scholarly journals Frequency of surgical complications and recurrence rate after extracapsular dissection of benign tumors of the parotid.

2021 ◽  
Vol 28 (7) ◽  
pp. 983-986
Author(s):  
Muhammad Arham ◽  
◽  
Jahangir Sarwar Khan ◽  
Muhammad Arish ◽  
Naveed Akhtar Malik ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Pleomorphic Adenoma ◽  
Recurrence Rate ◽  
Surgical Complications ◽  
Case Series ◽  
Lesion Size ◽  
Benign Tumors ◽  
Warthin Tumor ◽  
Extracapsular Dissection ◽  
Medical University

Objective: To determine surgical complications and recurrence rate in patients with benign lesions of the parotid undergoing extracapsular dissection. Study Design: Case Series. Setting: Department of Surgery, Rawalpindi Medical University, Rawalpindi. Period: January 2010 and December 2018. Material & Methods: The hospital records of all 50 patients who underwent extracapsular dissection with a diagnosis of either Pleomorphic adenoma or War thin tumor between reviewed retrospectively. Data regarding demographics, tumor, complications and recurrence was collected. Results: Out of 50 patients, 40 were males and 10 were females with age ranging from 26 to 52 years and mean age of 42 years. 44 of 50 parotid lumps were diagnosed as Pleomorphic adenoma and 6 were cases of Warthin tumor. The range of lesion size was 1.5 to 3 cm. 15 (30%) patients suffered from transient facial nerve weakness, whereas only 1 (2%) sustained a facial nerve injury which required repair. There was no case of Frey syndrome, sialocele and hematoma, however, salivary fistula was seen in 1 (2%) patient. Capsule rupture during surgery occurred in 15 (30%) patients and recurrence was seen in only 1 patient (2%). Conclusion: Extracapsular dissection has low recurrence rate, very few complications and is a safe and effective treatment for Pleomorphic adenoma and Warthin tumor.

scholarly journals Giant Parotid Pleomorphic Adenoma with Atypical Histological Presentation and Long-Term Recurrence-Free Follow-Up after Surgery: A Case Report and Review of the Literature

2020 ◽  
Vol 2020 ◽  
pp. 1-18
Author(s):  
Mohammed AlKindi ◽  
Sundar Ramalingam ◽  
Lujain Abdulmajeed Hakeem ◽  
Manal A. AlSheddi
Keyword(s):  
Pleomorphic Adenoma ◽  
Surgical Management ◽  
Early Stage ◽  
English Literature ◽  
Benign Tumors ◽  
Adjuvant Radiation ◽  
Extracapsular Dissection ◽  
Slow Growing

Salivary gland tumors (SGT) comprise 3% of all head and neck tumors, are mostly benign, and arise frequently in the parotid gland. Pleomorphic adenoma (PA) is the commonest SGT, representing 60-70% of all benign parotid tumors. Clinically, parotid PA presents as irregular, lobulated, asymptomatic, slow-growing preauricular mass, involving both superficial and deep lobes, and could grow to gigantic proportions. Histologically, PA has epithelial and mesenchymal elements in chondromyxoid matrix and is managed surgically. Based on a review of 43 cases reported in English literature since 1995, giant parotid PA is reported as large as 35 cm (diameter) and 7.3 kg (resected weight). Although rare, 10 cases of malignant transformation were reported in the review. Surgical management included extracapsular dissection (ECD), superficial parotidectomy, and total parotidectomy for benign tumors, and adjuvant radiation or chemotherapy for malignant tumors. We further present the case of a 36-year-old healthy male with slow-growing and asymptomatic giant parotid PA, of 4-year duration. The patient presented with firm, lobulated preauricular swelling, provisionally diagnosed as PA based on radiographic and cytological findings. The tumor was resected through ECD, and the patient had uneventful postoperative recovery and a 7-year recurrence-free follow-up period. Histological examination revealed epimyoepithelial proliferation punctuated by chondromyxoid areas, with extensive squamous metaplasia and keratin cysts. To the best of knowledge from indexed literature, giant parotid PA is rarely reported in Saudi Arabia. In addition to its rarity, this case is reported for its benign nature despite atypical histological presentation, successful surgical management without complications, and long-term recurrence-free follow-up. Based on this report, clinicians must be aware of atypical histological presentations associated with PA and plan suitable surgical management and follow-up to avoid morbidity. Nevertheless, attempts must be made to diagnose and manage these lesions at an early stage and before they reach gigantic proportions.

