scholarly journals Is the 3D exoscope better than the surgical microscope in parotid surgery: a prospective, randomized single-center study

2021 ◽  
Author(s):  
Ewelina Bartkowiak ◽  
Łukasz Łuczewski ◽  
Jadzia Tin-Tsen Chou ◽  
Małgorzata Wierzbicka
Keyword(s):  
Parotid Gland ◽  
3D Visualization ◽  
Operating Time ◽  
Facial Nerve Paralysis ◽  
Digastric Muscle ◽  
Operating Microscope ◽  
Nerve Paralysis ◽  
Parotid Gland Tumors ◽  
Conversion Rates ◽  
Parotid Surgery

Abstract Background High-definition, three-dimensional (3D) exoscopes are being used to perform a growing number of head and neck surgeries. However, the use of the 3D exoscope in parotid gland surgery has not been previously described. Our initial experience with the VITOM 3D exoscope in the surgical treatment of parotid gland tumors is detailed here. Methods We made a prospective study of patients with benign parotid gland tumors indicated for surgical resection. Between January and December 2018, patients were randomly assigned to undergo surgery assisted with the VITOM 3D system (n = 31) or an operating microscope (n = 40). Visualization quality (greater auricular nerve, digastric muscle, tragal pointer), operating time, conversion rates, and surgical outcomes were compared. Results A total of 71 patients underwent superficial (n = 18) or total parotidectomy (n = 53). No exoscope-related complications were observed. Five patients undergoing exoscope-guided deep lobe surgery required intraoperative conversion to a microscope. No differences were observed in the subjective quality of intraoperative visualization of key anatomical structures. However, a significantly higher percentage of patients in the exoscope group developed transient facial nerve paralysis (n = 9; 29% vs. n = 4, 10%). Conclusions These findings suggest that the VITOM 3D is a valid visualization tool for parotid gland surgery, comparable to the operating microscope but with higher resolution 3D visualization, an increased degree of freedom of movement, and better ergonomics. However, the high rate of transient nerve palsy, possibly related to decreased depth perception and the brief learning curve, merits further investigation.

scholarly journals Malignant Mucoepidermoid Tumor Arising in the Accessory Parotid Gland: A Case Report

2003 ◽  
Vol 46 (2) ◽  
pp. 79-83 ◽  
Author(s):  
Demetrio Tamiolakis ◽  
Vasilios Thomaidis ◽  
Ioannis Tsamis ◽  
Theodoros Jivannakis ◽  
Ageliki Cheva ◽  
...  
Keyword(s):  
Case Report ◽  
Parotid Gland ◽  
Facial Nerve ◽  
Mucoepidermoid Carcinoma ◽  
Low Grade ◽  
Facial Nerve Paralysis ◽  
Nerve Paralysis ◽  
Parotid Neoplasm ◽  
Parotid Surgery ◽  
Accessory Parotid Gland

Purpose: The head and neck surgeon’s fascination with parotid surgery arises from the gland’s spectrum of histopathological presentations, as well as the diversity of its morphological features. A mass arising in the mid-cheek region may often be overlooked as a rare accessory lobe parotid neoplasm. This report serves to revisit the topic of accessory parotid gland neoplasms to emphasize proper management, particularly the surgical aspects, so that consequences of salivary fistula, facial nerve paralysis, and recurrence are avoided. Case report: We report a case of mucoepidermoid carcinoma which was assessed pre-operatively as arising from the accessory parotid gland of a 11-year-old female. She had complained of a painless and round mass of the left cheek for a duration of 12 months. Sialography, ultrasonography, CT scan and MRI were performed preoperatively. Sialography revealed a small duct separating from the Stensen’s duct. CT and MRI showed that the tumor with smooth outline was lying on the masseter muscle and detached from the main parotid gland. The preoperative diagnosis was an accessory parotid gland tumor. The tumor was removed without facial nerve injury via standard parotidectomy incision. The tumor was composed of mucous, intermediate and epidermoid cells. The pathological diagnosis was low-grade mucoepidermoid carcinoma. Conclusions: Accessory parotid gland neoplasms are rare and may present as innocuous extraparotid mid-cheek masses. A high index of suspicion, prudent diagnostic skills (including fine-needle aspiration [FNA] biopsy followed by computed tomography [CT] imaging), and scrupulous surgical approach (extended parotidectomy-style incision and limited peripheral nerve dissection when possible) are the keys to successful management of these lesions.

