Surgical Outcome of Extracapsular Dissection of Benign Parotid Gland Tumor: A Comparative Study to Superficial Parotidectomy

Background/Objectives: Extracapsular dissection has the advantage of reducing complications by minimizing tissue loss of the parotid without intentionally exposing the facial nerve in patients with benign parotid tumor. However, there has been controversy over the surgical results. Thus, the surgical outcomes of extracapsular dissection for benign parotid tumor was compared to those of superficial parotidectomy.Materials & Methods: A retrospective chart review was conducted with 132 patients who received surgery for benign parotid tumor in our center from January 2014 to December 2018 retrospectively.Results: A total of 132 people were enrolled, with 62 people receiving extracapsular dissection, 38 people receiving partial superficial parotidectomy and 32 people receiving superficial parotidectomy. No significant difference was found between the three groups regarding complications such as facial nerve palsy, Frey's syndrome, or first bite syndrome. Operation time and hospital stay was significantly short in extracapsular dissection group.Conclusion: For well-selected cases, extracapsular dissection can be considered as an option for surgery of benign parotid tumor.

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Superficial Parotidectomy by Retrograde Facial Nerve Dissection

Journal of Gandaki Medical College-Nepal ◽

10.3126/jgmcn.v10i1.17909 ◽

2017 ◽

Vol 10 (1) ◽

pp. 25-27

Author(s):

Narendra Vikram Gurung ◽

D Shrestha ◽

A Acharya ◽

A Gurung ◽

S Shrestha ◽

...

Keyword(s):

Salivary Gland ◽

Parotid Gland ◽

Facial Nerve ◽

Head And Neck Neoplasms ◽

Complication Rate ◽

Gland Tumor ◽

Superficial Parotidectomy ◽

Salivary Fistula ◽

Parotid Tumors ◽

Parotid Gland Tumor

Introduction: Tumors of the salivary gland are relatively uncommon and represent less than two percentage of all head and neck neoplasms. Parotid gland tumor comprises 85% of the salivary gland tumors of which 80% are being benign. Superficial parotidectomy is the commonest procedure done for parotid tumors which can be performed by either anteretrograde or retrograde facial nerve dissection technique.Methods: Outcome of 60 patients after superficial parotidectomy with retrograde facial nerve dissection has been studied.Results: Total of 60 patients had been studied. Complications like facial nerve weakness, Freys syndrome, salivary fistula, and wound infection were taken into account. Among them, 13.33% patients developed temporary facial nerve weakness, followed by temporary salivary fistula, 1.6%. None of the patients developed any severe complication.Conclusion: Superficial parotidectomy by retrograde facial nerve dissection is an easy technique to carry out with low complication rate and without compromising surgical outcome.Journal of Gandaki Medical CollegeVol. 10, No. 1, 2017, page: 25-27

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Local Excision Procedure for Warthin's Tumor of the Parotid Gland

Otolaryngology ◽

10.1016/j.otohns.2004.09.071 ◽

2005 ◽

Vol 132 (4) ◽

pp. 577-580 ◽

Cited By ~ 20

Author(s):

Hiroshi Iwai ◽

Toshio Yamashita

Keyword(s):

