-
Ear, Nose, & Throat Journal Feb 2024Liposarcoma is extremely rare in the parotid gland. In this article, we report the case of an 87-year-old man who presented to our department with swelling in the left...
Liposarcoma is extremely rare in the parotid gland. In this article, we report the case of an 87-year-old man who presented to our department with swelling in the left parotid region. Magnetic resonance imaging (MRI) revealed a tumor in the superficial lobe of the parotid gland. Total parotidectomy and ipsilateral lymph node dissection were performed. Histologic examination confirmed the diagnosis of myxoid liposarcoma of the parotid gland. On imaging, there was no evidence of nodal or distant metastasis. Radiation therapy was planned, but the patient refused to receive treatment. After a follow-up of 3 years, MRI showed no sign of tumor recurrence and the patient remained symptom-free. The case is original by the tumor's location. Only 8 cases of primary parotid liposarcoma have been reported in the literature. The purpose of this article was to discuss, through our case, clinical and anatomopathological features of parotid gland liposarcomas as well as its treatment options and prognosis.
PubMed: 38424683
DOI: 10.1177/01455613241235499 -
Laryngoscope Investigative... Dec 2019The rarity of temporal bone squamous cell carcinoma (TBSCC) precludes a clear understanding of the disease and approach to its management. This review provides general... (Review)
Review
OBJECTIVES
The rarity of temporal bone squamous cell carcinoma (TBSCC) precludes a clear understanding of the disease and approach to its management. This review provides general background on the disease and discusses the current and emerging oncologic and rehabilitative management options.
DATA SOURCES
PubMed literature review.
METHODS
A review of the current literature was conducted to assess and collate up-to-date information regarding TBSCC management.
RESULTS
TBSCC is a rare and aggressive disease arising in the ear canal, temporal bone, or extratemporal sites. Prior radiation, chronic ear disease, or habitual ear picking may contribute to primary disease development. Because the symptoms of TBSCC and benign otologic disease are similar, TBSCC diagnosis may be delayed, allowing the tumor time to spread throughout the anatomically intricate temporal bone. The extent of the disease is determined based on imaging and is usually staged with the Pittsburgh Staging System. Temporal bone resection with parotidectomy and neck dissection is the current standard of care. Survival is generally good for early disease and poor for advanced disease, but chemotherapy is emerging as a promising treatment option. Auditory rehabilitation with osseointegrated hearing aids is recommended at initial oncologic resection.
CONCLUSIONS
The knowledge of and outcomes for TBSCC have improved with time, but because of the aggressive nature of the disease and the anatomic intricacy of the temporal bone, TBSCC treatment is complex and should be delivered by a multidisciplinary team. Inter-institutional collaboration may accelerate research for this rare disease.
LEVEL OF EVIDENCE
5.
PubMed: 31890889
DOI: 10.1002/lio2.330 -
Iranian Journal of Otorhinolaryngology Mar 2021The facial nerve is an important structure related to parotid gland surgery. Its identification at the time of surgery is critical. Multiple anatomical landmarks have...
INTRODUCTION
The facial nerve is an important structure related to parotid gland surgery. Its identification at the time of surgery is critical. Multiple anatomical landmarks have been described to aid in its identification. The objective of this study is to assess whether the tympanomastoid suture is a better surgical landmark than the tragal pointer for identifying the facial nerve while performing parotidectomy.
MATERIALS AND METHODS
Sixty patients presenting over a period of 3 years from 2016 to 2018 with a parotid swelling without pre-operative facial weakness were included in the study. The average distances between the facial nerve (FN) and the tragal pointer (TP), and the facial nerve (FN) and tympanomastoid suture (TMS) were calculated intra-operatively and compared.
RESULTS
Out of the 60 patients operated, 54 underwent superficial parotidectomy and 6 underwent total conservative parotidectomy. The mean distance between the FN (main trunk) and TP was found to be 18.38 ± 6.85 mm and that between FN and TMS was found to be 2.92 ± 0.6 mm (P<0.0001).
