The Role of Anatomical Location of Parotid Tumors in the Incidence of Post-Operative Facial Nerve Paresis

Abstract Background This study assesses the outcomes of total conservative parotidectomy in the management of benign parotid neoplasms. A retrospective review was conducted for all parotidectomies for benign superficial parotid neoplasms from 2013 to 2018. Facial nerve dysfunction, recurrence, and other side-effects were collected and statistically analyzed. Results A total of 21 patients were included in our study. Our series included a pleomorphic adenoma (16 patients), Warthin tumor (4 patients), and oncocytoma (1 patient). Overall, 12 patients had temporary facial nerve paresis (57.1%), 3 patients had temporary paralysis (14.3%)—no reported cases of permanent paralysis—and 6 patients sustained postoperative good facial nerve function (28.6%). No recurrence was reported in our study period. Other side effects included hemorrhage (1 patient), hematoma (2 patients), seroma (4 patients), and partial skin flap necrosis (2 patients). As well, Frey’s syndrome was reported in 11 patients, and most of them were managed conservatively. Conclusions Total conservative parotidectomy is a valuable approach for removing parotid tumors. The rate of complications after this procedure (facial nerve dysfunction and recurrence) is low provided that the technique was performed with meticulous care.

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Differential Expression of Peroxisomal Proteins in Distinct Types of Parotid Gland Tumors

International Journal of Molecular Sciences ◽

10.3390/ijms22157872 ◽

2021 ◽

Vol 22 (15) ◽

pp. 7872

Author(s):

Malin Tordis Meyer ◽

Christoph Watermann ◽

Thomas Dreyer ◽

Steffen Wagner ◽

Claus Wittekindt ◽

...

Keyword(s):

Redox Balance ◽

Matrix Proteins ◽

Parotid Tumor ◽

Gene Expressions ◽

Tissue Samples ◽

Cellular Redox ◽

Tumor Subtypes ◽

Parotid Tumors ◽

Aggressive Tumors

Salivary gland cancers are rare but aggressive tumors that have poor prognosis and lack effective cure. Of those, parotid tumors constitute the majority. Functioning as metabolic machinery contributing to cellular redox balance, peroxisomes have emerged as crucial players in tumorigenesis. Studies on murine and human cells have examined the role of peroxisomes in carcinogenesis with conflicting results. These studies either examined the consequences of altered peroxisomal proliferators or compared their expression in healthy and neoplastic tissues. None, however, examined such differences exclusively in human parotid tissue or extended comparison to peroxisomal proteins and their associated gene expressions. Therefore, we examined differences in peroxisomal dynamics in parotid tumors of different morphologies. Using immunofluorescence and quantitative PCR, we compared the expression levels of key peroxisomal enzymes and proliferators in healthy and neoplastic parotid tissue samples. Three parotid tumor subtypes were examined: pleomorphic adenoma, mucoepidermoid carcinoma and acinic cell carcinoma. We observed higher expression of peroxisomal matrix proteins in neoplastic samples with exceptional down regulation of certain enzymes; however, the degree of expression varied between tumor subtypes. Our findings confirm previous experimental results on other organ tissues and suggest peroxisomes as possible therapeutic targets or markers in all or certain subtypes of parotid neoplasms.

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Deep Lobe Parotid Tumors: A Systematic Review and Meta-analysis

Otolaryngology ◽

10.1177/01945998211009235 ◽

2021 ◽

pp. 019459982110092

Author(s):

Margaret H. Aasen ◽

Michael J. Hutz ◽

Brian T. Yuhan ◽

Christopher J. Britt

Keyword(s):

