Surgery of the parotid gland is usually indicated for the relief of an inflammatory disorder or for control of neoplasia. In all these procedures, the overriding critical factor is the management of the facial nerve. The facial nerve is embedded within the substance of the gland and is at risk of injury during any parotid gland operation. The various surgical approaches described in our study comprised a common thread, the surgeon’s awareness of facial nerve anatomy and efforts to protect the nerve from an inadvertent injury.
Parotid Gland ; Facial Nerve ; surgery ; Wounds and Injuries

OBJECTIVE: To determine the sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of FNAB in detecting parotid malignancies in our institution.
METHODS:
Design: Restrospective Chart Review
Setting: Tertiary Government Hospital
Participants: Postoperative records of seventy six (76) patients with tumors of the parotid gland preoperatively diagnosed by FNAB.
RESULTS: The sensitivity of FNAB was 46%. The specificity and positive predictive value were both 100% and negative predictive value was 90%. Overall accuracy in diagnosing malignant parotid tumor was 91%.
CONCLUSION: FNAB in this institution is a poor predictor of malignancy, having a sensitivity rate of only 46%. While this may serve as a basis for not recommending pre-operative FNAB for patients with parotid tumors in the interim, other factors should also be considered, including concerns with the actual performance and interpretation of FNAB in our institution.

 

Human ; General Surgery ; Parotid Gland ; Diagnosis

OBJECTIVES: This study aimed to evaluate the application value of a modified retroauricular hairline incision and a sternocleidomastoid flap with an inferior pedicle in the resection of benign parotid gland tumors. METHODS: Forty-eight patients with benign parotid gland tumors were retrospectively analyzed: 19 cases were included in the experimental group with an improved retroauricular hairline incision and a sternocleidomastoid flap with an inferior pedicle, and 29 cases were assigned in the control group with a modified facelift incision. Operation time, postoperative drainage, postoperative esthetic degree, and incidence of facial nerve paralysis, salivary fistula, and Frey's syndrome were compared. RESULTS: After the esthetic procedure, the average score of the experimental group was higher than that of the control group, and the esthetic effect of the former was better than that of the latter ( CONCLUSIONS The modified retroauricular hairline incision and sternocleidomastoid flap with an inferior pedicle can be applied to resect benign parotid gland tumors safely. It shows a better cosmetic effect and does not cause obvious postoperative complications. Therefore, it should be promoted for tumor treatments.
Esthetics, Dental ; Humans ; Parotid Gland/surgery* ; Parotid Neoplasms/surgery* ; Postoperative Complications ; Retrospective Studies ; Sweating, Gustatory

Hemangioma ; drug therapy ; Humans ; Infant ; Parotid Gland ; Parotid Neoplasms ; surgery ; Propranolol ; therapeutic use

Humans ; Parotid Gland ; surgery ; Parotid Neoplasms ; Ultrasonic Surgical Procedures ; instrumentation ; methods

OBJECTIVETo evaluate advantages of the superficial lobe preservation in the parotidectomy of deep-lobe tumors, which include much lower incidence in postparotidectomy depression, variable aesthetic deformities, facial nerve injury and Frey's syndrome.

METHODSThis retrospective review included 114 patients with benign parotid gland tumors hospitalized from 2001 to 2004, among which 13 patients with deep-lobe parotid tumors and 101 patients in the superficial lobe of parotid gland. Seven in the 13 patients with deep-lobe tumors were operated with the method of the superficial lobe preservation.

RESULTSDuring median 3 years and 3 months following-up, no any cases with either tumor recurrence, permanent facial nerve injury, postparotidectomy depression, or Frey's syndrome was found in the 7 operated patients. Only 1 case with the facial nerve marginal mandibular branch palsy occurred, but completely recovered over a 3-month period of time.

CONCLUSIONSPreservation of the superficial lobe for deep-lobe tumors parotidectomy could decrease the incidence of parotidectomy complications without any influence in the treatment effect. Additionally, the parotid function preservation and cosmetic appearance after operation also satisfy both the patients and surgeons.

Adult ; Facial Nerve ; surgery ; Female ; Humans ; Male ; Middle Aged ; Parotid Gland ; surgery ; Parotid Neoplasms ; surgery ; Retrospective Studies

A dermoid cyst of the head and neck region is a relatively infrequent occurrence and accounts for only 6.9% of all dermoid cysts. Its anatomical distribution is the orbit, floor of the mouth, other midline and nose in the order of frequency. A dermoid cyst of the parotid gland is extremely rare, and due to this and the absence of pathognomonic findings, it is often difficult to diagnose preoperatively. Thus thorough and careful examination including ultrasonic study is needed to evaluate this lesion. It must be differentiated from malignant tumors and other cystic lesions. Dermoid cysts usually recur after simple excision, so it is mandatory to excise it completely with a parotidectomy. This paper presents two cases of parotid gland dermoid cyst with a brief review of the literature.
Adult ; Case Report ; Dermoid Cyst/*diagnosis/surgery ; Human ; Male ; Parotid Gland/pathology/radiography ; Parotid Neoplasms/*diagnosis/surgery ; Sialography ; Ultrasonography

OBJECTIVETo investigate the feasibility of endoscopy-assisted partial-superficial parotidectomy.

