Microscopic Antegrade Parotidectomy for Different Types of Parotid Tumor
DOI:
https://doi.org/10.22502/jlmc.v8i2.338Keywords:
Antegrade parotidectomy, Facial nerve trunk, Microsurgical techniqueAbstract
Introduction: Salivary gland tumor accounts for about 5% of all the neoplasms of the head and neck. 75% of such tumors occur in the parotid glands. Pleomorphic adenoma is the most common type of benign salivary gland tumor. It tends to recur after inappropriate treatment. Surgery of parotid tumor includes enucleation, superficial parotidectomy and total parotidectomy. Identification and preservation of facial nerve trunk and its branches are very important in parotid surgery. Advancement of microsurgical technique has helped in better visualization, identification and preservation of the facial nerve. Methods: This prospective study included twenty-seven patients. Preoperative ultrasonography and fine needle aspiration cytology were done for all cases. Computed tomography/magnetic resonance imaging were performed in some cases when needed. Standard microsurgical technique with the help of microscope was performed for antegrade parotidectomy. Data analysis was done using SPSS version 26.0. Results: The patients' age ranged from 12 to 78 years. Fifteen (55.6%) patients were female and 12 (44. 4%) were males. Sixteen (59.3%) tumors were located on the right side whereas 11 (40.7%) were on the left side. Most of the tumors (n=18, 66.7%) were pleomorphic adenoma. Two (7.4%) of the patients had temporary facial paralysis which improved with time. Two (7.4%) patients had developed hematoma. Frey’s syndrome was not found in follow-up. Conclusion: This study showed low morbidity in parotidectomy using microsurgical techniques. No permanent injury to the facial nerve was found.
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References
Hoda SA, Hoda RS. Rubin’s pathology: Clinicopathologic foundations of medicine. The Journal of American Medical Association. 2007;298(17):2070-75. DOI: http://dx.doi.org/10.1001/jama.298.17.2073
Spiro RH. Salivary neoplasms: overview of a 35â€year experience with 2,807 patients. Head Neck Surg. 1986;8(3):177-84. PMID: 3744850. DOI: https://doi.org/10.1002/hed.2890080309
Woods JE, Chong GC, Beahrs OH. Experience with 1,360 primary parotid tumors. The American Journal of Surgery 1975;130(4):460-62. DOI: https://doi.org/10.1016/0002-9610(75)90484-5
Carta F, Chuchueva N, Gerosa C, Sionis S, Caria R, Puxeddu R. Parotid tumours: clinical and oncologic outcomes after microscope-assisted parotidectomy with intraoperative nerve monitoring. Acta Otorhinolaryngologica Italica. 2017;37(5):375-86. Available from: https://www.actaitalica.it/issues/2017/5-2017/03_CARTA.pdf
Klintworth N, Zenk J, Koch M, Iro H. Postoperative complications after extracapsular dissection of benign parotid lesions with particular reference to facial nerve function. The Laryngoscope. 2010;120(3):484-90. DOI: https://doi.org/10.1002/lary.20801
Anjum K, Revington P, Irvine GH. Superficial parotidectomy: antegrade compared with modified retrograde dissections of the facial nerve. British Journal of Oral and Maxillofacial Surgery. 2008;46(6):433-34. DOI: https://doi.org/10.1016/j.bjoms.2008.03.018
Janes RM. Tumours of the Parotid Gland. Ann R Coll of Surg Engl. 1957;21(1):1-20. PMID: 13445068
Park SY, Han KT, Kim M, Lim JS. Recurrent Pleomorphic Adenoma of the Parotid Gland. Arch Craniofac Surg. 2016;17(2):90-92. PMID: 28913262. DOI: https://doi.org/10.7181/acfs.2016.17.2.90
Webb AJ, Eveson JW. Pleomorphic adenomas of the major salivary glands: a study of the capsular form in relation to surgical management. Clinical Otolaryngology & Allied Sciences. 2001;26(2):134-42. DOI: https://doi.org/10.1046/j.1365-2273.2001.00440.x
Bussu F, Parrilla C, Rizzo D, Almadori G, Paludetti G, Galli J. Clinical approach and treatment of benign and malignant parotid masses, personal experience. Acta Otorhinolaryngol Ital. 2011;31(3):135-43. PMID: 22058591
Harish K. Management of primary malignant epithelial parotid tumors. Surgical Oncology. 2004;13(1):7-16. DOI: https://doi.org/10.1016/j.suronc.2003.10.002
Johnson JT, Ferlito A, Fagan JJ, Bradley PJ, Rinaldo A. Role of limited parotidectomy in management of pleomorphic adenoma. J Laryngol Otol. 2007;121(12):1126-8. PMID: 17666140. DOI: https://doi.org/10.1017/s0022215107000345
O’Brien CJ. Current management of benign parotid tumors--the role of limited superficial parotidectomy. Head Neck. 2003;25(11):946-52. PMID: 14603455. DOI: https://doi.org/10.1002/hed.10312
Frankenthaler RA, Luna MA, Lee SS, Ang KK, Byers RM, Guillamondegui OM, et al. Prognostic variables in parotid gland cancer. Arch Otolaryngol Head Neck Surg. 1991;117(11):1251-6. PMID: 1747227. DOI: https://doi.org/10.1001/archotol.1991.01870230067009
Hoff SR, Mohyuddin N, Yao M. Complications of parotid surgery. Operative Techniques in Otolaryngology-Head and Neck Surgery. 2009;20(2):123-30. DOI: https://doi.org/10.1016/j.otot.2009.04.001
Salgarelli AC, Bellini P, Consolo U, Collini M. Technical tips for a cosmetic approach to parotid surgery. Journal of Craniofacial Surgery. 2012;23(2):e106-e108. Available from: https://journals.lww.com/jcraniofacialsurgery/toc/2012/03000
Nicoli F, D’Ambrosia C, Lazzeri D, Orfaniotis G, Ciudad P, Maruccia M, et al. Microsurgical dissection of facial nerve in parotidectomy: a discussion of techniques and long-term results. Gland Surgery. 2017;6(4):308-14. Available from: https://www.researchgate.net/publication/319045637
Witt RL. Facial nerve function after partial superficial parotidectomy: An 11-year review (1987-1997). Otolaryngol Head Neck Surg. 1999;121(3):210-3. PMID: 10471859. DOI: https://doi.org/10.1016/s01945998(99)70173-7
McGurk M, Renehan A, Gleave E, Hancock BD. Clinical significance of the tumor capsule in the treatment of parotid pleomorphic adenomas. British journal of surgery 1996;83(12):1747-49. DOI: https://doi.org/10.1002/bjs.1800831227
Rodopoulou S, Keramidas E, Metaxotos N, Tagaris G, Tsati E, Ioannovich J. Treatment of Frey’s syndrome using botulinum toxin type A. European Journal of Plastic Surgery. 2001;24(6):297-302. DOI: https://doi.org/10.1007/s002380100297
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