CONCLUSION
Tympanomastoid suture is a fairly constant and consistent bony landmark to locate the facial nerve during parotid surgeries as compared to the more commonly used cartilaginous tragal pointer. The results of this study can guide surgeons during parotidectomy, to correctly and promptly identify the facial nerve thereby reducing the risk of injury.
PubMed: 33912484
DOI: 10.22038/ijorl.2020.43760.2446 -
Brazilian Journal of Otorhinolaryngology 2022To investigate the prognostic factors to developing parotid and neck metastasis in locally advanced and relapsed Cutaneous Squamous Cell Carcinoma (CSCC) of the head and...
OBJECTIVE
To investigate the prognostic factors to developing parotid and neck metastasis in locally advanced and relapsed Cutaneous Squamous Cell Carcinoma (CSCC) of the head and neck region.
METHODS
Single-center retrospective cohort study enrolling consecutive patients with advanced CSCC from 2009 to 2019. Seventy-four cases were identified. Study variables demographic data, clinical skin tumor stage, neck stage, parotid stage (P stage), surgical treatment features, and parotid, regional, and distant metastases. Survival measures: Overall Survival (OS) and Disease-Specific Survival (DSS).
RESULTS
The study group included 72.9% men (median age, 67 years); 67.5% showed T2/T3 tumors, 90.5% comorbidities, 20.2% immunosuppressed, with median follow-up: 35.8 months. The most frequent skin primary were auricular and eyelid regions, 75% underwent primary resection with flap reconstruction. Parotid metastasis was present in 50%, 32.4% showing parotid extracapsular spread, multivariate analysis found OR = 37.6 of positive parotid metastasis evolving into positive neck metastasis, p = 0.001. Occult neck metastasis, neck metastasis, and neck extracapsular spread were observed in 13.5%, 51.3%, and 37.8%, respectively. Kaplan-Meier survival: Clinical T4 versus T1, p = 0.028, P1 stage: 30% and 5% survival at 5 and 10 years, P3 stage: 0%, p = 0.016; OS and DSS showed negative survival for the parotid metastasis group, p = 0.0283.
CONCLUSION
Our outcomes support a surgically aggressive approach for locally advanced and relapsed CSCC, with partial parotidectomy for P0, total parotidectomy for P1-3, selective I-III neck dissection for all patients and adjuvant radiochemotherapy to appropriately treat these patients with advanced CSCC of the head and neck region.
LEVEL OF EVIDENCE
II b - Retrospective Cohort Study - Oxford Centre for Evidence-Based Medicine (OCEBM).
Topics: Male; Humans; Aged; Female; Neck Dissection; Carcinoma, Squamous Cell; Squamous Cell Carcinoma of Head and Neck; Retrospective Studies; Parotid Neoplasms; Skin Neoplasms; Neoplasm Staging; Neoplasm Recurrence, Local; Head and Neck Neoplasms
PubMed: 35042657
DOI: 10.1016/j.bjorl.2021.11.007 -
Journal of Otolaryngology - Head & Neck... Feb 2021Superficial parotidectomy has a potential to be performed as an outpatient procedure. The objective of the study is to evaluate the safety and selection profile of... (Comparative Study)
Comparative Study
BACKGROUND
Superficial parotidectomy has a potential to be performed as an outpatient procedure. The objective of the study is to evaluate the safety and selection profile of outpatient superficial parotidectomy compared to inpatient parotidectomy.
METHODS
A retrospective review of individuals who underwent superficial parotidectomy between 2006 and 2016 at a tertiary care center was conducted. Primary outcomes included surgical complications, including transient/permanent facial nerve palsy, wound infection, hematoma, seroma, and fistula formation, as well as medical complications in the postoperative period. Secondary outcome measures included unplanned emergency room visits and readmissions within 30 days of operation due to postoperative complications.
RESULTS
There were 238 patients included (124 in outpatient and 114 in inpatient group). There was no significant difference between the groups in terms of gender, co-morbidities, tumor pathology or tumor size. There was a trend towards longer distance to the hospital from home address (111 Km in inpatient vs. 27 in outpatient, mean difference 83 km [95% CI,- 1 to 162 km], p = 0.053). The overall complication rates were comparable between the groups (24.2% in outpatient group vs. 21.1% in inpatient, p = 0.56). There was no difference in the rate of return to the emergency department (3.5% vs 5.6%, p = 0.433) or readmission within 30 days (0.9% vs 0.8%, p = 0.952).