METHODS38 cases with benign tumors located in the superficial lobe of the parotid gland were randomly assigned to receive conventional (20 cases) or endoscopic (18 cases) partial-superficial parotidectomy. Two short incisions, which were 2 to approximately 2.5 cm in length and located at retromandibular and postauricular area, were adopted for endoscopy-assisted surgery. The facial nerve was dissected through retrograde approach.

RESULTSThe tumors were successfully resected with endoscopy in 18 cases. The operation time was not significantly different between the conventional and endoscopy-assisted procedures (P > 0.05). The intraoperative blood loss was markedly lower in endoscopy-assisted group, compared with conventional group (P < 0.01). All the 18 cases with endoscopy-assisted surgery were satisfactory with the postoperative cosmetic results. The great auricular nerve was preserved very well in 12 patients (66.6%). Transient facial paralysis happened in 1 case and relieved 1 month later. Salivary fistula occurred in 1 case and recovered after dressing with pressure for 2 weeks. All the patients were followed up for 24 to approximately 50 months (mean, 39 months) without relapse.

CONCLUSIONSEndoscopy-assisted partial-superficial parotidectomy can successfully treat benign tumors located in the superficial lobe of parotid gland with a better postoperative cosmetic result.

Adolescent ; Adult ; Aged ; Endoscopy ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Parotid Gland ; surgery ; Parotid Neoplasms ; surgery ; Young Adult

OBJECTIVE: To investigate the utilization of functional surgery in benign parotid tumor of superficial lobe. METHOD: Conventional parotidectomy were modified in the following aspects: incision, preservation of great auricular nerve, local facial nerve dissection, partial superficial parotidectomy and repairing of sunken deformity. The post-operative recurrence incidence, functional outcomes and complications of 21 patients with benign parotid tumor of superficial lobe undergoing functional surgery were analyzed retrospectively. RESULT: No recurrence of tumor was found in follow-ups. No obvious scar and sunken deformity was found. The area with abnormal sensory around the auricle was smaller compared with those whose great auricular nerve had not been preserved. Post-operative transient facial paralysis was observed in 4 cases and all recovered in 3 months. One case complained about Frey's syndrome. Salivary leakage was found on 1 case. CONCLUSION Compared with conventional surgery, functional surgery for benign parotid tumor of superficial lobe may improve cosmetic, sensory, salivary function, facial nerve function and quality of life without raising post-operative recurrence.
Adult ; Female ; Humans ; Male ; Middle Aged ; Parotid Gland ; surgery ; Parotid Neoplasms ; surgery ; Postoperative Complications ; epidemiology ; Retrospective Studies ; Young Adult

OBJECTIVE: To investigate the clinicopathological characteristics of micro and mini parotid gland tumors and to provide reference for their clinical diagnosis and treatment. METHODS: Patients with parotid gland tumors treated in the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology from December 2012 to April 2020 were selected. Relevant clinical data of the patients with tumor diameter ≤20 mm detected by preoperative CT were collected to analyze the clinicopathological characteristics and prognosis of micro and mini parotid gland tumors. And the collected data were divided into two groups with diameter 11-20 mm and diameter ≤10 mm according to tumor diameter measured by preoperative CT. The clinicopathological differences between the two groups were statistically analyzed. RESULTS: A total of 2 067 patients with primary epithelial parotid gland tumors were collected, and 685 patients with tumor diameter ≤20 mm were examined by CT, accounting for 33.1%. The ratio of male to female patients with micro and mini parotid gland tumors was 1 ∶1.93, the average age was (45.3±13.8) years (12-83 years), and the median course of disease was 12 months (1 week to 30 years). Among them, 635 cases (92.7%) were benign tumors, 50 cases (7.3%) were malignant tumors, and the ratio of benign to malignant was 12.7 ∶1. The most common benign tumor was pleomorphic adenoma, and the most common malignant tumor was mucoepidermoid carcinoma. The micro and mini parotid gland tumors were divided into 11-20 mm group (n=611) and ≤10 mm group (n=74), the clinical characteristics comparison of the two groups of gender ratio, average age, course of di-sease had no statistical difference (P>0.05). In the 11-20 mm diameter group, the percentage of benign and malignant tumor was 92.8% (567/611) and 7.2% (44/611) respectively, and the ratio of benign to malignant tumors was 12.9 ∶1. In the ≤10 mm diameter group, the percentage of benign and malignant tumor was 91.9% (68/74) and 8.1% (6/74) respectively, and the ratio of benign to malignant tumors was 11.3 ∶1. There was no significant difference between the two groups (P>0.05). Fifty patients with malignant tumor were followed up for the median follow-up period of 39.5 months (1-91 months). Local recurrence occurred in 2 patients with one death. The overall 2-year survival rate was 93.7% and the 5-year survival rate was 89.3%. CONCLUSION The majority of micro and mini parotid gland tumors was benign lesion. There was a good prognosis for micro and mini parotid gland carcinoma. Early surgical treatment was recommended for micro and mini parotid gland tumors.
Adenoma, Pleomorphic/surgery* ; Adult ; Carcinoma, Mucoepidermoid/pathology* ; Female ; Humans ; Male ; Middle Aged ; Parotid Gland ; Parotid Neoplasms/surgery* ; Retrospective Studies