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Laryngoscope Investigative... Jun 2024The objective of this study is to summarize the clinical characteristics, treatment, and prognosis of parotid tumors in children and adolescents.
OBJECTIVES
The objective of this study is to summarize the clinical characteristics, treatment, and prognosis of parotid tumors in children and adolescents.
METHODS
Fifty-three children and adolescents diagnosed with parotid gland tumors were included. Survival was evaluated using the Kaplan-Meier method. Log-rank test and multivariate analysis were used to analyze the association between clinical factors and recurrence.
RESULTS
Of the 53 patients, 30 cases were benign and 23 cases were malignant. All patients underwent surgery. Patients with malignant tumors with high-risk factors received radiotherapy or chemotherapy. The median follow-up time was 61 months. Of these, 1 patient with benign tumor and 5 patients with malignant tumors recurred. Of the patients with malignant tumors, 2 developed distant metastases and 2 died. The 5-year overall survival (OS) and 5-year locoregional recurrence-free survival (LRFS) rates for benign tumors were 100.0% and 92.9%, respectively, whereas the 5-year OS and 5-year LRFS rates for malignant tumors were 94.4% and 72.5%, respectively. The log-rank univariate test showed that tumor size >3.5 cm ( = .056), distant metastasis ( = .056), and stage III and IV ( = .032) were associated with recurrence. However, multivariate analysis did not show the above factors to be independent prognostic factors for LRFS.
CONCLUSION
Surgery for benign tumors depends on the location and size. Surgery for malignant parotid tumors depends mainly on the stage, grade, pathological type, and recurrence. Prophylactic lymph node dissection is required for high-grade tumors. Radiotherapy or chemotherapy for children needs more research. Both benign and malignant tumors have high survival rates after active treatment.
LEVEL OF EVIDENCE
Level 2.
PubMed: 38835331
DOI: 10.1002/lio2.1275 -
Cureus May 2024Anatomical preservation and functional integrity of the facial nerve (FN) are the main concerns of parotid surgery. Even though a variety of anatomical landmarks have...
INTRODUCTION
Anatomical preservation and functional integrity of the facial nerve (FN) are the main concerns of parotid surgery. Even though a variety of anatomical landmarks have been proposed and widely utilized, temporal or permanent postoperative FN palsy is still a significant comorbidity of parotid surgery. Therefore, the literature must fully elucidate the consistency of the anatomical relationship between the FN and the retromandibular vein (RMV).
METHODS
We conducted a cadaveric study of 24 hemifaces to map the relationship between the FN and the RMV. Three distinct patterns were identified. Fourteen of the hemifaces were males, and 10 were females. Thirteen cadaveric dissections were performed on the right side and 11 on the left side.
RESULTS
Our study found three distinct patterns and proposed a classification system. Type I (66.7%) is when the nerve lies exclusively lateral to the RMV. Type II (29.2%) is when the FN lies superficial to the RMV, but its mandibular branch lies deep to the anterior branch of the RMV, and type III (4.1%) is when the FN lies exclusively medial to the RMV.
CONCLUSION
The FN and RMV relationship is not constant, and surgeons should be aware of every anatomical variation. Especially in cases where the FN is estimated to lie more in-depth to the level of the RMV, a retrograde approach may be required to avoid a FN injury.
PubMed: 38832166
DOI: 10.7759/cureus.59637 -
BMC Oral Health May 2024This study assessed the effect of cevimeline and different concentrations of gum arabic on the parotid gland of rats being given xerostomia-inducing methotrexate. (Comparative Study)
Comparative Study
OBJECTIVE
This study assessed the effect of cevimeline and different concentrations of gum arabic on the parotid gland of rats being given xerostomia-inducing methotrexate.
METHODS
One hundred twenty-five rats were divided into five equal groups of twenty-five each. The rats in Group I received basic diets, while those in Groups II, III, IV, and V received 20 mg/kg MTX as a single intraperitoneal dose on day one. Group III received 10 mg/kg CVM dissolved in saline orally and daily, and the other two groups aqueous suspension of GA. Therefore, Group IV received 2 ml/kg suspension orally and daily, while Group V received 3 ml/kg suspension orally and daily. After 9 days, the parotid glands were dissected carefully and prepared for hematoxylin and eosin (H&E) staining as a routine histological stain and caspase-3 and Ki67 immunohistochemical staining. Quantitative data from α-Caspase-3 staining and Ki67 staining were statistically analysed using one-way ANOVA followed by Tukey's multiple comparisons post hoc test.