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

2007 ◽  
Vol 35 (3) ◽  
pp. 189-192 ◽  
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

Surgical treatment of benign parotid gland tumors in the years 2014–2018 at the ENT department of Hospital České Budějovice, a.s.

2021 ◽  
Vol 70 (2) ◽  
pp. 82-88
Author(s):  
Hana Zapletalová ◽  
Martin Kuchař ◽  
Lubor Mrzena
Keyword(s):  
Surgical Treatment ◽  
Parotid Gland ◽  
Facial Nerve ◽  
Pleomorphic Adenoma ◽  
Benign Tumors ◽  
Histological Structure ◽  
Warthin’S Tumor ◽  
Parotid Gland Tumors ◽  
Warthin's Tumor ◽  
Keywords Parotid Gland

ntroduction: Salivary tumors represent a heterogeneous group of tumors of diverse location, histological structure and bio logical behavior. The purpose of this study was a retrospective evaluation of surgical treatment of a group of patients with newly dia gnosed benign tumors of the parotid salivary gland operated in the years 2014–2018 at the ENT department of Hospital České Budějovice, a.s. Material and methods: A type of surgery, defi nitive histology, postoperative complications and a number of recurrences were monitored. The data were evaluated by descriptive statistical methods. Results: A total of 190 surgeries with benign histological fi ndings in 182 patients were performed. The most common benign result was Warthin‘s tumor (90 cases, 47.4%), followed by pleomorphic adenoma (66 cases, 34.7%). Uncommon histological types of tumors were dia gnosed in 14 patients (7.4%). Non-tumorous fi ndings were found in 20 cases (10.5%). The most frequently performed procedure in 84 cases (44.2%) was extracapsular extirpation. Transient lesion in the area of innervation of the temporofacial and / or cervicofacial branch of the facial nerve was present in 34 (17.9%) patients. Permanent paresis of some of the branches of the facial nerve was reported in 2 (1.1%) patients. In 12 patients, the postoperative course was complicated by the development of salivary fi stula (6.3%). Pleomorphic adenoma relapsed after extracapsular extirpation in 5 cases (20.0%). After partial parotidectomy, one recurrence of pleomorphic adenoma (3.6%) was recorded. Warthin‘s tumor relapsed after simple extirpation in 4 cases (20.0%). Conclusion: Our evaluation results of the surgical treatment of benign parotid gland tumors lead us to make further eff orts improve the care of our patients. We see reserves mainly in the routine use of ultrasonographic examination with performance FNAC and thus planning a safe and suffi ciently radical operational solution. Keywords: parotid gland – pleomorphic adenoma – Warthin‘s tumor – parotidectomy – recurrence – facial nerve paresis – FNAC

A Modified Mini Incision for The Surgery of Parotid Benign Tumor: A Retrospective Analysis of 48 Cases

2020 ◽  
Author(s):  
Mang Jin ◽  
Wei Zhu ◽  
Chengyu Wang ◽  
Hui Jiang
Keyword(s):  
Facial Nerve ◽  
Benign Tumor ◽  
Histopathological Examination ◽  
Symptomatic Treatment ◽  
Benign Tumors ◽  
Surgical Incision ◽  
Parotid Neoplasm ◽  
Extracapsular Dissection ◽  
Mini Incision

Abstract Background: Parotid neoplasm is a result of inadequate surgical incision during the treatment of head and neck cancers, and most of them are benign tumors. Hence, to explore a new surgical incision for parotid benign tumor in order to minimize the scar size on the premise of guaranteeing the safety of operation.Methods: We conducted a retrospective study of 48 patients who had undergone parotid surgeries from Jan. 01 2008 to Dec. 30 2014 at the department of otolaryngology, Jinshan Hospital of Fudan University. Histopathological examination confirmed benign parotid tumor (Warthin's tumor, pleomorphic adenoma, cysts, and monomorphic adenomas.) in all cases. All patients underwent a mini incision (cutting the skin directly on the surface of the tumor, and the incision was slightly longer than the diameter of the tumor). Results: Among the 48 cases, no recurrence and facial nerve injury were reported during the follow-up period of more than 4 years. Two cases of saliva fistula and one case of temporary facial nerve dysfunction were reported; however, they recovered quickly after symptomatic treatment.Conclusion: Extracapsular dissection is a safe and effective surgical procedure for the treatment of parotid benign tumor, and the postoperative scar is very small.