Facial Nerve ◽

Local Excision ◽

Operation Time ◽

Warthin’S Tumor ◽

Parotid Tumors ◽

Significant Difference ◽

Warthin's Tumor ◽

Group A ◽

Surgical Field ◽

Group B

The aim of this work is to establish a local excision procedure (LEP) and indications of this procedure for Warthin's tumor. Seventy-three patients (82 sides) with Warthin's tumor were studied. Point I was located 1 cm from the intertragal notch in the direction indicated by the notch. Point S was located 5 mm superior to the inferior end of the mandibular angle. The trunk of the facial nerve and the marginal mandibular branch run at the points I and S, respectively. In surgical maneuvers below the I-S line, the marginal mandibular and colli branches may exist within the surgical field, but the trunk and other peripheral branches of the facial nerve will not be encountered. For Warthin's tumor estimated to be below the I-S line (Group A), LEP was used, involving resection of the tumor after locating and dissecting the marginal mandibular and colli branches. For tumors not meeting these criteria (Group B), partial superficial parotidectomy was performed. Results indicated that mean volume of hemorrhage was significantly smaller, and that mean operation time was significantly shorter in Group A than in Group B. Conversely, no significant difference in tumor size or incidence of postoperative facial paresis was identified between the 2 groups. Recurrence has not yet been noted in either group. In conclusion, LEP is useful for Warthin's tumor below the I-S line. This procedure seems applicable not only to Warthin's tumors, but also to other benign parotid tumors in the surgical field below the I-S line, such as pleomorphic adenoma and lymphoepithelial cyst.

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Role of limited parotidectomy in management of pleomorphic adenoma

The Journal of Laryngology & Otology ◽

10.1017/s0022215107000345 ◽

2007 ◽

Vol 121 (12) ◽

pp. 1126-1128 ◽

Cited By ~ 28

Author(s):

J T Johnson ◽

A Ferlito ◽

J J Fagan ◽

P J Bradley ◽

A Rinaldo

Keyword(s):

Twentieth Century ◽

Parotid Gland ◽

Facial Nerve ◽

Pleomorphic Adenoma ◽

Lower Incidence ◽

Tumour Recurrence ◽

Superficial Parotidectomy ◽

Cosmetic Results ◽

Extracapsular Dissection

AbstractThere is continued controversy over the extent of parotidectomy required for removal of a benign pleomorphic adenoma from the parotid gland. Currently, consensus exists that the integrity of the facial nerve must be preserved when the tumour is totally removed.As a result of experience gained in the first half of the twentieth century, it was recommended that superficial parotidectomy with facial nerve dissection should be the minimal biopsy for pleomorphic adenoma. Since that time, however, research has indicated that partial parotidectomy or extracapsular dissection of benign pleomorphic adenoma can be accomplished with preservation of the facial nerve without an increase in tumour recurrence. Partial parotidectomy or extracapsular dissection results in impaired cosmetic results and a lower incidence of Frey's syndrome, and thus may be the preferred approach when undertaken by experienced surgeons.

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Percutaneous glycerol rhizotomy for trigeminal neuralgia in patients with multiple sclerosis: a long-term retrospective cohort study

Journal of Neurosurgery ◽

10.3171/2019.1.jns183093 ◽

2020 ◽

Vol 132 (5) ◽

pp. 1405-1413 ◽

Cited By ~ 1

Author(s):

Michael D. Staudt ◽

Holger Joswig ◽

Gwynedd E. Pickett ◽

Keith W. MacDougall ◽

Andrew G. Parrent

Keyword(s):

Multiple Sclerosis ◽

Pain Relief ◽

Trigeminal Neuralgia ◽

Retrospective Chart Review ◽

Medication Usage ◽

Free Response ◽

Free Survival ◽

Time To Recurrence ◽

Significant Difference

OBJECTIVEThe prevalence of trigeminal neuralgia (TN) in patients with multiple sclerosis (MS-TN) is higher than in the general population (idiopathic TN [ITN]). Glycerol rhizotomy (GR) is a percutaneous lesioning surgery commonly performed for the treatment of medically refractory TN. While treatment for acute pain relief is excellent, long-term pain relief is poorer. The object of this study was to assess the efficacy of percutaneous retrogasserian GR for the treatment of MS-TN versus ITN.METHODSA retrospective chart review was performed, identifying 219 patients who had undergone 401 GR procedures from 1983 to 2018 at a single academic institution. All patients were diagnosed with medically refractory MS-TN (182 procedures) or ITN (219 procedures). The primary outcome measures of interest were immediate pain relief and time to pain recurrence following initial and repeat GR procedures. Secondary outcomes included medication usage and presence of periprocedural hypesthesia.RESULTSThe initial pain-free response rate was similar between groups (p = 0.726): MS-TN initial GR 89.6%; MS-TN repeat GR 91.9%; ITN initial GR 89.6%; ITN repeat GR 87.0%. The median time to recurrence after initial GR was similar between MS-TN (2.7 ± 1.3 years) and ITN (2.1 ± 0.6 years) patients (p = 0.87). However, there was a statistically significant difference in the time to recurrence after repeat GR between MS-TN (2.3 ± 0.5 years) and ITN patients (1.2 ± 0.2 years; p < 0.05). The presence of periprocedural hypesthesia was highly predictive of pain-free survival (p < 0.01).CONCLUSIONSPatients with MS-TN achieve meaningful pain relief following GR, with an efficacy comparable to that following GR in patients with ITN. Initial and subsequent GR procedures are equally efficacious.

