-
Indian Journal of Otolaryngology and... Dec 2022Pleomorphic adenoma (PA) is the most common benign salivary gland neoplasm. Metastasising PA (MPA) is a rare subtype which is histologically and molecularly...
Pleomorphic adenoma (PA) is the most common benign salivary gland neoplasm. Metastasising PA (MPA) is a rare subtype which is histologically and molecularly indistinguishable from the tumor in the primary location that often occurs after multiple recurrences.We herein report a case of 29 year female who underwent right parotidectomy for PA 15 years ago which was followed by history of recurrences and now presenting with MPA involving ipsilateral lymph nodes.
PubMed: 36742660
DOI: 10.1007/s12070-021-03065-y -
The Journal of International Advanced... Mar 2023Adenoid cystic carcinoma of the external auditory canal is a rare primary malignancy, and surgery is the primary management strategy. This study aims to optimize...
BACKGROUND
Adenoid cystic carcinoma of the external auditory canal is a rare primary malignancy, and surgery is the primary management strategy. This study aims to optimize management strategies and improve prognosis of adenoid cystic carcinoma of the external auditory canal.
METHODS
Seventeen patients with adenoid cystic carcinoma of external auditory canal who had been admitted to a single institution from January 2008 to March 2019 were recruited and retrospectively reviewed. Among patients with T1 tumors, 2 underwent local external auditory canal resection, 1 received lateral temporal bone resection+superficial parotidectomy. Among patients with T2 tumors, all 5 patients underwent lateral temporal bone resection+superficial parotidectomy. Among patients with T3 tumors, 3 underwent subtotal temporal bone resection+superficial parotidectomy, 2 underwent subtotal temporal bone resection+superficial parotidectomy+radiotherapy, and 1 underwent extended temporal bone resection+superficial parotidectomy+radiotherapy. Among patients with T4 tumors, 2 underwent subtotal temporal bone resection+superficial parotidectomy and 1 underwent extended temporal bone resection+total parotidectomy+radiotherapy.
RESULTS
The common manifestations included otalgia (82.4%), hearing loss (23.5%), external auditory canal mass (23.5%), otorrhea (17.6%), and aural fullness (5.9%). In the study, 5/17 (29.4%) patients had been misdiagnosed preoperatively, 5/17 (29.4%) patients revealed local recurrence, and 3/17 patients (17.6%) were identified with distant metastasis postoperatively. The 3- and 5-year overall survival rates were 88.2% and 82.3%, respectively. There was no significant difference in overall survival (P=.746) and disease-free survival (P=.933) between patients receiving different surgical approaches. Three out of 17 patients (17.6%) died of T2, T3, and T4 diseases, respectively.
CONCLUSION
Otalgia is the most common manifestation of adenoid cystic carcinoma of the external auditory canal, and misdiagnosis is frequently encountered. Surgery is the preferred therapy, and local resection is associated with relapse, lateral temporal bone resection is strongly recommended in patients with early-stage tumor. Regular follow-up should be routinely conducted postoperatively to early identify local recurrence.
Topics: Humans; Carcinoma, Adenoid Cystic; Retrospective Studies; Ear Canal; Earache; Neoplasm Staging; Neoplasm Recurrence, Local; Prognosis; Ear Neoplasms
PubMed: 36975087
DOI: 10.5152/iao.2023.22850 -
Annals of Palliative Medicine Jun 2021Actinomycosis of the parotid gland is very rare. We sought to examine the clinical features, treatment methods, and treatment results of actinomycosis of the parotid...
BACKGROUND
Actinomycosis of the parotid gland is very rare. We sought to examine the clinical features, treatment methods, and treatment results of actinomycosis of the parotid gland in our hospital.
METHODS
We retrospectively enrolled 5 patients with histopathologically identified actinomycosis of the parotid gland from January 2010 to May 2020.
RESULTS
This study included 3 male and 2 female subjects. All patients had a common complaint of the mass in the parotid gland. Skin necrosis was observed in one patient. However, skin necrosis and fistula track occurred in the other 2 patients after fine-needle aspiration cytology (FNAC). Based on the result of FNAC two cases of inflammation and abscess were identified. Four patients with suspicion of parotid tumors before surgery underwent parotidectomy, and one patient with consideration of parotid abscess underwent incision and drainage. After surgery, intravenous administration of antibiotics was performed for an average of 6 days and oral antibiotics were prescribed for about 2 months for patients with actinomycosis of the parotid gland.
