A Contemporary View on the Anatomy of Parotid Gland

One of the up-to-date issues of contemporary medicine is the study of the features of individual anatomical structure variability of various organs. In recent years, the incidence of parotid gland diseases has been rising. This phenomenon can be associated with an absolute increase in this organ pathologies incidence as well as with the development of additional methods of examination and visualization of the gland. Most pathologies of major salivary glands, in particular the parotid gland, require surgical treatment. Knowledge of topographical relationship of the parotid gland with the adjacent vessels and nerve trunks is utterly necessary for planning and performing surgical interventions and reconstructive operations in the parotid region. According to the statistics, surgical interventions on the parotid gland take the leading place among the causes of damage to the facial nerve branches. This fact may also prove a large variation in the syntopy of the facial nerve and the parotid gland. The paper reviews the data of native and foreign literature on the anatomy of parotid gland and the place of radiation research methods in the study of its topographical and anatomical features. The analysis revealed a wide range of anatomical norm of parotid gland in many parameters, including shape, linear size, blood supply, and topographical features. The practice of using anthropometric studies aimed at structuring the existing knowledge and narrowing the borders of anatomical norm for various organs proved to be successful. However, in the pool of scientific papers, we have not found similar studies concerning parotid gland. The facts mentioned above make the background and justify further studies of parotid gland in the context of normal individual variability.

A cutaneous representation of parotid adenocarcinoma not otherwise specified

<p class="abstract">Cutaneous manifestations of adenocarcinoma is a very rare entity. The patient reported to our institute with a complain of swelling on right parotid region that would bleed profusely merely on palpation. The hematological values revealed very low Hemoglobin, RBC and PCV counts indicating severe hemolytic anemia. The patient had palpable lymph nodes of level I and IIA which were enlarged. The patient underwent excision of the lesion along with modified radical neck dissection and reconstruction of the skin defect using pectoralis major myocutaneous flap.</p>

The Rare Cases of Parotid Gland Arteriovenous Malformations

Arteriovenous malformation (AVM) results from errors in vascular development during embryogenesis; absent capillary beds lead to shunting directly from the arterial to venous circulation. Although it is common in the head and neck region, AVMs located in the parotid gland are quite rare. Here, we report two cases of arteriovenous malformation of the parotid gland that presented to our out-patient setup with swelling in the parotid region and were diagnosed as arteriovenous malformation on histopathological study after surgical resection.

Apocrine Hidrocystoma of the Parotid Gland

Apocrine hidrocystoma is a cystic tumor originating from apocrine sweat glands. It is predominantly located in the eyelid margins. Here, we report a case of apocrine hidrocystoma of the parotid gland in a 19-year-old man who was referred to our outpatient clinic with a 5-year history of a gradual swelling in the left parotid region. The patient underwent left superficial parotidectomy. Histological examination confirmed the diagnosis of apocrine hidrocystoma. The case is original by the tumor’s location: to the best of our knowledge, this could be the first case in English and French literature reporting an apocrine hidrocystoma affecting the parotid gland. The purpose of this article is to report our case and discuss its clinical and anatomopathological features as well as its differential diagnoses.

Profile of parotid cancers at the ENT clinic Lamine Sine Diop of Fann teaching hospital

INTRODUCTION: Parotid cancers are characterized by a great histological diversity and they pose diagnostic, therapeutic and evolutionary problems. We deliver through this study our experience on the management of malignant parotid tumors. MATERIALS AND METHODS: This is a retrospective, descriptive and analytical study carried out over a period of 12 years in the ENT department of Fann teaching hospital. RESULTS: The mean age at diagnosis was 48 years with a sex-ratio of 1.6. The time to symptom progression was approximately 47 months. Parotid swelling was present in all patients and peripheral facial palsy was found in 31% of patients. Ultrasound of the parotid region was performed in 11 patients, i.e. 34%, and computed tomography in 18 patients, i.e. 56%. Fine needle aspiration was performed in 11 patients. Parotid cancers accounted for 44% of all parotid tumors. Sixty-eight percent of patients consulted at the T4 stage. Seventy-one percent of patients received surgical treatment. The most common histologic type was muco-epidermoid carcinoma. Five patients received radiotherapy. The postoperative effects were dominated by PFP (18%). Seven cases of death were recorded. CONCLUSION: The management of parotid cancer still poses diagnostic and above all therapeutic problems. The combination of radiotherapy surgery, very rarely encountered in our study, provides a better prognosis and better survival.