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Incidence of nonaccidental head trauma in infants: a call to revisit prevention strategies

Journal of Neurosurgery Pediatrics ◽

10.3171/2019.7.peds195 ◽

2019 ◽

Vol 24 (6) ◽

pp. 689-696 ◽

Cited By ~ 1

Author(s):

LaVerne W. Thompson ◽

Kathryn D. Bass ◽

Justice O. Agyei ◽

Hibbut-Ur-Rauf Naseem ◽

Elizabeth Borngraber ◽

...

Keyword(s):

New York ◽

Parent Education ◽

Shaken Baby Syndrome ◽

Retrospective Chart Review ◽

Educational Interventions ◽

Significant Rise ◽

Significant Incidence ◽

Significant Difference ◽

Icd 10 ◽

Parent Education Programs

OBJECTIVETraumatic brain injury is a major sequela of nonaccidental trauma (NAT) that disproportionately affects young children and can have lasting sequelae. Considering the potentially devastating effects, many hospitals develop parent education programs to prevent NAT. Despite these efforts, NAT is still common in Western New York. The authors studied the incidence of NAT following the implementation of the Western New York Shaken Baby Syndrome Education Program in 1998.METHODSThe authors performed a retrospective chart review of children admitted to our pediatric hospital between 1999 and 2016 with ICD-9-CM and ICD-10-CM codes for types of child abuse and intracranial hemorrhage. Data were also provided by the Safe Babies New York program, which tracks NAT in Western New York. Children with a diagnosis of abuse at 0–24 months old were included in the study. Children who suffered a genuine accidental trauma or those with insufficient corroborating evidence to support the NAT diagnosis were excluded.RESULTSA total of 107 children were included in the study. There was a statistically significant rise in both the incidence of NAT (p = 0.0086) and the incidence rate of NAT (p = 0.0235) during the study period. There was no significant difference in trendlines for annual NAT incidence between sexes (y-intercept p = 0.5270, slope p = 0.5263). When stratified by age and sex, each age group had a distinct and statistically significant incidence of NAT (y-intercept p = 0.0069, slope p = 0.0374).CONCLUSIONSDespite educational interventions targeted at preventing NAT, there is a significant rise in the trend of newly reported cases of NAT, indicating a great need for better injury prevention programming.

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IDENTIFICATION OF THE FACIAL NERVE TRUNK DURING SUPERFICIAL PAROTIDECTOMY BY TRIDENT LANDMARK

Fayoum University Medical journal ◽

10.21608/fumj.2019.55042 ◽

2019 ◽

Vol 2 (1) ◽

pp. 17-26

Author(s):

Yasser Hatata ◽

Mohamed Ibrahim ◽

Reda Fawzy ◽

Hazem Elgohary

Keyword(s):

Facial Nerve ◽

Nerve Trunk ◽

Superficial Parotidectomy

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Efficacy evaluation of three-dimensional printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-019-1403-7 ◽

2019 ◽

Vol 14 (1) ◽

Cited By ~ 3

Author(s):

Yuan-Wei Zhang ◽

Xin Xiao ◽

Wen-Cheng Gao ◽

Yan Xiao ◽

Su-Li Zhang ◽

...