Role of limited parotidectomy in management of pleomorphic adenoma

2007 ◽  
Vol 121 (12) ◽  
pp. 1126-1128 ◽  
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.

scholarly journals Deep Learning for Differentiating Benign From Malignant Parotid Lesions on MR Images

2021 ◽  
Vol 11 ◽  
Author(s):  
Xianwu Xia ◽  
Bin Feng ◽  
Jiazhou Wang ◽  
Qianjin Hua ◽  
Yide Yang ◽  
...  
Keyword(s):  
Deep Learning ◽  
Parotid Gland ◽  
Pleomorphic Adenoma ◽  
Malignant Tumor ◽  
Training Dataset ◽  
Validation Dataset ◽  
Benign Tumors ◽  
Mr Images ◽  
Warthin Tumor ◽  
Parotid Gland Tumors

Purpose/Objectives(s)Salivary gland tumors are a rare, histologically heterogeneous group of tumors. The distinction between malignant and benign tumors of the parotid gland is clinically important. This study aims to develop and evaluate a deep-learning network for diagnosing parotid gland tumors via the deep learning of MR images.Materials/MethodsTwo hundred thirty-three patients with parotid gland tumors were enrolled in this study. Histology results were available for all tumors. All patients underwent MRI scans, including T1-weighted, CE-T1-weighted and T2-weighted imaging series. The parotid glands and tumors were segmented on all three MR image series by a radiologist with 10 years of clinical experience. A total of 3791 parotid gland region images were cropped from the MR images. A label (pleomorphic adenoma and Warthin tumor, malignant tumor or free of tumor), which was based on histology results, was assigned to each image. To train the deep-learning model, these data were randomly divided into a training dataset (90%, comprising 3035 MR images from 212 patients: 714 pleomorphic adenoma images, 558 Warthin tumor images, 861 malignant tumor images, and 902 images free of tumor) and a validation dataset (10%, comprising 275 images from 21 patients: 57 pleomorphic adenoma images, 36 Warthin tumor images, 93 malignant tumor images, and 89 images free of tumor). A modified ResNet model was developed to classify these images. The input images were resized to 224x224 pixels, including four channels (T1-weighted tumor images only, T2-weighted tumor images only, CE-T1-weighted tumor images only and parotid gland images). Random image flipping and contrast adjustment were used for data enhancement. The model was trained for 1200 epochs with a learning rate of 1e-6, and the Adam optimizer was implemented. It took approximately 2 hours to complete the whole training procedure. The whole program was developed with PyTorch (version 1.2).ResultsThe model accuracy with the training dataset was 92.94% (95% CI [0.91, 0.93]). The micro-AUC was 0.98. The experimental results showed that the accuracy of the final algorithm in the diagnosis and staging of parotid cancer was 82.18% (95% CI [0.77, 0.86]). The micro-AUC was 0.93.ConclusionThe proposed model may be used to assist clinicians in the diagnosis of parotid tumors. However, future larger-scale multicenter studies are required for full validation.

Retrospective study on parotid gland tumors

ORL ro ◽  
2016 ◽  
Vol 4 (1) ◽  
pp. 22-23
Author(s):  
Ibric Cioranu ◽  
Vlad Petrescu Seceleanu ◽  
Viorel Ibric Cioranu ◽  
Andreea Smarandache ◽  
Sorin Vasilescu ◽  
...  
Keyword(s):  
Malignant Tumors ◽  
Maxillofacial Surgery ◽  
Squamous Carcinoma ◽  
Benign Tumors ◽  
Warthin Tumor ◽  
Parotid Tumors ◽  
Non Hodgkin Lymphoma ◽  
Adenoid Cystic ◽  
Modal Treatment ◽  
Surgery Department

During 2011-2012, 56 patients diagnosed with parotid tumors were admitted to the Maxillofacial Surgery Department of “Lucian Blaga” University and in Euroclinic Hospital. 72% were benign tumors and 28% malignant. All patients received surgical treatment (total or partial parotidectomy). For the malignant tumors, radiotherapy was added to the modal treatment (94% of the cases). Pleomorphic adenoma was encountered in 70% of the benign cases, followed by Warthin tumor in 15%. Adenoid cystic carcinoma was noticed in 31% of the malignant cases, mucoepidermoid carcinoma in 25% of the cases, and squamous carcinoma and non-Hodgkin lymphoma on 12.5% of the malignant cases.  