scholarly journals Facial nerve paralysis postparotidectomy: A retrospective review of the prevalence and risk factors at a tertiary center

2017 ◽  
Vol 3 (4) ◽  
pp. 1
Author(s):  
Shahad T. Ghandoura ◽  
Mahmood Z. Al-Madani ◽  
Qusai A. Tawakul ◽  
Nada J. Farsi ◽  
Rolina K. Alwassia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Facial Nerve ◽  
Retrospective Review ◽  
Categorical Variables ◽  
Facial Nerve Paralysis ◽  
Tumor Characteristics ◽  
Nerve Paralysis ◽  
Operative Duration ◽  
Parotid Surgery ◽  
Tertiary Center

Objective: Facial nerve paralysis is one of the most devastating complications after parotid gland surgery. We aimed to determine the prevalence and risk factors of facial palsy after parotidectomy.Methods: We performed a retrospective review of the data from 54 patients who underwent parotid surgery between 2004 and 2015 at a tertiary medical care center. The prevalence of facial nerve paralysis and possible risk factors (demographic characteristics, tumor characteristics, and operative factors) associated with postoperative paralysis were assessed. Categorical variables were evaluated using the Fisher’s exact test, and a two-tailed t-test was used to assess the associations between continuous and binary outcome variables.Results: The postparotidectomy prevalence of temporary and permanent facial nerve paralysis were 26% and 13%, respectively. Tumors involving both lobes were significantly associated with permanent facial nerve paralysis (p = .048). Long operative duration (> 164 minutes) was associated with both temporary and permanent facial nerve paralysis (p = .040).Conclusions: Operative factors such as operative duration and tumor characteristics such as bilobal involvement increased the risk of postparotidectomy facial nerve paralysis. Such factors should be considered to reduce the risk of palsy in patients undergoing parotidectomy.

scholarly journals Facial Nerve Schwannoma of Parotid Gland: Difficulties in Diagnosis and Management

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Murat Damar ◽  
Aykut Erdem Dinç ◽  
Sultan Şevik Eliçora ◽  
Sultan Bişkin ◽  
Gül Erten ◽  
...  
Keyword(s):  
Parotid Gland ◽  
Facial Nerve ◽  
Benign Tumors ◽  
Facial Nerve Paralysis ◽  
Nerve Paralysis ◽  
Seventh Cranial Nerve ◽  
Peripheral Facial Nerve Palsy ◽  
Painless Mass ◽  
Facial Nerve Schwannoma ◽  
Left Parotid Gland

Facial nerve schwannomas (FNS) are encapsulated benign tumors arising from Schwann cells of seventh cranial nerve. Most of the facial nerve schwannomas are localized in intratemporal region; only 9% of cases involve a portion of the extratemporal segment. Preoperative diagnosis is often unclear; diagnosis is often made intraoperatively. Management of intraparotid FNS is troublesome because of the facial nerve paralysis. In this report we presented a case of intraparotid schwannoma in a 55-year-old male patient complaining of a painless mass without peripheral facial nerve palsy in left parotid gland. Clinical features, preoperative and intraoperative diagnosis, and difficulties during management are discussed with the review of the literature.

scholarly journals Parotid Gland Abscess with Facial Nerve Paralysis

2006 ◽  
Vol 99 (11) ◽  
pp. 941-944
Author(s):  
Kazuhiko Nario ◽  
Hiroshi Miyahara ◽  
Hiroshi Kajikawa
Keyword(s):  
Parotid Gland ◽  
Facial Nerve ◽  
Facial Nerve Paralysis ◽  
Nerve Paralysis

Oncocytic differentiation in salivary gland tumours

1995 ◽  
Vol 109 (6) ◽  
pp. 569-571 ◽  
Author(s):  
Jorge A. Ferreiro ◽  
Nickolaos Stylopoulos
Keyword(s):  
Salivary Gland ◽  
Parotid Gland ◽  
Facial Nerve ◽  
Mucoepidermoid Carcinoma ◽  
Facial Nerve Paralysis ◽  
Major Salivary Gland ◽  
Superficial Parotidectomy ◽  
Nerve Paralysis ◽  
Salivary Gland Tumours ◽  
Pleomorphic Adenomas

AbstractAn oncocytic mucoepidermoid carcinoma and an oncocytic pleomorphic adenoma occurred in a 47-year-old male and a 75-year-old female, respectively. Both presented as asymptomatic parotid gland masses without evidence of facial nerve paralysis and were treated by superficial parotidectomy. There has been no evidence of recurrence or metastasis. Oncocytic change is rare in major salivary gland mucoepidermoid carcinoma with only two previously reported cases. Marked oncocytic transformation of pleomorphic adenomas can cause their confusion with oncocytomas. Recognition of oncocytic differentiation in various salivary gland tumours is important to avoid misclassification of these lesions.