RESULTS
Regarding caspase-3 and Ki67 immunohistochemical staining, one-way ANOVA revealed a significant difference among the five groups. For Caspase-3, the highest mean value was for group II (54.21 ± 6.90), and the lowest mean value was for group I (15.75 ± 3.67). The other three groups had mean values of 31.09 ± 5.90, 30.76 ± 5.82, and 20.65 ± 3.47 for groups III, IV, and V, respectively. For Ki67, the highest mean value was for group I (61.70 ± 6.58), and the lowest value was for group II (18.14a ± 5.16). The other three groups had mean values of 34.4 ± 9.27, 48.03 ± 8.40, and 50.63 ± 8.27 for groups III, IV, and V, respectively.
CONCLUSION
GA, rather than the normally used drug CVM, had a desirable effect on the salivary glands of patients with xerostomia.
Topics: Animals; Rats; Xerostomia; Parotid Gland; Ki-67 Antigen; Methotrexate; Gum Arabic; Thiophenes; Caspase 3; Male; Rats, Wistar; Quinuclidines
PubMed: 38807094
DOI: 10.1186/s12903-024-04374-8 -
Seminars in Arthritis and Rheumatism Aug 2024To assess whether addition of the salivary gland ultrasonography (SGUS) OMERACT score influences the performance of the 2016 ACR/EULAR classification criteria for...
OBJECTIVES
To assess whether addition of the salivary gland ultrasonography (SGUS) OMERACT score influences the performance of the 2016 ACR/EULAR classification criteria for Sjögren's disease (SjD) in daily clinical practice.
METHODS
Patients visiting the Sjögren Expertise centre in the University Medical Center Groningen for a diagnostic trajectory because of a suspicion of SjD were included. SGUS was performed of both parotid and submandibular glands. ROC analysis was used to assess the accuracy to predict clinical diagnosis of SjD with the SGUS OMERACT score, and by adding the SGUS OMERACT score to the ACR/EULAR criteria. Furthermore, the performance of the SGUS OMERACT and total SGUS Hocevar score were compared.
RESULTS
In total, 419 consecutive patients were included. ROC analysis of the highest SGUS OMERACT score out of all four salivary glands (range 0-3) showed good accuracy (AUC 0.849) to predict clinical diagnosis of SjD, comparable to the accuracy of the total SGUS OMERACT score (range 0-12; AUC 0.868) and total Hocevar score (range 0-48; AUC 0.864). When incorporating the highest SGUS OMERACT score (cut-off score of ≥2) as additional item in the ACR/EULAR criteria, accuracy remained excellent (AUC 0.974), and clinical diagnosis could be predicted with a sensitivity of 96.4% and specificity of 86.5%.
CONCLUSION
The accuracy of the ACR/EULAR classification criteria for predicting the clinical diagnosis of SjD remained excellent after incorporating the SGUS OMERACT score and extends the diagnostic options in patients suspected with SjD.
Topics: Humans; Ultrasonography; Female; Middle Aged; Male; Salivary Glands; Sjogren's Syndrome; Aged; Adult; Severity of Illness Index
PubMed: 38805898
DOI: 10.1016/j.semarthrit.2024.152473 -
Frontiers in Oncology 2024The pathological classification and imaging manifestation of parotid gland tumors are complex, while accurate preoperative identification plays a crucial role in...
OBJECTIVE
The pathological classification and imaging manifestation of parotid gland tumors are complex, while accurate preoperative identification plays a crucial role in clinical management and prognosis assessment. This study aims to construct and compare the performance of clinical models, traditional radiomics models, deep learning (DL) models, and deep learning radiomics (DLR) models based on ultrasound (US) images in differentiating between benign parotid gland tumors (BPGTs) and malignant parotid gland tumors (MPGTs).
