospital of Hebei Medical University
| | - B Chen
- Department of Oraland Maxillofacial Surgery,the Second Hospital of Hebei Medical University
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14
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Martin H, Jayasinghe J, Lowe T. Superficial parotidectomy versus extracapsular dissection: literature review and search for a gold standard technique. Int J Oral Maxillofac Surg 2019; 49:192-199. [PMID: 31301925 DOI: 10.1016/j.ijom.2019.06.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 04/24/2019] [Accepted: 06/05/2019] [Indexed: 11/17/2022]
Abstract
Benign parotid tumours usually present as a slow-growing, asymptomatic mass in the pre-auricular region. Although they are uncommon, surgical excision is the mainstay of treatment due to the risk of malignant transformation in some benign tumours. Surgical techniques have evolved over the years, with superficial parotidectomy and extracapsular dissection being the current procedures of choice. There is currently no gold standard, and it remains unclear which surgical modality is the superior option. A literature review was performed in relation to the relative merits of each technique and to evaluate the reasons underpinning the ongoing debate. A total of 16 papers comparing the main clinical outcomes of the procedures were critically reviewed using the PRISMA protocol. Overall, extracapsular dissection indicated a reduced recurrence rate, facial nerve paralysis, Frey syndrome, and operation time. The superior outcomes following extracapsular dissection could be attributed to the less radical nature of the procedure. However, there were various limitations identified within the review that may have affected the results. Selection bias was the most significant, with patients assigned to the different procedures depending on the tumour size and location. Consequently, the debate continues as to what constitutes the gold standard of care for benign parotid tumours.
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Affiliation(s)
- H Martin
- University of Aberdeen Dental Institute, Aberdeen, UK; Oral and Maxillofacial Department, Aberdeen Royal Infirmary, Aberdeen, UK.
| | - J Jayasinghe
- University of Aberdeen Dental Institute, Aberdeen, UK; Oral and Maxillofacial Department, Aberdeen Royal Infirmary, Aberdeen, UK
| | - T Lowe
- University of Aberdeen Dental Institute, Aberdeen, UK; Oral and Maxillofacial Department, Aberdeen Royal Infirmary, Aberdeen, UK
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15
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Xiao Y, Yuan S, Liu F, Liu B, Zhu J, He W, Li W, Kan Q. Comparison between wait-and-see policy and elective neck dissection in clinically N0 cutaneous squamous cell carcinoma of head and neck. Medicine (Baltimore) 2018; 97:e10782. [PMID: 29851784 PMCID: PMC6392757 DOI: 10.1097/md.0000000000010782] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
To analyze the superiority of wait-and-see policy and elective neck dissection in treating cN0 patients with facial cutaneous cell carcinoma (cSCC).Patients with clinically negative parotid and neck metastasis disease were prospectively enrolled. Three groups were divided based on whether the patient received an operation of superficial parotidectomy or/and elective dissection, and regional control and disease-specific survival rates were compared.The occult parotid and neck metastasis rate was 20% and 16%, respectively. There was neck node metastasis without parotid metastasis in only 1 patient. All the node metastasis occurred in level II. Regional recurrence was noted in 16 (16%) patients, and 6 patients died of the disease. In the group undergoing superficial parotidectomy and elective neck dissection, 2 patients had neck node metastasis, and there was no disease-related death, further survival analysis indicated it had better regional control and disease-specific survival rates compared with the other 2 groups.Superficial parotidectomy and elective neck dissection are suggested for patients with T3-4 facial cutaneous squamous cell carcinoma.
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Affiliation(s)
| | | | | | | | | | - Wei He
- Department of Oral Medicine
| | | | - Quancheng Kan
- Department of Gastroenterology, The first Affiliated Hospital of Zhengzhou University, Zhengzhou, P.R. China
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16
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Liu Z, Pan C, Yin P, Liao H. Well-differentiated acinic cell carcinoma with lymphoid stroma associated with osteoclast-like giant cells of the parotid gland in children: a case report and literature review. Int J Clin Exp Pathol 2018; 11:1770-1776. [PMID: 31938283 PMCID: PMC6958099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 01/07/2018] [Indexed: 06/10/2023]
Abstract
Acinic cell carcinoma of the parotid gland in children rarely occurs. Well-differentiated acinic cell carcinoma with lymphoid stroma is a subtype hardly seen but has a better prognosis than conventional acinic cell carcinoma. We hereby report a previously unreported case of a 9-year-old Chinese girl with well-differentiated acinic cell carcinoma with lymphoid stroma associated with osteoclast-like giant cells of the parotid gland. The pathology, diagnosis, presentation, management, and the clinical outcome are discussed and the literature is reviewed.