Imaging Features of Primary Tumors of the Hand

2020 ◽  
Vol 16 ◽  
Author(s):  
Filippo Boriani ◽  
Edoardo Raposio ◽  
Costantino Errani
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
Epithelioid Sarcoma ◽  
Case Series ◽  
Malignant Neoplasm ◽  
Benign Tumors ◽  
Imaging Features ◽  
Primary Tumors ◽  
Therapeutic Decisions ◽  
Tumors Of The Hand

: Musculoskeletal tumors of the hand are a rare entity and are divided into skeletal and soft tissue tumors. Either category comprises benign and malignant or even intermediate tumors. Basic radiology allows an optimal resolution of bone and related soft tissue areas, ultrasound and more sophisticated radiologic tools such as scintigraphy, CT and MRI allow a more accurate evaluation of tumor extent. Enchondroma is the most common benign tumor affecting bone, whereas chondrosarcoma is the most commonly represented malignant neoplasm localized to hand bones. In the soft tissues ganglions are the most common benign tumors and epithelioid sarcoma is the most frequently represented malignant tumor targeting hand soft tissues. The knowledge regarding diagnostic and therapeutic management of these tumors is often deriving from small case series, retrospective studies or even case reports. Evidences from prospective studies or controlled trials are limited and for this lack of clear and supported evidences data from the medical literature on the topic are controversial, in terms of demographics, clinical presentation, diagnosis prognosis and therapy.The correct recognition of the specific subtype and extension of the tumor through first line and second line radiology is essential for the surgeon, in order to effectively direct the therapeutic decisions.

Combining Microfractures, Autologous Bone Graft, and Autologous Matrix-Induced Chondrogenesis for the Treatment of Juvenile Osteochondral Talar Lesions

2017 ◽  
Vol 38 (5) ◽  
pp. 485-495 ◽  
Author(s):  
Riccardo D’Ambrosi ◽  
Camilla Maccario ◽  
Chiara Ursino ◽  
Nicola Serra ◽  
Federico Giuseppe Usuelli
Keyword(s):  
Bone Graft ◽  
Repeated Measures ◽  
Osteochondral Lesion ◽  
Young Patients ◽  
Case Series ◽  
Autologous Bone Graft ◽  
Lesion Size ◽  
Level Of Evidence ◽  
Significant Difference ◽  
Autologous Bone

Background: The purpose of this study was to evaluate the clinical and radiologic outcomes of patients younger than 20 years, treated with the arthroscopic-talus autologous matrix-induced chondrogenesis (AT-AMIC) technique and autologous bone graft for osteochondral lesion of the talus (OLT). Methods: Eleven patients under 20 years (range 13.3-20.0) underwent the AT-AMIC procedure and autologous bone graft for OLTs. Patients were evaluated preoperatively (T0) and at 6 (T1), 12 (T2), and 24 (T3) months postoperatively, using the American Orthopaedic Foot & Ankle Society Ankle and Hindfoot (AOFAS) score, the visual analog scale and the SF-12 respectively in its Mental and Physical Component Scores. Radiologic assessment included computed tomographic (CT) scan, magnetic resonance imaging (MRI) and intraoperative measurement of the lesion. A multivariate statistical analysis was performed. Results: Mean lesion size measured during surgery was 1.1 cm3 ± 0.5 cm3. We found a significant difference in clinical and radiologic parameters with analysis of variance for repeated measures ( P < .001). All clinical scores significantly improved ( P < .05) from T0 to T3. Lesion area significantly reduced from 119.1 ± 29.1 mm2 preoperatively to 77.9 ± 15.8 mm2 ( P < .05) at final follow-up as assessed by CT, and from 132.2 ± 31.3 mm2 to 85.3 ± 14.5 mm2 ( P < .05) as assessed by MRI. Moreover, we noted an important correlation between intraoperative size of the lesion and body mass index (BMI) ( P = .011). Conclusions: The technique can be considered safe and effective with early good results in young patients. Moreover, we demonstrated a significant correlation between BMI and lesion size and a significant impact of OLTs on quality of life. Level of Evidence: Level IV, retrospective case series.

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