Facial Nerve ◽

Imaging Modality ◽

Meta Analysis ◽

Needle Aspiration ◽

Computed Tomography Scan ◽

Fine Needle ◽

Deep Lobe ◽

Parotid Tumors ◽

Superficial Lobe ◽

Tomography Scan

Objective We performed a systematic review and meta-analysis of deep lobe parotid tumors to evaluate their unique characteristics. Data Sources PubMed/Medline, Embase, Web of Sciences, and Cochrane Library databases were queried for relevant literature. Review Methods Studies were individually assessed by 2 independent reviewers. Risk of bias was assessed with the Cochrane bias tool, GRADE criteria, and MINORS criteria. Results were reported according to the PRISMA guidelines. Statistical analysis was performed by comparing rates of malignancy between deep and superficial lobe tumors. Results In total, 8 studies including 379 deep lobe parotid tumors met inclusion criteria. Mean age at diagnosis was 44.9 years. Computed tomography scan was the most common imaging modality. Preoperative diagnostic fine-needle aspiration was utilized in 39.4% of patients and demonstrated high sensitivity for malignant disease. The most common approach was subtotal parotidectomy with facial nerve preservation (58.9%). The rate of malignancy was 26.6%, which was significantly higher than that of the superficial lobe tumors in this study (risk ratio, 1.25; 95% CI, 1.01-1.56). The rate of temporary postoperative facial nerve weakness between deep and superficial lobe tumors was 32.5% and 11.7%, respectively. Conclusion Deep lobe parotid tumors had a 26.6% rate of malignancy. On meta-analysis, deep lobe tumors appeared to have higher rates of malignancy than superficial lobe tumors. Surgical excision of deep lobe tumors showed increased rates of temporary facial nerve paresis as compared with superficial lobe tumors. Computed tomography scan was the most common imaging modality. There were limited data regarding the utility of fine-needle aspiration.

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Long-term recurrence rate of pleomorphic adenoma and postoperative facial nerve paresis (in parotid surgery)

Journal of Cranio-Maxillofacial Surgery ◽

10.1016/j.jcms.2007.02.003 ◽

2007 ◽

Vol 35 (3) ◽

pp. 189-192 ◽

Cited By ~ 30

Author(s):

Oliver Zernial ◽

Ingo N. Springer ◽

Patrick Warnke ◽

Franz Härle ◽

Christian Risick ◽

...

Keyword(s):

Facial Nerve ◽

Pleomorphic Adenoma ◽

Recurrence Rate ◽

Parotid Surgery ◽

Nerve Paresis ◽

Long Term Recurrence Rate

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The Anatomical Location and Course of the Facial Nerve in Vestibular Schwannomas : A Study of 163 Surgically Treated Cases

Journal of Korean Neurosurgical Society ◽

10.3340/jkns.2007.42.6.450 ◽

2007 ◽

Vol 42 (6) ◽

pp. 450 ◽

Cited By ~ 8

Author(s):

Chae Wan Bae ◽

Young Hyun Cho ◽

Seok Ho Hong ◽

Jeong Hoon Kim ◽

Jung-kyo Lee ◽

...

Keyword(s):

Facial Nerve ◽

Vestibular Schwannomas ◽

Anatomical Location

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The Role of Extracapsular Dissection for Benign Parotid Tumors

Current Otorhinolaryngology Reports ◽

10.1007/s40136-014-0045-x ◽

2014 ◽

Vol 2 (2) ◽

pp. 55-63 ◽

Cited By ~ 6

Author(s):

Robert L. Witt ◽

Heinrich Iro ◽

Mark McGurk

Keyword(s):

Parotid Tumors ◽

Extracapsular Dissection

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The Offprint of an Abnormal Pre-Parotidectomy Electrodiagnostic Finding in a Normally Functioning Facial Nerve: Correlation with Intraoperative Findings, Histology and Postoperative Facial Nerve Function

Journal of Clinical Medicine ◽

10.3390/jcm11010248 ◽

2022 ◽

Vol 11 (1) ◽

pp. 248

Author(s):

Verena Katheder ◽

Matti Sievert ◽

Sarina Katrin Müller ◽

Vivian Thimsen ◽

Antoniu-Oreste Gostian ◽

...

