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Zhonghua Kou Qiang Yi Xue Za Zhi =... Sep 2021Parotid gland tumor is the most common salivary gland tumor and surgery is the main treatment method. The conventional surgery for the treatment of parotid tumor is... (Review)
Review
Parotid gland tumor is the most common salivary gland tumor and surgery is the main treatment method. The conventional surgery for the treatment of parotid tumor is mostly performed by using large incision which often causes complications and aesthetic problems to patients. With the advancement of medical technology, deeper understanding of histopathology and anatomy by the surgeons, as well as patients' higher demands on aesthetics and functions, the surgical methods and incisions have been constantly improved. This review focuses on the evolution of surgical approaches and incisions for the treatment of parotid tumors and provides an outlook based on the preliminary application of endoscopically assisted parotid tumor resection.
Topics: Esthetics, Dental; Humans; Parotid Gland; Parotid Neoplasms; Postoperative Complications
PubMed: 34496545
DOI: 10.3760/cma.j.cn112144-20201016-00529 -
Otolaryngology--head and Neck Surgery :... Jan 2020To evaluate the risks of neoplasm and malignancy in surgically treated cystic parotid masses compared with solid or mixed lesions and to evaluate the performance of... (Comparative Study)
Comparative Study
OBJECTIVES
To evaluate the risks of neoplasm and malignancy in surgically treated cystic parotid masses compared with solid or mixed lesions and to evaluate the performance of fine-needle aspiration (FNA) in parotid cysts.
STUDY DESIGN
Retrospective cross-sectional study.
SETTING
Single-institution academic tertiary care center.
SUBJECTS AND METHODS
Patients without a history of human immunodeficiency virus or head and neck cancer who underwent parotidectomy for parotid masses and had preoperative imaging to characterize lesions as cystic, solid, or mixed (ie, partially cystic and partially solid). We assessed the risks of neoplasia and malignancy, adjusting for age, sex, race/ethnicity, facial nerve weakness, and history of malignancy. We also evaluated the sensitivity and specificity of FNA.
RESULTS
We included 308 patients, 27 of whom had cystic parotid masses (5 simple and 22 complex). Cystic masses were less likely to be neoplastic compared to solid or mixed masses (44% vs 97%; odds ratio [OR], 0.03; 95% confidence interval [CI], 0.01-0.07); however, there was no difference in the risk of malignancy (22% vs 26%; OR, 0.81; 95% CI, 0.32-2.10). Cystic masses were more likely to yield nondiagnostic FNA cytology results, but for diagnostic samples, FNA was 86% sensitive and 33% specific for diagnosing neoplasia and 75% sensitive and 83% specific for diagnosing malignancy.
CONCLUSION
In our population, cystic masses undergoing surgery were less likely to be neoplastic but had a similar risk of malignancy as solid masses. The risk of malignancy should be considered in the management of cystic parotid masses.
Topics: Academic Medical Centers; Adult; Aged; Biopsy, Fine-Needle; Cell Transformation, Neoplastic; Cross-Sectional Studies; Cysts; Diagnosis, Differential; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Multivariate Analysis; Odds Ratio; Pancreatic Diseases; Parotid Gland; Parotid Neoplasms; Precancerous Conditions; Retrospective Studies; Risk Assessment; Tertiary Care Centers; United States
PubMed: 31791199
DOI: 10.1177/0194599819889699 -
Bosnian Journal of Basic Medical... Feb 2021An accurate preoperative diagnosis of parotid tumors is essential for the selection and planning of surgical treatment. Various modern cross-sectional imaging and... (Review)
Review
An accurate preoperative diagnosis of parotid tumors is essential for the selection and planning of surgical treatment. Various modern cross-sectional imaging and cytologic investigations can support the differential diagnosis of parotid tumors. The aim of this study was to achieve a comprehensive and updated review of modern imaging and cytologic investigations used in parotid tumor diagnosis, based on the latest literature data. This literature review could serve as a guide for clinicians in selecting different types of investigations for the preoperative differential diagnosis of parotid tumors. Magnetic resonance imaging (MRI) with its dynamic and advanced sequences is the first-line imaging investigation used in differentiating parotid tumors. Computed tomography (CT) and positron emission tomography (PET)-CT provide limited indications in differentiating parotid tumors. Fine needle aspiration biopsy and core needle biopsy can contribute with satisfactory results to the cytological diagnosis of parotid tumors. Dynamic MRI with its dynamic contrast-enhanced and diffusion-weighted sequences provides the best accuracy for the preoperative differential diagnosis of parotid tumors. CT allows the best evaluation of bone invasion, being useful when MRI cannot be performed, and PET-CT has value in the follow-up of cancer patients. The dual cytological and imaging approach is the safest method for an accurate differential diagnosis of parotid tumors.