Keyword(s):

3D Printing ◽

Blood Loss ◽

Three Dimensional ◽

Operation Time ◽

Varus Deformity ◽

Conventional Group ◽

Intraoperative Blood Loss ◽

Cubitus Varus ◽

Guide Plate ◽

Significant Difference

Abstract Background This present study is aimed to retrospectively assess the efficacy of three-dimensional (3D) printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity. Material and methods Twenty-five patients (15 males and 10 females) with the cubitus varus deformity from June 2014 to December 2017 were included in this study and were enrolled into the conventional group (n = 11) and 3D printing group (n = 14) according to the different surgical approaches. The operation time, intraoperative blood loss, osteotomy degrees, osteotomy end union time, and postoperative complications between the two groups were observed and recorded. Results Compared with the conventional group, the 3D printing group has the advantages of shorter operation time, less intraoperative blood loss, higher rate of excellent correction, and higher rate of the parents’ excellent satisfaction with appearance after deformity correction (P < 0.001, P < 0.001, P = 0.019, P = 0.023). Nevertheless, no significant difference was presented in postoperative carrying angle of the deformed side and total complication rate between the two groups (P = 0.626, P = 0.371). Conclusions The operation assisted by 3D printing osteotomy guide plate to correct the adolescent cubitus varus deformity is feasible and effective, which might be an optional approach to promote the accurate osteotomy and optimize the efficacy.

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Cerebellum and brain stem volume loss in relapsing remission multiple sclerosis by MRI volumetry: relation to neurological disability score and number of relapses

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-020-00394-w ◽

2021 ◽

Vol 52 (1) ◽

Author(s):

Magdy Elzayady ◽

Naglaa Lotfy Debees ◽

Mohamed Khalil ◽

Mohammed Mahmoud Dawoud

Keyword(s):

Brain Stem ◽

Tissue Loss ◽

Cerebellar Hemisphere ◽

Stem Volume ◽

Volume Loss ◽

Neurological Disability ◽

Disability Score ◽

Brain Volume Loss ◽

Significant Difference ◽

Mri Volumetry

Abstract Background MRI is the method of choice in the diagnosis of MS as well as in monitoring the disease activity. MRI volumetry is used to assess whole or regional brain volume loss which reflects neurodegenerative aspect of the disease and plays an important role in all stages of disease. The aim of this work is to study MRI volumetry in the evaluation of cerebellum and brain stem volume loss in RRMS patients and its correlation with neurological disability score and number of relapses. Results Volumes of whole brainstem, medulla, and pons showed a significant decrease in RRMS cases compared to controls (p < 0.05). Brainstem volume had a mean volume of 22.17 and 25.09 cm3 in cases and controls, respectively. However, midbrain volume showed no significant difference between cases and controls (p = 0.134). Volume of left cerebellar cortex showed a significant decrease in RRMS cases compared to controls (p < 0.001). It had mean volumes of 81.64 and 92.14 ml in cases and controls, respectively, at left cerebellar hemisphere, while right cerebellar hemisphere cortex volumes were 80.37 and 91.97 ml in cases and controls, respectively. Cerebellar white matter showed no significant volume decrease in cases and controls. Conclusion Volumetric MR imaging is an important tool for quantifying the MS disease, assesses MS activity, progression, and tissue loss. The degree and the pattern of atrophy on MRI images correlate significantly with the neurological disability score and number of relapses.

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Clinical Evaluation of Microendoscopy-Assisted Oblique Lateral Interbody Fusion

Medicina ◽

10.3390/medicina57020135 ◽

2021 ◽

Vol 57 (2) ◽

pp. 135

Author(s):

Tomohide Segawa ◽

Hisashi Koga ◽

Masahito Oshina ◽

Katsuhiko Ishibashi ◽

Yuichi Takano ◽

...