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17
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Mantsopoulos K, Goncalves M, Iro H. Transdermal scopolamine for the prevention of a salivary fistula after parotidectomy. Br J Oral Maxillofac Surg 2018; 56:212-215. [PMID: 29402551 DOI: 10.1016/j.bjoms.2018.01.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 01/20/2018] [Indexed: 12/20/2022]
Abstract
Our aim was to investigate whether perioperative transdermal application of scopolamine could help to prevent fistulas after parotidectomy, and to this end we retrospectively studied the records of all patients (n=645) who had benign parotid tumours treated by partial parotidectomy between 2011 and 2016. We found that scopolamine led to a significant decrease in the incidence of salivary fistulas from 54/371(15%) in the group not given it to 10/274 (4%) in the group given it (p<0.0001). The "number needed to treat" was 9.17. There was a relatively low incidence of all adverse effects after scopolamine. Our results are encouraging. Thorough consideration of the contraindications and a knowledge of the potential adverse effects are crucial for its successful implementation.
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Affiliation(s)
- Konstantinos Mantsopoulos
- Department of Otolaryngology, Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
| | - Miguel Goncalves
- Department of Otolaryngology, Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Heinrich Iro
- Department of Otolaryngology, Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
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18
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Lu HB, Ma WN, Yu H, Sun L, Guo XL. [Retrospective study of partial superficial parotidectomy and superficial parotidectomy on superficial parotid benign tumor]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2017; 31:901-905. [PMID: 29798408 DOI: 10.13201/j.issn.1001-1781.2017.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Indexed: 11/12/2022]
Abstract
Objective:To compare the clinical effect between partial superficial parotidectomy (PSP) and superficial parotidectomy (SP) through a retrospective analysis and to provide evidence for the benign tumor surgical strategy. Method:According to different surgical strategies performed, 168 patients with superficial parotid benign tumor were reviewed and divided into PSP group and SP group. Clinical data was compared between two groups from different aspects, including operation condition, complications, recurrence rate, as well as parotid function. SPSS 22.0 software was used in statistical analysis. Result:PSP group has an average operative incision length of (6.65±1.17)cm, and average operation time of (82.25±11.56)min, while SP group is (10.86±1.65)cm and (121.42±17.32)min. So, compared with the SP group, PSP has obvious advantages in operation conditions (P<0.01). Furthermore, PSP group also presents an advantage over SP group in occurrence of postoperative complications (P<0.05), while there is no significant difference between two groups in palindromia rate (P>0.05). As for the maintenance of parotid gland functions, PSP group could retain most of parotid functions, but no function would be retained in SP group. Statistical analysis confirms the significance (P<0.05). Conclusion: Compared with SP, in PSP there is declined complication incidence but no increased palindromia recurrence. However, PSP has an apparent advantage on decreased surgical incision length, downscaled operation scope, reduced operation time and retained original functions of gland. All these advantages present the reliability and feasibility of PSP in treating superficial parotid benign tumor.
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Affiliation(s)
- H B Lu
- Department of Oral and Maxillofacial Surgery,Zhongshan Hospital Affiliated to Dalian University, Dalian, 116001, China
| | - W N Ma
- Department of Oral and Maxillofacial Surgery,Zhongshan Hospital Affiliated to Dalian University, Dalian, 116001, China
| | - H Yu
- Department of Oral and Maxillofacial Surgery,Zhongshan Hospital Affiliated to Dalian University, Dalian, 116001, China
| | - L Sun
- Department of Oral and Maxillofacial Surgery,Zhongshan Hospital Affiliated to Dalian University, Dalian, 116001, China
| | - X L Guo
- Department of Endodontics, Dalian Stomaological Hospital Affiliated to Dalian Medical University
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19
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Jia ZY, Zhang XY, Jiang CB, Zhao YZ, Zhang R, Fan XH, Zhang YH. [Extracapsular dissection versus superficial parotidectomy for treatment of parotid benign tumors: evidence based medicine analysis]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2017; 31:863-869. [PMID: 29775003 DOI: 10.13201/j.issn.1001-1781.2017.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Indexed: 11/12/2022]
Abstract
Objective:The aim of this study is to systematically assess the clinical outcomes of extracapsular dissection (ECD) and superficial parotidectomy (SP), and to provide evidences for the clinical decision for treatment of parotid gland benign tumors. Method:Relevant studies that compared the outcomes of extracapsular dissection and superficial parotidectomy for the parotid benign tumors were searched in Pubmed, CNKI and Wangfang data databases, and Meta-analysis was performed using software RevMan 5.0. Result:Fifteen studies were selected for the Meta-analysis. A total of 2 929 participants were included in those studies, of which 1 796 underwent ECD and 1 133 underwent SP. The recurrence rates for ECD and SP were 1.29% (23 of 1 776 cases) and 1.48% (16 of 1 081 cases), respectively. There were no statistically significant in recurrence rate between ECD and SP. The rates of transient facial nerve paresis for ECD and SP were 5.48% (74 of 1 350) and 22.94% (139 of 606), that of permanent facial nerve paralysis were 0.66% (8 of 1 221) and 2.71% (15 of 554). The incidences of Frey's syndrome in ECD group and SP group were 1.91% (26 of 1 360) and 16.71% (111 of 664), that of fistula in were 0.53% (5 of 946) and 2.96% (10 of 338). ECD could reduce the risk for complications compared with SP. Conclusion:This systematic review with Meta-analysis suggests that ECD has a similar recurrence rate as SP with fewer postoperative complications. ECD may be considered as an alternative surgical modality for select benign parotid tumor.