Recurrent benign pleomorphic adenoma of the parotid gland: Facial nerve identification and risk factors for facial nerve paralysis at re-operation

2019 ◽  
Vol 46 (5) ◽  
pp. 779-784 ◽  
Author(s):  
Tatsuro Kuriyama ◽  
Ryo Kawata ◽  
Masaaki Higashino ◽  
Shuji Nishikawa ◽  
Takaki Inui ◽  
...  
Keyword(s):  
Risk Factors ◽  
Parotid Gland ◽  
Facial Nerve ◽  
Pleomorphic Adenoma ◽  
Facial Nerve Paralysis ◽  
Nerve Paralysis ◽  
Nerve Identification

scholarly journals Parotidectomy and Facial Paralysis, A Retrospective Review at A Tertiary Care Hospital

2021 ◽  
Vol 10 (3) ◽  
pp. 164-168
Author(s):  
Israr ud Din ◽  
Muhammad Junaid ◽  
Imran Khan ◽  
Arshad Aziz ◽  
Sakhawat Khan ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Facial Paralysis ◽  
Tertiary Care ◽  
Occurrence Rate ◽  
Facial Nerve Paralysis ◽  
Care Hospital ◽  
Female Population ◽  
Nerve Paralysis ◽  
Parotid Tumors ◽  
Parotid Surgery

Background: Facial Nerve is in close proximity with parotid gland and encountered during parotid surgery.  Facial nerve   paralysis   has   15 to 66% occurrence rate after parotidectomies. The objective of this study was to find out the frequency of facial paralysis resulting from superficial or total parotidectomies done for various parotid tumors. Material and Methods: This retrospective study was conducted at the Department of ENT, Khyber Teaching Hospital, Peshawar from January 2018 to May 2020. A total of 203 patients were reviewed for data on demographics, parotidectomies, histopathology and facial paralysis. The information on facial paralysis was compared against various parameters. Results:   The mean age of   the participants was 46.12 ± 11.11 years. The most common parotid tumor was pleomorphic adenoma (68.9%) followed by mucoepidermoid carcinoma. 57 (28.07%) patients showed facial paralysis with a higher rate of occurrence in total parotidectomy (40.90%). Among 57 patients with facial paralysis, 6 (10.53%) showed permanent facial paralysis. Conclusion: Tendency of permanent facial paralysis is high with total parotidectomies. Female population and elderly have a slightly higher rate of facial paralysis. The duration of procedure has no effect on the occurrence of facial paralysis.

scholarly journals Oncocytoma of the Parotid Gland with Facial Nerve Paralysis

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Seijiro Hamada ◽  
Keishi Fujiwara ◽  
Hiromitsu Hatakeyama ◽  
Akihiro Homma
Keyword(s):  
Parotid Gland ◽  
Facial Nerve ◽  
Malignant Tumor ◽  
Case Reports ◽  
Benign Tumors ◽  
Facial Nerve Paralysis ◽  
Gland Tumor ◽  
Nerve Paralysis ◽  
Parotid Gland Tumor

Parotid gland tumor with facial nerve paralysis is strongly suggestive of a malignant tumor. However, several case reports have documented benign tumors of the parotid gland with facial nerve paralysis. Here, we report a case of oncocytoma of the parotid gland with facial nerve paralysis. A 61-year-old male presented with pain in his right parotid gland. Physical examination demonstrated the presence of a right parotid gland tumor and ipsilateral facial nerve paralysis of House–Brackmann (HB) grade III. Due to the facial nerve paralysis, a malignant tumor of the parotid gland was suspected and right parotidectomy was performed. Oncocytoma was confirmed histopathologically. The facial nerve paralysis was resolved 2 months after surgery. During the follow-up period (one and a half years), no recurrence was observed. As the tumor showed a distinctive dumbbell shape and increased somewhat due to inflammation (i.e., infection), the facial nerve was pinched by the enlarged tumor. Ischemia and strangulation of the nerve were considered to be the cause of the facial nerve paralysis associated with the benign tumor in this case.

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