Keyword(s):

Interbody Fusion ◽

Outcome Measure ◽

Operation Time ◽

Secondary Outcome ◽

Invasive Technique ◽

Lateral Interbody Fusion ◽

Surgical Methods ◽

Significant Difference ◽

Oblique Lateral Interbody Fusion ◽

Lateral Interbody

Background and objectives: Oblique Lateral Interbody Fusion (OLIF) is a widely performed, minimally invasive technique to achieve lumbar lateral interbody fusion. However, some complications can arise due to constraints posed by the limited surgical space and visual field. The purpose of this study was to assess the short-term postoperative clinical outcomes of microendoscopy-assisted OLIF (ME-OLIF) compared to conventional OLIF. Materials and Methods: We retrospectively investigated 75 consecutive patients who underwent OLIF or ME-OLIF. The age, sex, diagnosis, and number of fused levels were obtained from medical records. Operation time, estimated blood loss (EBL), and intraoperative complications were also collected. Operation time and EBL were only measured per level required for the lateral procedure, excluding the posterior fixation surgery. The primary outcome measure was assessed using the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ). The secondary outcome measure was assessed using the Oswestry Disability Index (ODI) and the European Quality of Life–5 Dimensions (EQ-5D), measured preoperatively and 1-year postoperatively. Results: This case series consisted of 14 patients in the OLIF group and 61 patients in the ME-OLIF group. There was no significant difference between the two groups in terms of the mean operative time and EBL (p = 0.90 and p = 0.50, respectively). The perioperative complication rate was 21.4% in the OLIF group and 21.3% in the ME-OLIF group (p = 0.99). In both groups, the postoperative JOABPEQ, EQ-5D, and ODI scores improved significantly (p < 0.001). Conclusions: Although there was no significant difference in clinical results between the two surgical methods, the results suggest that both are safe surgical methods and that microendoscopy-assisted OLIF could serve as a potential alternative to the conventional OLIF procedure.

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Comparative Morbidity Profile of Elective vs Therapeutic Neck Dissection

Otolaryngology ◽

10.1177/01945998211008915 ◽

2021 ◽

pp. 019459982110089

Author(s):

Quinn Dunlap ◽

James Reed Gardner ◽

Amanda Ederle ◽

Deanne King ◽

Maya Merriweather ◽

...

Keyword(s):

Neck Dissection ◽

Surgical Complications ◽

Chart Review ◽

Care Center ◽

Tertiary Care ◽

Retrospective Chart Review ◽

Neck Surgery ◽

Continuous Variables ◽

Significant Difference ◽

History Of

Objective Neck dissection (ND) is one of the most commonly performed procedures in head and neck surgery. We sought to compare the morbidity of elective ND (END) versus therapeutic ND (TND). Study Design Retrospective chart review. Setting Academic tertiary care center. Methods Retrospective chart review of 373 NDs performed from January 2015 to December 2018. Patients with radical ND or inadequate chart documentation were excluded. Demographics, clinicopathologic data, complications, and sacrificed structures during ND were retrieved. Statistical analysis was performed with χ2 and analysis of variance for comparison of categorical and continuous variables, respectively, with statistical alpha set a 0.05. Results Patients examined consisted of 224 males (60%) with a mean age of 60 years. TND accounted for 79% (n = 296) as compared with 21% (n = 77) for END. Other than a significantly higher history of radiation (37% vs 7%, P < .001) and endocrine pathology (34% vs 2.6%, P < .001) in the TND group, no significant differences in demographics were found between the therapeutic and elective groups. A significantly higher rate of structure sacrifice and extranodal extension within the TND group was noted to hold in overall and subgroup comparisons. No significant difference in rate of surgical complications was appreciated between groups in overall or subgroup analysis. Conclusion While the significantly higher rate of structure sacrifice among the TND population represents an increased morbidity profile in these patients, no significant difference was found in the rate of surgical complications between groups. The significant difference seen between groups regarding history of radiation and endocrine pathology likely represents selection bias.

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