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Affiliation(s)
- Z Y Jia
- Department of Oral and Maxillofacial Surgery, the Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - X Y Zhang
- Respiratory Sleep Division, the Third Hospital of Hebei Medical University
| | - C B Jiang
- Department of Oral and Maxillofacial Surgery, the Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - Y Z Zhao
- Department of Oral and Maxillofacial Surgery, the Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - R Zhang
- Department of Oral and Maxillofacial Surgery, the Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - X H Fan
- Department of Oral and Maxillofacial Surgery, the Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - Y H Zhang
- Department of Oral and Maxillofacial Surgery, the Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China
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20
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Grosheva M, Shabli S, Volk GF, Sommer B, Ludwig L, Finkensieper M, Wittekindt C, Klussmann JP, Guntinas-Lichius O, Beutner D. Sensation loss after superficial parotidectomy: A prospective controlled multicenter trial. Head Neck 2017; 39:520-526. [PMID: 28067982 DOI: 10.1002/hed.24647] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 09/04/2016] [Accepted: 10/21/2016] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The purpose of this study was to evaluate the occurrence of hypoesthesia after superficial parotidectomy depending on preservation of posterior branch of the great auricular nerve (GAN). METHODS This prospective, controlled, double blind, multicenter trial included 130 patients. The posterior branch was preserved in 93 patients (GAN group), and ligated in 33 patients (non-GAN group). In 4 patients, GAN status was unknown. Included patients underwent sensory testing (TouchTest) and subjective evaluation at 6, 12, and 24 months after surgery. RESULTS Better improvement of sensation was present in the GAN group. After 12 months, 59% of the patients in the GAN-group showed positive test results in the lobule, versus 24% of the non-GAN group (p = .013). Additionally, after 24 months, 71% of the patients in the GAN-group showed a positive test in the antitragus, versus 31% in the non-GAN group (p = .045). Hypoesthesia equally limited quality of life in both groups (all p > .05). CONCLUSION Preservation of the posterior branch of the GAN led to significantly better improvement of sensation in the lobule and antitragus, and should be recommended during parotidectomy. © 2017 Wiley Periodicals, Inc. Head Neck 39: 520-526, 2017.
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Affiliation(s)
- Maria Grosheva
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
| | - Sami Shabli
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
| | - Gerd Fabian Volk
- Department of Otorhinolaryngology, Head and Neck Surgery, Jena University Hospital, Jena, Germany
| | - Barbara Sommer
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Giessen, Giessen, Germany
| | - Laura Ludwig
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
| | - Mira Finkensieper
- Department of Otorhinolaryngology, Head and Neck Surgery, Jena University Hospital, Jena, Germany.,Department of Otorhinolaryngology, Head and Neck Surgery, St. Anna Clinic, Wuppertal, Germany
| | - Claus Wittekindt
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Giessen, Giessen, Germany
| | - Jens Peter Klussmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Giessen, Giessen, Germany
| | - Orlando Guntinas-Lichius
- Department of Otorhinolaryngology, Head and Neck Surgery, Jena University Hospital, Jena, Germany
| | - Dirk Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
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21
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Brennan PA, Ammar M, Matharu J. Contemporary management of benign parotid tumours - the increasing evidence for extracapsular dissection. Oral Dis 2016; 23:18-21. [PMID: 27260128 DOI: 10.1111/odi.12518] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 06/02/2016] [Indexed: 12/23/2022]
Abstract
Benign parotid tumours have historically often been managed surgically by superficial parotidectomy. While this approach usually gives a generous cuff of surrounding normal parotid tissue to increase tumour margins, it requires a much larger incision than the increasingly used extracapsular dissection (ECD) technique. Furthermore, superficial parotidectomy can result in marked facial hollowing, Frey syndrome and an increased risk of both temporary and permanent facial nerve weakness. ECD has been popularised as a safe alternative to parotidectomy primarily for the removal of mobile, benign parotid tumours with safe outcomes and reduced risk to the facial nerve. In this article, we review the growing body of evidence for ECD and include our own experience confirming the move away from superficial parotidectomy in contemporary practice for the treatment of benign parotid tumours.