Topics: Biopsy; Contrast Media; Diagnosis, Differential; Humans; Parotid Neoplasms; Patient Care Planning; Preoperative Period
PubMed: 32893758
DOI: 10.17305/bjbms.2020.5028 -
Otolaryngology--head and Neck Surgery :... Jan 2022We performed a systematic review and meta-analysis of deep lobe parotid tumors to evaluate their unique characteristics. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
We performed a systematic review and meta-analysis of deep lobe parotid tumors to evaluate their unique characteristics.
DATA SOURCES
PubMed/Medline, Embase, Web of Sciences, and Cochrane Library databases were queried for relevant literature.
REVIEW METHODS
Studies were individually assessed by 2 independent reviewers. Risk of bias was assessed with the Cochrane bias tool, GRADE criteria, and MINORS criteria. Results were reported according to the PRISMA guidelines. Statistical analysis was performed by comparing rates of malignancy between deep and superficial lobe tumors.
RESULTS
In total, 8 studies including 379 deep lobe parotid tumors met inclusion criteria. Mean age at diagnosis was 44.9 years. Computed tomography scan was the most common imaging modality. Preoperative diagnostic fine-needle aspiration was utilized in 39.4% of patients and demonstrated high sensitivity for malignant disease. The most common approach was subtotal parotidectomy with facial nerve preservation (58.9%). The rate of malignancy was 26.6%, which was significantly higher than that of the superficial lobe tumors in this study (risk ratio, 1.25; 95% CI, 1.01-1.56). The rate of temporary postoperative facial nerve weakness between deep and superficial lobe tumors was 32.5% and 11.7%, respectively.
CONCLUSION
Deep lobe parotid tumors had a 26.6% rate of malignancy. On meta-analysis, deep lobe tumors appeared to have higher rates of malignancy than superficial lobe tumors. Surgical excision of deep lobe tumors showed increased rates of temporary facial nerve paresis as compared with superficial lobe tumors. Computed tomography scan was the most common imaging modality. There were limited data regarding the utility of fine-needle aspiration.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Female; Humans; Male; Middle Aged; Otorhinolaryngologic Surgical Procedures; Parotid Neoplasms; Young Adult
PubMed: 33878987
DOI: 10.1177/01945998211009235 -
Journal of Oral Pathology & Medicine :... Mar 2022Superficial parotidectomy has been the gold standard for surgical removal of benign mobile parotid gland tumours. The comparatively newer technique of extracapsular... (Review)
Review
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.
Topics: Adenoma, Pleomorphic; Humans; Neoplasm Recurrence, Local; Parotid Gland; Parotid Neoplasms; Postoperative Complications; Retrospective Studies; Sweating, Gustatory
PubMed: 34697837
DOI: 10.1111/jop.13251 -
American Journal of Otolaryngology 2022Determine rates of intra-parotid and neck nodal metastasis, identify risk factors for recurrence, and report outcomes in patients with primary high-grade parotid...
PURPOSE
Determine rates of intra-parotid and neck nodal metastasis, identify risk factors for recurrence, and report outcomes in patients with primary high-grade parotid malignancy who undergo total parotidectomy and neck dissection.
MATERIALS & METHODS
Retrospective review of patients undergoing total parotidectomy and neck dissection for high-grade parotid malignancy between 2005 and 2015. The presence and number of parotid lymph nodes, superficial and deep, as well as cervical lymph nodes involved with metastatic disease were assessed. Risk factors associated with metastatic spread to the parotid deep lobe were identified and recurrence rates reported.
RESULTS
75 patients with median follow-up time of 47 months. 35 patients (46.7%) had parotid lymph node metastasis. Seven patients (9.3%) had deep lobe nodal metastasis without metastasis to the superficial lobe nodes. Nine patients (12%) had positive intra-parotid nodes without positive cervical nodes. Cervical nodal disease was identified in 49.3% patients (37/75). Local, parotid-bed recurrence rate was 5.3% (4/75). Regional lymph node recurrence rate was also 5.3% (4/75). Rate of distant metastasis was 30.6% (23/75). The overall disease free survival rate for all patients at 2 and 5 years were 71% and 60% respectively.