CONCLUSION
Superficial parotidectomy can be performed safely as an outpatient procedure without elevated risk of complications.
Topics: Academic Medical Centers; Adolescent; Adult; Aged; Aged, 80 and over; Ambulatory Surgical Procedures; Feasibility Studies; Female; Humans; Inpatients; Male; Middle Aged; Ontario; Otorhinolaryngologic Surgical Procedures; Outpatients; Parotid Diseases; Parotid Gland; Patient Readmission; Postoperative Complications; Retrospective Studies
PubMed: 33579392
DOI: 10.1186/s40463-020-00484-9 -
International Journal of Oral Science Aug 2019The principle of modern oncological surgery is to conserve the functional organs or tissues as much as possible based on eradication of the tumour. For salivary gland... (Review)
Review
The principle of modern oncological surgery is to conserve the functional organs or tissues as much as possible based on eradication of the tumour. For salivary gland tumours, conservative and functional salivary surgery, including partial sialoadenectomy as well as anatomical and functional preservation of the facial nerve, great auricular nerve, superficial musculo-aponeurotic system (SMAS), and Stensen's duct, has become increasingly popular. In the present review, we discuss the following aspects of conservative and functional surgery in the treatment of salivary gland tumours: (i) partial superficial parotidectomy (PP) to treat benign parotid gland tumours, (ii) modification of surgical incisions to improve cosmetic results, (iii) modification of the surgical approach to decrease complications, (iv) extracardial dissection to treat benign superficial parotid tumours, (v) partial sialoadenectomy to treat benign submandibular gland tumours, and (vi) I brachytherapy to preserve facial nerves. The majority of the operated parotid or submandibular glands are preserved, and surgical complications are also decreased. Conservative and functional surgery plays a significant role in maintaining normal salivary gland function and in improving patients' quality of life during the treatment of salivary gland tumours and thus should be further promoted.
Topics: Conservative Treatment; Humans; Parotid Gland; Parotid Neoplasms; Quality of Life; Salivary Gland Neoplasms; Submandibular Gland; Submandibular Gland Neoplasms
PubMed: 31413317
DOI: 10.1038/s41368-019-0059-9 -
The Journal of International Medical... Jul 2022This study was performed to report and analyze the prevalence of permanent facial nerve paralysis following parotidectomy for various benign and malignant lesions in a...
OBJECTIVE
This study was performed to report and analyze the prevalence of permanent facial nerve paralysis following parotidectomy for various benign and malignant lesions in a single center.
METHODS
This single-center retrospective study included all patients who underwent parotidectomy (total and superficial) for benign and malignant tumors and chronic inflammatory diseases during a 6-year period. Patients who had previously undergone an operation of the parotid gland and those with preoperative facial weakness were excluded.
RESULTS
The study included 127 patients ranging in age from 14 to 83 years (median, 45.89 years). Most patients were female (n = 83, 65.4%). The most prevalent procedure was superficial parotidectomy (n = 117, 92.1%), followed by total parotidectomy (n = 6, 4.7%). The average operative duration was 138 minutes (range, 80-400 minutes). Histopathology revealed that 109 (85.8%) patients had benign tumors, 14 (11.0%) had malignant tumors, and 4 (3.1%) had chronic sialadenitis. Only two patients sustained an injury to the cervical branch of the facial nerve.