METHODS
Retrospective analysis was conducted on 526 patients with confirmed PGTs after surgery, who were randomly divided into a training set and a testing set in the ratio of 7:3. Traditional radiomics and three DL models (DenseNet121, VGG19, ResNet50) were employed to extract handcrafted radiomics (HCR) features and DL features followed by feature fusion. Seven machine learning classifiers including logistic regression (LR), support vector machine (SVM), RandomForest, ExtraTrees, XGBoost, LightGBM and multi-layer perceptron (MLP) were combined to construct predictive models. The most optimal model was integrated with clinical and US features to develop a nomogram. Receiver operating characteristic (ROC) curve was employed for assessing performance of various models while the clinical utility was assessed by decision curve analysis (DCA).
RESULTS
The DLR model based on ExtraTrees demonstrated superior performance with AUC values of 0.943 (95% CI: 0.918-0.969) and 0.916 (95% CI: 0.861-0.971) for the training and testing set, respectively. The combined model DLR nomogram (DLRN) further enhanced the performance, resulting in AUC values of 0.960 (95% CI: 0.940- 0.979) and 0.934 (95% CI: 0.876-0.991) for the training and testing sets, respectively. DCA analysis indicated that DLRN provided greater clinical benefits compared to other models.
CONCLUSION
DLRN based on US images shows exceptional performance in distinguishing BPGTs and MPGTs, providing more reliable information for personalized diagnosis and treatment plans in clinical practice.
PubMed: 38803533
DOI: 10.3389/fonc.2024.1384105 -
Journal of Oral and Maxillofacial... 2024Pleomorphic adenoma (PA) is a benign epithelial tumour originating from the salivary gland, specifically the parotid gland. This study aims to comprehensively analyse...
INTRODUCTION
Pleomorphic adenoma (PA) is a benign epithelial tumour originating from the salivary gland, specifically the parotid gland. This study aims to comprehensively analyse the clinical and pathological features of PA by examining the characteristics of the tumour, including its histological structure and immunohistochemical profile.
MATERIALS AND METHODS
Over 8 years, beginning in October 2015 and ending in October 2023, an exhaustive retrospective study was conducted in the Department of Pathology, Kasturba Medical College, Mangalore, Manipal University, Karnataka, India. The research focused on 100 cases of pleomorphic adenoma and involved a meticulous examination of the clinical and pathological characteristics obtained by retrieving the pertinent files.
RESULTS
Out of all the primary tumours, the majority ( = 70) was found in the parotid gland, followed by PA that developed from the minor salivary glands of the palate ( = 07), the submandibular gland ( = 17), and the lacrimal gland ( = 04). Only two cases had a primary tumour located in the lips. Females were more susceptible to these tumours than males. The parotid gland tumours showed a distinct trend in laterality, with 73 cases observed on the right side. In 85%, the initial symptom of the condition was painless swelling.
CONCLUSION
Salivary gland PA is typically a benign tumour. However, a subset of these tumours can exhibit a malignant phenotype. The preferred treatment is surgical excision with adequate margins.
PubMed: 38800432
DOI: 10.4103/jomfp.jomfp_452_23 -
Ear, Nose, & Throat Journal May 2024
PubMed: 38775425
DOI: 10.1177/01455613241257307 -
Technology in Cancer Research &... 2024This prospective study aims to evaluate acute irradiation-induced xerostomia during radiotherapy by utilizing the normalized iodine concentration (NIC) derived from...