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Affiliation(s)
- P A Brennan
- Maxillofacial Unit, Queen Alexandra Hospital, Portsmouth, UK
| | - M Ammar
- Maxillofacial Unit, Queen Alexandra Hospital, Portsmouth, UK
| | - J Matharu
- Maxillofacial Unit, Queen Alexandra Hospital, Portsmouth, UK
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22
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Eldamati A, Niaz R, Tanveer S, Zakaria H, AlJazzan N, El-Sharkawy T, AlDhafery B, Al-Mulhim AA. Sialolipoma of the Superficial Lobe of the Parotid Gland: A Case Report and Literature Review. Saudi J Med Med Sci 2015; 4:38-41. [PMID: 30787695 PMCID: PMC6298259 DOI: 10.4103/1658-631x.170893] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Sialolipoma of the parotid gland is very rare. We report a case of a 38-year-old woman who presented with a painless, slowly growing, mobile lump of the parotid gland. Computed tomography revealed lipoma of the superficial lobe of the parotid gland. Superficial parotidectomy was performed with uneventful postoperative course. The histology showed sialolipoma. Review of the 25 reported cases (including our case) of parotid sialolipoma shows that this tumor is more common in the fifth decade of life, on the left side and the superficial lobe. It has a slight preference for men. Its clinical presentation mimics the standard (pure) parotid lipoma and other more common benign parotid tumors particularly pleomorphic adenoma and Warthin's tumor. Surgical excision is curative with minor complications and small recurrence rate. Histological examination is necessary to establish the diagnosis and to exclude malignancy.
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Affiliation(s)
- Ahmed Eldamati
- Department of Surgery, King Fahd Hospital of the University, College of Medicine, University of Dammam, Saudi Arabia
| | - Rabia Niaz
- Department of Surgery, King Fahd Hospital of the University, College of Medicine, University of Dammam, Saudi Arabia
| | - Shumaila Tanveer
- Department of Surgery, King Fahd Hospital of the University, College of Medicine, University of Dammam, Saudi Arabia
| | - Hazem Zakaria
- Department of Surgery, King Fahd Hospital of the University, College of Medicine, University of Dammam, Saudi Arabia
| | - Nasser AlJazzan
- Department of ENT, King Fahd Hospital of the University, College of Medicine, University of Dammam, Saudi Arabia
| | - Tarek El-Sharkawy
- Department of Pathology, King Fahd Hospital of the University, College of Medicine, University of Dammam, Saudi Arabia
| | - Bander AlDhafery
- Department of Radiology, King Fahd Hospital of the University, College of Medicine, University of Dammam, Saudi Arabia
| | - Abdulmohsen A Al-Mulhim
- Department of Surgery, King Fahd Hospital of the University, College of Medicine, University of Dammam, Saudi Arabia
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Huang G, Yan G, Wei X, He X. Superficial parotidectomy versus partial superficial parotidectomy in treating benign parotid tumors. Oncol Lett 2014; 9:887-890. [PMID: 25621064 PMCID: PMC4301479 DOI: 10.3892/ol.2014.2743] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 11/11/2014] [Indexed: 11/06/2022] Open
Abstract
The aim of the present study was to compare the outcomes of superficial parotidectomy (SP) and partial superficial parotidectomy (PSP) in treating benign parotid tumors. Individuals who had undergone SP or PSP between 2005 and 2008 were enrolled, the medical records were reviewed, and a questionnaire was created and mailed to the patients. For the statistical analysis, χ2 and non-parametric Mann-Whitney tests were used to analyze the variables. In total, 320 patients were included in the present study. Within the PSP group, immediate facial nerve weakness occurred in six patients (7.6%), and Frey's syndrome occurred in five (6.3%). Despite this, facial nerve function recovered fully during the follow-up, and recurrence was not identified. Within the SP group, Frey's syndrome occurred in 38 patients (15.8%), immediate facial nerve weakness in 55 patients (22.8%) and permanent facial nerve dysfunction in two patients (0.8%). However, no recurrence was evident. In total, 216 (67.5%) patients returned the questionnaire. Those with PSP demonstrated improved scores in the domains of appearance, facial contours, facial nerve function and Frey's syndrome. Compared with SP, PSP not only decreased the incidence of Frey's syndrome and transient facial nerve weakness, but also improved quality of life outcomes and guaranteed a low recurrence rate.