CONCLUSION
In this single-center experience of parotid surgery, the rates of transient and permanent facial paralysis were acceptably low at 9.0% and 1.6%, respectively, for all pathologies.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Facial Nerve; Facial Paralysis; Female; Humans; Male; Middle Aged; Parotid Gland; Parotid Neoplasms; Postoperative Complications; Retrospective Studies; Young Adult
PubMed: 35808820
DOI: 10.1177/03000605221108930 -
Cureus Dec 2021First described by Polish Neurologist Łucja Frey in 1923, Frey's syndrome (FS), or auriculotemporal syndrome, is a rare condition characterised by gustatory sweating,... (Review)
Review
First described by Polish Neurologist Łucja Frey in 1923, Frey's syndrome (FS), or auriculotemporal syndrome, is a rare condition characterised by gustatory sweating, typically encountered as sequelae following invasive head and neck surgery. The pathophysiology of FS can be described by aberrant reinnervation of postganglionic parasympathetic neurons to the surrounding denervated sweat glands and cutaneous blood vessels. Multiple invasive procedures have been associated with FS ranging from salivary gland surgery to burn reconstruction and thoracoscopic sympathectomies. Rarely, FS can be secondary to trauma or non-surgical aetiologies, including diabetes and infection. Physical symptoms vary based on the severity and surface area affected by FS and range from mild symptoms to severe psychosocial morbidity for patients. Surgeons operating in the head and neck, including otolaryngologists, maxillofacial surgeons, and plastic surgeons, should be aware of this potential complication and be up to date with diagnosis and treatment strategies for FS. This review article summarises the literature relating to FS focusing on its aetiologies, symptomatology, prevention, and available treatments, aiming to provide an up-to-date review of this condition for surgeons operating in the head and neck region. Although various treatment options have been suggested, these are often limited to topical agents that require life-long administration for symptom control. Further research is recommended to identify the optimal treatment for this condition and the role of surgery as a treatment for severe or refractory cases.
PubMed: 34873562
DOI: 10.7759/cureus.20107 -
Journal of Surgical Oncology Dec 2022The purpose of this study was to report incidence, clinicopathologic behavior, management, and outcome of pediatric patients treated surgically for salivary gland (SG)...
BACKGROUND
The purpose of this study was to report incidence, clinicopathologic behavior, management, and outcome of pediatric patients treated surgically for salivary gland (SG) malignancies.
METHODS
Patients who underwent surgery for SG malignancies from 1985 to 2015 were identified. Clinical, pathological, treatment and outcomes data were collected. Disease-specific survival (DSS), recurrence-free survival (RFS), and overall survival (OS) were calculated using Kaplan-Meier method.
RESULTS
Twenty-eight pediatric patients were included. The most common histopathological types were mucoepidermoid (n = 18, 64.3%), acinic cell (n = 7, 25.0%), adenoid cystic (n = 2, 7.1%), and adenocarcinoma (n = 1, 3.6%). Surgical approach varied and ranged from superficial parotidectomy (n = 11, 39.3%) to partial maxillectomy (n = 6, 21.4%). Nine patients (32%) required postoperative radiotherapy. DSS, OS, and RFS probability at 5 years were 96.4%, 96.4%, and 89.3%, respectively.
CONCLUSION
Pediatric SG malignancies are rare and have favorable outcome at 5 years. Larger, multi-institutional studies are required to better understand the natural history of these rare tumors.
Topics: Humans; Child; Carcinoma, Mucoepidermoid; Cohort Studies; Retrospective Studies; Salivary Gland Neoplasms; Adenocarcinoma
PubMed: 35969241
DOI: 10.1002/jso.27063 -
Biomedical Papers of the Medical... Mar 2021This is a review of the clinical and histopathological published data on very rare heterotopic acinic cell carcinomas (AcCCs) with suggested optimal management.... (Review)
Review
This is a review of the clinical and histopathological published data on very rare heterotopic acinic cell carcinomas (AcCCs) with suggested optimal management. Extrasalivary AcCCs originate primarily in parotid lymph nodes. They present at low clinical stage, show mostly low-grade histopathology and are circumscribed with a complete nodal capsule. Extracapsular dissection was advocated as adequate therapy. In rare cases with positive surgical margins, a completion parotidectomy or adjuvant radiotherapy should follow. Heterotopic high-grade AcCCs are rare, necessitating radical surgery including neck dissection and adjuvant radiotherapy. The short term prognosis is excellent, long term outcomes are not known. Longer term follow-up is essential.
Topics: Carcinoma, Acinar Cell; Humans
PubMed: 33177745
DOI: 10.5507/bp.2020.047