This prospective study aims to evaluate acute irradiation-induced xerostomia during radiotherapy by utilizing the normalized iodine concentration (NIC) derived from energy spectrum computed tomography (CT) iodine maps. In this prospective study, we evaluated 28 patients diagnosed with nasopharyngeal carcinoma. At 4 distinct stages of radiotherapy (0, 10, 20, and 30 fractions), each patient underwent CT scans to generate iodine maps. The NIC of both the left and right parotid glands was obtained, with the NIC at the 0-fraction stage serving as the baseline measurement. After statistically comparing the NIC obtained in the arterial phase, early venous phase, late venous phase, and delayed phase, we chose the late venous iodine concentration as the NIC and proceeded to analyze the variations in NIC at each radiotherapy interval. Using the series of NIC values, we conducted hypothesis tests to evaluate the extent of change in NIC within the parotid gland across different stages. Furthermore, we identified the specific time point at which the NIC decay exhibited the most statistically significant results. In addition, we evaluated the xerostomia grades of the patients at these 4 stages, following the radiation therapy oncology group (RTOG) xerostomia evaluation standard, to draw comparisons with the changes observed in NIC. The NIC in the late venous phase exhibited the highest level of statistical significance ( < .001). There was a noticeable attenuation in NIC as the RTOG dry mouth grade increased. Particularly, at the 20 fraction, the NIC experienced the most substantial attenuation ( < .001), a significant negative correlation was observed between the NIC of the left, right, and both parotid glands, and the RTOG evaluation grade of acute irradiation-induced xerostomia ( < .001, = -0.46; < .001, = -0.45; < .001, = -0.47). The critical NIC values for the left, right, and both parotid glands when acute xerostomia occurred were 0.175, 0.185, and 0.345 mg/ml, respectively, with AUC = 0.73, AUC = 0.75, and AUC = 0.75. The NIC may be used to evaluate changes in parotid gland function during radiotherapy and acute irradiation-induced xerostomia.
Topics: Humans; Xerostomia; Male; Parotid Gland; Female; Nasopharyngeal Carcinoma; Middle Aged; Adult; Tomography, X-Ray Computed; Aged; Nasopharyngeal Neoplasms; Iodine; Prospective Studies; Radiation Injuries; Radiotherapy Dosage
PubMed: 38773777
DOI: 10.1177/15330338241256814 -
BMC Oral Health May 2024Lymph node (LN) status is an important prognostic factor for parotid gland cancer (PGC). This study aimed to analyze the impact of extranodal extension (ENE) of...
BACKGROUND
Lymph node (LN) status is an important prognostic factor for parotid gland cancer (PGC). This study aimed to analyze the impact of extranodal extension (ENE) of intraparotid LN and LN metastasis burden on survival in PGC.
METHODS
Patients with surgically treated PGC and at least one metastatic cervical LN were retrospectively enrolled. Primary outcome variables were distant metastasis-free survival (DMFS), disease-specific survival (DSS), and overall survival (OS). The impact of ENE and LN metastasis burden was assessed using the Cox model.
RESULTS
A total of 292 patients were included. ENE in cervical or intraparotid LN was not associated with DMFS, DSS, or OS. Intraparotid LN metastasis had a significant impact on prognosis, and the presence of only one metastatic intraparotid LN offered an approximately 1.5-fold risk of distant metastasis. Prognostic models based on the number of positive LNs (1 vs. 2-3 vs. 4+) were superior to the AJCC N stage in terms of DMFS, DSS, and OS.
CONCLUSIONS
ENE of cervical or intraparotid LN has a limited effect on the prognosis of PGC, and the number of positive LNs is better than the AJCC N stage in LN status evaluation.
Topics: Humans; Parotid Neoplasms; Male; Female; Middle Aged; Lymphatic Metastasis; Neoplasm Staging; Retrospective Studies; Lymph Nodes; Aged; Prognosis; Adult; Extranodal Extension; Survival Rate; Aged, 80 and over; Disease-Free Survival; Neck
PubMed: 38773438
DOI: 10.1186/s12903-024-04346-y -
Radiology Case Reports Aug 2024Cystic lesions in the parotid gland are uncommon, constituting around 5% of salivary gland tumors, with epidermoid cysts being a rare subset. This report presents the...
Cystic lesions in the parotid gland are uncommon, constituting around 5% of salivary gland tumors, with epidermoid cysts being a rare subset. This report presents the case of a 14-year-old girl with a slowly growing left parotid mass for 2 years. Radiological assessments, including ultrasound and MRI, revealed a well-defined cystic mass. Surgical excision confirmed the diagnosis of an epidermoid cyst, supported by histopathological examination. Epidermoid cysts in the parotid gland are infrequent, often asymptomatic, and their radiological features may overlap with other cystic lesions. This article discusses the clinical presentation, radiological aspects, and differential diagnoses of parotid epidermoid cysts.
PubMed: 38770392
DOI: 10.1016/j.radcr.2024.04.016