CONCLUSIONS
In case of skin necrosis of the parotid lesion without evidence of a malignant tumor, or if FNAC does not reveal the presence of cancerous cells, and fistula tract or skin necrosis occurs after the FNAC, then actinomycosis of the parotid gland should be suspected. If the actinomycosis of the parotid gland was localized to the parotid gland and removed surgically, it would be sufficient to treat the patients with antibiotics for about 2 months while observing the clinical response.
Topics: Actinomycosis; Female; Humans; Male; Parotid Gland; Parotid Neoplasms; Retrospective Studies; Sensitivity and Specificity
PubMed: 33977749
DOI: 10.21037/apm-21-755 -
Ear, Nose, & Throat Journal Dec 2022First bite syndrome (FBS) is a rare but potentially debilitating complication observed after surgery involving the upper cervical region. Patients classically complain... (Review)
Review
INTRODUCTION
First bite syndrome (FBS) is a rare but potentially debilitating complication observed after surgery involving the upper cervical region. Patients classically complain of severe facial pain in the ipsilateral parotid region with the first few bites of a meal.
OBJECTIVE
The aim of this study is to shed light on the incidence and potential risk factors of FBS, including a series of cases depicting FBS observed after parotidectomy.
METHODS
Retrospective review of 419 patients who underwent parotidectomy at a single tertiary care facility between December 2016 and June 2020.
RESULTS
With a mean follow-up time of 16.5 months, 8 (2%) patients were documented to have symptoms of FBS after parotid gland surgery. Six of these patients underwent partial parotidectomy by dissection of the deep lobe of the parotid (DLP).
CONCLUSION
Patients undergoing dissection of the DLP are particularly at risk for the development of FBS. All patients should be appropriately counseled during informed consent discussions, especially in high-risk cases.
Topics: Humans; Mastication; Parotid Gland; Parotid Region; Syndrome; Retrospective Studies; Facial Pain; Parotid Neoplasms; Postoperative Complications
PubMed: 33314982
DOI: 10.1177/0145561320980179 -
Indian Journal of Otolaryngology and... Dec 2022The aim of this study was to investigate the diagnostic accuracy rates of the patients who underwent an operation for parotid mass, by comparing their fine needle...
The aim of this study was to investigate the diagnostic accuracy rates of the patients who underwent an operation for parotid mass, by comparing their fine needle aspiration biopsy (FNAB) cytology results with the final pathology. A total of 136 patient files of those who applied to Otorhinolaryngology clinic due to parotid mass and underwent parotidectomy procedure between 2010 and 2020 at a tertiary center were scanned retrospectively. Database on patient age, gender, preoperative FNAB results, and final surgical histopathology results was created. The mean age of the patients was 48.26 ± 17.37 Superficial parotidectomy was performed to 108 (79.4%) and total parotidectomy to 28 (20.6%) of the patients. The sensitivity of FNAB was found as 85.2%, specificity as 96.2%, positive predictive value as 85.2%, negative predictive value as 96.2% and accuracy as 94.0%. It is found that FNAB has the high specificity and high negative predictive value with high diagnostic accuracy on detecting preoperative malignancy in parotid gland. We think that FNAB is a significant, necessary and safe method in the diagnosis of parotid lesions in preoperative sense.
PubMed: 36742705
DOI: 10.1007/s12070-021-02451-w -
The Pan African Medical Journal 2022Tumors of the parotid gland can be challenging if left untreated. We report three cases of patients with initial clinical and therapeutic manifestations of neglected...
Tumors of the parotid gland can be challenging if left untreated. We report three cases of patients with initial clinical and therapeutic manifestations of neglected parotid tumours in Madagascar: two women and one man aged 42, 47 and 51 years, with tumours that had been developing for 4, 7 and 11 years respectively. One patient was suspected to have malignant tumour due to skin necrosis. The diagnosis was then confirmed by cytopuncture. After obtaining the informed consent, total parotidectomy was performed in all patients. Facial nerve sacrifice with cervical lymph node dissection was established in the patient with a malignant tumour. No intraoperative adverse events were reported. Parotid tumors can become cancerous without proper treatment. Socio-economic factors are involved in delayed consultation. However, early consultation in patients with parotid tumors would prevent management risks.