A rare case of sclerosing polycystic adenosis of parotid gland

The parotid gland tumors are classified according to their morphological and histological patterns. The most common site of presentation of a salivary neoplasm is the parotid gland. Sclerosing polycystic adenosis (SPA) is a rare disease of the salivary glands, first described by Smith et al at 1996. We report a case of 61 year gentleman admitted in KVG Medical college and hospital with complains of swelling in right side of face since 6 months. Local examination of right parotid region showed solitary swelling with ipsilateral mandibular lymphadenopathy. EBV profile was positive. CT head and neck revealed an enlarged right sided parotid gland resembling features of Pleomorphic adenoma. Fine needle aspiration of gland showed features of chronic sialo-adenitis. A provisional diagnosis of Pleomorphic Adenoma was made. Patient underwent superficial parotidectomy. Histopathology of the operated specimen had features suggestive of Sclerosing polycystic adenosis of parotid gland. Patient was followed up for a period of one year and he had no recurrence. To conclude, Sclerosing polycystic adenosis of the parotid gland is a rare benign salivary gland lesion with histologic analogies to sclerosing adenosis of the mammary gland. Complete surgical excision is the reference treatment, to reduce the risk of recurrence and/or evolution.

Parotid Myoepithelial Carcinoma in a Pediatric Patient with Multiple Recurrences: Case Report

Myoepithelial carcinoma of the salivary glands is a rare entity, with scarce amount of case reports in the literature. Due to its infrequency, its diagnosis is usually difficult and uncertain. Although there are reports of locoregional recurrences and distant metastases, its low incidence and varied biological behavior limits the clinical evidence that can be used to predict the prognosis and determine the course of treatment. We present a 23-year-old female patient without past medical history with an initial 1-year history of volume increase in the right parotid region of tumor aspect and painful on palpation. As a malignancy was suspected, a total parotidectomy was performed, reporting in the deep lobe a parotid myoepithelial carcinoma with vascular and neural invasion, negative borders, and 3–9 negative regional nodes. During her 16-year clinical evolution, she presented approximately every 2 years and a total of 9 locoregional recurrences and hepatic metastases, including cervical lymphoid nodules, temporal bone, frontal bone, and temporal fossa. Those recurrences have been treated with coordinated efforts between repeated external radiotherapy, chemotherapy, and multiple surgical resections. Myoepithelial tumors represent only 1.0–1.5% of all salivary gland tumors. The literature reports suggest a high incidence of locoregional recurrences and distant metastases in de novo myoepithelial carcinomas. Due to its rarity, treatment continues to be based on the experience of medical staff.

Management of two rare cases of dermatofibrosarcoma protuberans arising in the parotid region

Dermatofibrosarcoma protuberans (DFSP) is a rare cutaneous tumour, accounting for less than 1% of malignant tumours of the head and neck region. This tumour rarely presents metastatic disease, but has a high recurrence rate. Therefore, wide surgical excision with microscopically free margins is the therapeutic gold standard. Only five cases are described in literature of this tumour arising in the parotid region, a site that presents challenges both in achieving a wide demolition and in reconstructing the resulting defect. Here we describe two cases of DFSP arising in the parotid region that were treated surgically, achieving microscopically free margins. Reconstruction of the vast skin defect was achieved by means of a supraclavicular artery island flap, with good functional and aesthetic results.

CONSERVATIVE MANAGEMENT OF PAROTID SIALOCELE :- A CASE REPORT

The collection of the saliva in the soft tissue plane is termed as sialocele. When this communicates with the skin and drains it is known as parotid fistula. Sialocele occurs due to injury to the parotid gland parenchyma or duct, this result in accumulation of saliva in periglandular and glandular tissues or in subcutaneous cavity. In this article we report a case of Parotid sialocele formation following inadvertant incison given for space infection in parotid region. We followed conservative treatment and got excellent result.