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Affiliation(s)
- Gang Huang
- Department of Oral and Maxillofacial Surgery, General Hospital of Benxi Iron and Steel Co., Benxi, Liaoning 117000, P.R. China
| | - Guangqi Yan
- Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang, Liaoning 110002, P.R. China
| | - Xinli Wei
- Department of Oral and Maxillofacial Surgery, General Hospital of Benxi Iron and Steel Co., Benxi, Liaoning 117000, P.R. China
| | - Xin He
- Department of Oral and Maxillofacial Surgery, General Hospital of Benxi Iron and Steel Co., Benxi, Liaoning 117000, P.R. China
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24
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Abstract
Angiofibromas are rare, benign, locally invasive vascular tumors, which represent 0.05-0.5% of all head and neck tumors. Most frequent site of occurrence is the posterior nasopharynx, called as nasopharyngeal angiofibromas (NA), when these arise outside the nasopharyngeal region they are termed as extranasopharyngeal angiofibromas (ENA). Only 65 cases of ENA have been reported, and the most common site has been reported to be maxilla followed by ethmoids. Other unusual sites of occurrence reported so far in literature are nasal cavity, nasal septum, larynx, sphenoid sinus, pterygomaxillary fissure, infratemporal fossa, cheek, oropharynx, retromolar area, middle turbinate, inferior turbinate, and tonsil. ENA arising from the superficial lobe of parotid gland has not been reported in the literature so far and this case is the first to be reported.
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Affiliation(s)
- Neelakamal H Hallur
- Department of Oral and Maxillofacial Surgery, Al Badar Rural Dental College and Hospital, Gulbarga, Karnataka, India
| | - Heena Zainab
- Department of Oral Pathology, Al Badar Rural Dental College and Hospital, Gulbarga, Karnataka, India
| | - Ashwin Shah
- Department of Oral and Maxillofacial Surgery, Al Badar Rural Dental College and Hospital, Gulbarga, Karnataka, India
| | - Aaisha Siddiqua
- Department of Oral and Maxillofacial Surgery, Al Badar Rural Dental College and Hospital, Gulbarga, Karnataka, India
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25
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Werner RL, Castle JT. Recurrent pleomorphic adenoma. Head Neck Pathol 2013; 8:303-6. [PMID: 24197723 PMCID: PMC4126920 DOI: 10.1007/s12105-013-0504-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 10/23/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Rachel L. Werner
- Department of Oral and Maxillofacial Pathology, Naval Postgraduate Dental School, Bethesda, MD 20889 USA
| | - James T. Castle
- Department of Anatomic Pathology, Naval Medical Center Portsmouth, 620 John Paul Jones Circle, Portsmouth, VA 23704 USA
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Abstract
AIM This study was undertaken to compare the proximal and distal facial nerve exploration approach during superficial parotidectomy. MATERIALS AND METHODS A retrospective analysis of patients who underwent superficial parotidectomy at our center was conducted. Cases were divided into those who underwent superficial parotidectomy using distal facial nerve exploration and those who underwent standard proximal facial nerve exploration. Statistical comparisons of intraoperative blood loss and margin status (negative, focally, positive) were conducted between these two approaches. RESULTS A total of 39 patients underwent superficial parotidectomy at our center between 2008 and 2010. The technique used in most of the cases was conventional proximal nerve exploration technique (29 cases). Distal exploration of the buccal branch was undertaken only in 10 cases, on account of difficulty in locating the main trunk intraoperatively due to the presence of postinflammatory fibrosis. The average patient age was 48 years with a female preponderance (67%). Both the techniques consumed almost same average operative time (2.4 hours) and average intraoperative blood loss (68.0 cc vs 25.4 cc) was more in the cases where proximal nerve exploration was resorted (S.E (d) = 0.89). No significant difference in surgical margin status was noticed between the two techniques (P > 0.05). CONCLUSION Both the techniques are efficient without compromising the surgical margins, but the average intraoperative blood loss is less in distal facial nerve exploration technique.
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Affiliation(s)
- Rohit Sharma
- Department of Maxillofacial Surgery, MH Jalandhar Cantt, India
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