CONCLUSION
Parotid lymph node metastasis occurred at a similar rate to cervical lymph node metastasis (46.7% and 49.3%, respectively). Deep lobe parotid nodal metastasis occurred in nearly a quarter of patients and can occur without superficial parotid nodal metastasis. Rate of recurrence in the parotid bed, which may represent local or regional recurrence, was similar to regional cervical lymph node recurrence. Total parotidectomy and neck dissection should be considered high-grade parotid malignancy regardless of clinical nodal status.
Topics: Adult; Aged; Aged, 80 and over; Digestive System Surgical Procedures; Female; Follow-Up Studies; Humans; Lymph Nodes; Lymphatic Metastasis; Male; Middle Aged; Neck; Neck Dissection; Neoplasm Recurrence, Local; Neoplasm Staging; Parotid Gland; Parotid Neoplasms; Retrospective Studies; Risk Factors; Survival Rate; Time Factors; Treatment Outcome
PubMed: 34509079
DOI: 10.1016/j.amjoto.2021.103194 -
Head & Neck Mar 2022Mammary analogue secretory carcinomas (MASCs) of the parotid gland are considered as low-grade malignancies with good clinical outcome but lacking data regarding... (Meta-Analysis)
Meta-Analysis Review
Mammary analogue secretory carcinomas (MASCs) of the parotid gland are considered as low-grade malignancies with good clinical outcome but lacking data regarding prognostic factors. We performed meta-analysis assessing prognostic factors for disease-free survival (DFS) and overall survival (OS) in 256 patients with MASCs of the parotid gland. A total of 73 studies have met the inclusion criteria and 76.3% of patients were seen with T1 and T2 tumors and negative neck nodes. Lymph node metastasis (57.4%) and distant recurrences (46.2%) were particularly found in T4 tumors (p < 0.001). DFS at 5 and 10 years was 77.9% and 47.2% compared to 88.1% and 77.2% for OS at the same time points. Male sex, T3-T4 tumors, and recurrent disease represented independent worse prognosticators for survival outcome. Altogether, parotid gland MASCs show good long-term outcome, but T4 tumors behave significantly more aggressive and require extended treatment strategies along with close follow-ups.
Topics: Humans; Male; Mammary Analogue Secretory Carcinoma; Neoplasm Staging; Parotid Gland; Parotid Neoplasms; Prognosis; Retrospective Studies
PubMed: 34964195
DOI: 10.1002/hed.26971 -
JAMA Otolaryngology-- Head & Neck... Jun 2022
Topics: Female; Humans; Middle Aged; Parotid Diseases; Parotid Gland; Parotid Neoplasms
PubMed: 35511199
DOI: 10.1001/jamaoto.2022.0661 -
International Journal of Oral and... Apr 2022
Topics: Adenoma, Pleomorphic; Dissection; Humans; Parotid Neoplasms
PubMed: 34426055
DOI: 10.1016/j.ijom.2021.08.004 -
European Archives of... Oct 2020Acinic cell carcinoma (ACCs) is uncommon malignant epithelial neoplasm of the salivary glands; the most common presentation is a well-defined painless solid mass.... (Review)
Review
PURPOSE
Acinic cell carcinoma (ACCs) is uncommon malignant epithelial neoplasm of the salivary glands; the most common presentation is a well-defined painless solid mass. Diagnosis of ACCs is frequently complicated, due to its similarity with benign tumors.
METHODS
A review of the literature available on ACCs was carried out. Studies were sourced from PubMed with searching of relevant headings and sub-headings and cross-referencing.
RESULTS
There are no clear characteristics of ACCs found on CT, MRI and ultrasound imaging. The management of the ACC, a rare malignancy of the parotid gland, is often difficult and controversial. Radical surgery is the best treatment option. The role of radiotherapy remains controversial: the precise indications and oncologic effects of adjuvant radiotherapy in ACC of the parotid gland are not well known. There is insufficient literature regarding the chemotherapy for metastatic ACC.
CONCLUSION
Knowledge about ACC, a rare malignancy of parotid gland, has changed over the past few decades. More clinical randomized works would be needed, both to assess the real effectiveness of radio and chemotherapy and to have an unanimous consensus about their indications.
Topics: Carcinoma; Carcinoma, Acinar Cell; Humans; Parotid Gland; Parotid Neoplasms; Radiotherapy, Adjuvant; Salivary Glands
PubMed: 32367151
DOI: 10.1007/s00405-020-05998-6