Keyword(s):

Facial Nerve ◽

Malignant Tumor ◽

Facial Palsy ◽

Benign Lesion ◽

Nerve Function ◽

Facial Nerve Function ◽

Nerve Preservation ◽

Clinically Normal ◽

Parotid Tumors ◽

Supramaximal Stimulation

The aim of this study was to search for associations between an electrodiagnostically abnormal but clinically normal facial nerve before parotidectomy and the intraoperative findings, as well as the postoperative facial nerve function. The records of all patients treated for parotid tumors between 2002 and 2021 with a preoperative House–Brackmann score of grade I but an abnormal electrophysiologic finding were studied retrospectively. A total of 285 patients were included in this study, and 222 patients had a benign lesion (77.9%), whereas 63 cases had a malignant tumor (22.1%). Electroneurographic facial nerve involvement was associated with nerve displacement in 185 cases (64.9%) and infiltration in 17 cases (6%). In 83 cases (29.1%), no tumor–nerve interface could be detected intraoperatively. An electroneurographic signal was absent despite supramaximal stimulation in 6/17 cases with nerve infiltration and in 17/268 cases without nerve infiltration (p < 0.001). The electrophysiologic involvement of a normal facial nerve is not pathognomonic for a malignancy (22%), but it presents a rather rare (~6%) sign of a “true” nerve infiltration and could also appear in tumors without any contact with the facial nerve (~29%). Of our cases, two thirds of those with an anatomic nerve preservation and facial palsy had already directly and postoperatively recovered to a major extent in the midterm.

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The Role of Radiotherapy for Pancreatic Malignancies- A Population-based Analysis of the SEER-Medicare Database.

10.21203/rs.3.rs-120622/v1 ◽

2020 ◽

Author(s):

yunxiu luo ◽

Shengjun Xiao

Keyword(s):

Pancreatic Cancer ◽

Pancreatic Carcinoma ◽

Adjuvant Radiotherapy ◽

Adenosquamous Carcinoma ◽

Early Stage ◽

Pancreatic Head ◽

Population Based ◽

Anatomical Location ◽

Duct Carcinoma

Abstract Background and objective. To investigate the role of adjuvant radiotherapy in patients after surgical resection for pancreatic cancer. Methods and patients. The patients with pancreatic cancer from 18 registered institutions in the Surveillance Epidemiology and End Results (SEER) database were retrospectively analyzed. The characteristics of patients who would benefit from adjuvant radiotherapy were screened, as well as whether neoadjuvant or adjuvant radiotherapy conferred to a better clinical outcome. Results. 30249 patients included in this study (21295 vs 8954 in surgery and adjuvant radiotherapy group) .The median survivals in the surgery (S) group and adjuvant radiotherapy (S+R) group were 24 and 21 months respectively, The 1, 3, and 5-year overall survival (OS) rates in the S group and S+R group were 68%, 40%, 31% ,and 75%, 30%, 20%, respectively (p<0.001).Stratified analysis showed patients with histological classified as adenocarcinoma(15 VS 21, P<0.0001), infiltrating duct carcinoma (17 VS 21,P<0.0001), adenosquamous carcinoma(10 VS 18,P<0.0001) could be benefit from adjuvant radiotherapy. Adjuvant radiotherapy was helpful to improve the OS for patients with pancreatic head (19 VS 21, P=0.0003) and duct carcinoma (18VS 28, P=0.0121). Subgroup stratified assay indicated specific patients with early stage (AJCC 7th I, II, T2, N0) pancreatic carcinoma had better OS after additional radiotherapy than surgery alone. Conclusion. Additional radiotherapy may contribute to improved prognosis for patients with pancreatic carcinoma of specific histological types (adenocarcinoma/carcinoma, infiltrating duct carcinoma, adenosquamous carcinoma, and squamous), anatomical location, and advanced stage. A specific subgroup of patients with an early stage (I/II, T2) pancreatic cancer should be considered for additional radiotherapy.

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