Topics: Male; Humans; Female; Parotid Neoplasms; Adenoma, Pleomorphic; Parotid Gland; Lymph Node Excision; Risk Management; Retrospective Studies
PubMed: 36915420
DOI: 10.11604/pamj.2022.43.184.29628 -
Translational Cancer Research Jul 2022Endoscopic parotidectomy has the potential to become a reliable procedure for benign and low-grade malignant parotid gland tumors. Based on the previous literature...
Endoscopic parotidectomy has the potential to become a reliable procedure for benign and low-grade malignant parotid gland tumors. Based on the previous literature review and our own clinical experience, we introduced in detail the surgical procedure of single incision-plus approach for gasless endoscopic parotidectomy. This method contributes a logical approach to achieving endoscopic resection of parotid gland tumor and preservation of facial nerve, which can be summarized into the following seven-step method: preoperative preparation; design of retroauricular-hairline incision and plus-incision; surgical cavities creation and coalescence; separation of surgical boundaries; separation and protection of the facial nerve trunk; processing of the branches of facial nerve; en bloc resection of the superficial parotid gland and tumor. Endoscopic parotidectomy is a more difficult procedure than conventional parotid surgery, requiring more precision as well as more experience and equipment. The learning curve of time and frequency is influenced by many factors, like anatomy, instruments, procedures and patience. We contribute our clinical exploration of anatomical precautions, feasible instruments, and surgical procedures and summarize precautions under single incision-plus in gasless endoscopic parotidectomy. Given the growing interest in the aesthetic process of the parotid region, the seven-step method may have the potential to be a method for teaching gasless endoscopic parotidectomy.
PubMed: 36249887
DOI: 10.21037/tcr-22-226 -
HNO Apr 2023Handling of the facial nerve during surgery for parotid cancer is relevant for the patient's long-term quality of life. In about two thirds of cases, the facial nerve is... (Review)
Review
Handling of the facial nerve during surgery for parotid cancer is relevant for the patient's long-term quality of life. In about two thirds of cases, the facial nerve is not affected by the tumor. In these cases, in addition to complete tumor resection, identification and preservation of the facial nerve are important components of a successful operation. If the nerve is infiltrated by the tumor, the affected part must be resected during radical parotidectomy. When possible, primary nerve reconstruction leads to the best long-term cosmetic and functional outcomes. Individual selection of the optimal treatment concept is based on clinical examination of facial muscle mobility, preoperative imaging to understand the positional relationship between tumor and nerve, and on the basis of an electrophysiological examination of nerve function. Intraoperatively, standardized dissection helps to identify and preserve the facial nerve. If radical parotidectomy is indicated, in addition to one-step reconstruction, preoperative diagnostic tests can help to plan postoperative adjuvant therapy. The aim of rehabilitation is restoration of facial tone, facial symmetry, and movement of the paralyzed face. Restoration of eye closure is of high importance. The surgical treatment of facial paralysis has seen many improvements in recent years. The present work provides an overview of the most recent advances in diagnostics, surgical techniques, and further possibilities for preventing damage to the normal facial nerve during parotid cancer treatment. Furthermore, the options for rehabilitation of the tumor-infiltrated facial nerve in the context of treatment of salivary gland malignancies are described.
Topics: Humans; Facial Nerve; Parotid Neoplasms; Quality of Life; Facial Paralysis; Parotid Gland; Postoperative Complications
PubMed: 35288765
DOI: 10.1007/s00106-022-01148-y -
Diagnostics (Basel, Switzerland) Sep 2022Intraoperative facial nerve monitoring (FNM) has been widely accepted as an adjunct during parotid surgery to facilitate identification of the facial nerve (FN) main... (Review)
Review
Intraoperative facial nerve monitoring (FNM) has been widely accepted as an adjunct during parotid surgery to facilitate identification of the facial nerve (FN) main trunk, dissection of FN branches, confirmation of FN function integrity, detection of FN injury and prognostication of facial expression after tumor resection. Although the use of FNM in parotidectomy is increasing, little uniformity exists in its application from the literature. Thus, not only are the results of many studies difficult to compare but the value of FNM technology is also limited. The article reviews the current literature and proposes our standardized FNM procedures during parotid surgery, such as standards in FNM setup, standards in general anesthesia, standards in FNM procedures and application of stimulus currents, interpretation of electrophysiologic signals and prediction of the facial expression outcome and pre-/post-operative assessment of facial expressions. We hope that the FNM standardized procedures will provide greater uniformity, improve the quality of applications and contribute to future research.
PubMed: 36292076
DOI: 10.3390/diagnostics12102387