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At least 973 records · Page 54Linked to original sources
PubMed1990

The neurofasciocutaneous radial forearm flap in head and neck reconstruction: a preliminary report.

The radial forearm free flap has achieved considerable popularity as a reconstructive technique due to its thin, pliable tissue and long vascular pedicle. The successful use of this flap as a carrier of a vascularized nerve to bridge motor nerve gaps and as a sensate flap has not been previously reported in head and neck reconstruction. The superficial branch of the radial nerve was used as a vascularized nerve graft to bridge a facial nerve defect following radical parotidectomy. The medial and lateral antebrachial cutaneous nerves were used to re-establish sensation in a reconstructed pharyngeal mucosal defect. The published clinical and experimental studies on vascularized nerves and sensate flaps are reviewed in detail.

Adolescent↗
PubMed1990

Treatment of Frey's syndrome with topical 2% diphemanil methylsulfate (Prantal): a double-blind evaluation of 15 patients.

Fifteen patients with severe gustatory sweating after total parotidectomy and facial nerve preservation were asked to take part in a double-blind study. All patients were alternatively treated with topically applied placebo and topically applied 2% diphemanil methylsulfate (an anticholinergic agent). A 10-day period was allowed between applications for return of symptoms. Two-percent diphemanil methylsulfate provided partial relief in 33.3% of patients and total relief in 40% of patients. Involvement of the hairy temporal line region with gustatory sweating was the main reason for failure. Duration of relief varied from 2 to 4 days. The only side effect was dryness of the mouth noted in two patients.

Administration, Topical↗
PubMed1990

The surgical management of chronic parotitis.

Chronic parotitis is a disorder characterized by recurrent painful swelling of the gland with purulent sialorrhea. Occasionally, the condition fails to respond to medical management and definitive surgical therapy is necessary. Sialolithiasis is the usual etiology in cases of parotitis, although occasionally severe recurrent parotid infections are superimposed on underlying Sjögren's disease. Total parotidectomy with facial nerve dissection has been used in such cases in our department and has proved to be an excellent way to manage this disease. A summary of our results indicate that the recurring infections were eradicated and that the complication rate is tolerable, considering the magnitude of the problem. We feel that it is better to use surgical management early rather than wait for the formation of fistulae or abscesses.

Adult↗
PubMed1992

Same-day-stay head and neck surgery.

The purpose of this study was to determine if selective head and neck surgical procedures on a same-day basis are justifiable. Two hundred consecutive head and neck same-day procedures were reviewed, including 84 parotidectomies and 116 other procedures previously managed as inpatients. Of the 200 patients, 36 (18%) were admitted, 33 for overnight observation, and 164 (82%) were discharged the same day. There were no complications reported in the discharged patients and a later questionnaire showed that 97% of the patients were satisfied. The advantages of selective same-day procedures outweigh the disadvantages for otolaryngologist and patient. The study shows that same-day-stay head and neck surgery for selective procedures is safe, reasonable, and cost-effective, but the combined efforts of the otolaryngologists, nurses, and administrators are required. Because of rising healthcare costs, experts are predicting a significant increase in the next few years of outpatient surgery, including surgery of the head and neck.

Adult↗
PubMed2000

Mucoepidermoid carcinoma involving Warthin tumor. A report of five cases and review of the literature.

We describe 5 cases of mucoepidermoid carcinoma (MEC) involving Warthin tumor (WT) of the parotid gland. The WT size ranged from 1.7 to 6.0 cm. The MECs were much smaller, 0.3 to 1.7 cm. In 3 cases, the WT completely surrounded the MEC, and in 2 cases neither WT nor MEC surrounded the other. Each MEC was low grade, 3 grade I and 2 grade II. One MEC had evidence of vascular invasion. All patients underwent partial or subtotal parotidectomy with negative resection margins. Clinical follow-up (range, 8-52 months) for 3 patients showed no evidence of recurrence. The pathogenetic relationship between WT and MEC in these cases is uncertain. In 4 cases, foci of squamous or mucous metaplasia were found in the WT component, associated with mild cytologic atypia in 3 tumors. However, a direct transition from WT to MEC was not identified. In 1 case, MEC was present 45 months before WT, suggesting that the recurrent MEC involved WT coincidentally. The small size and low grade of the MEC and the negative resection margins most likely explain the good outcome for the 3 patients with clinical follow-up data available.

Adenolymphoma↗
PubMed1999

HIV-associated parotid lymphoepithelial cysts.

BACKGROUND: An outstanding feature of the diffuse infiltrative lymphocytosis syndrome, or DILS, a subset of HIV-1 disease, is asymptomatic bilateral parotid swelling. Recognition of the entity is important because people with this disease will seek routine dental care. CASE DESCRIPTION: The authors present a classic case of DILS. The patient exhibited bilateral parotid swellings caused by lymphoepithelial cysts, cervical lymphadenopathy, a CD8 circulating lymphocytosis and a CD8 lymphocytic infiltration into the labial salivary glands. A right superficial parotidectomy had been performed several years previously. However, no intervention was advised for the remaining left parotid because of its benign course. CLINICAL IMPLICATIONS: Since patients with DILS can develop lymphomas, periodic observation is mandatory. Any change in the growth pattern requires that a fine-needle aspiration biopsy be performed.

Adult↗
PubMed2000

The role of computerized tomography in the diagnosis and therapy of parotid stones: a case report.

BACKGROUND: Small, semi-calcified parotid stones are difficult to diagnose as imaging can be extremely difficult. Understanding how to diagnose parotid stones is important to dentists, however, because people with this condition develop parotid swellings and may seek routine dental care. CASE DESCRIPTION: The authors describe a classic case of parotid sialadenitis secondary to a small lucent stone in Stensen's duct. They discovered the stone only because of the keen sensitivity of computerized tomography, or CT, to minimal amounts of calcific salts. The CT scan's ability to accurately locate the stone and its position within 1 centimeter of the orifice facilitated a successful intraoral surgical approach. CLINICAL IMPLICATIONS: CT can be a significant aid in early diagnosis and therapy of patients with parotid stones, who eventually develop sialadenitis. With early intervention, further gland degeneration and parotidectomy will be prevented.

Adult↗
PubMed1999

Perioperative frozen section examination in parotid gland tumors.

CONTEXT: The minimal recommended surgical approach to parotid tumors is partial parotidectomy with resection of the superficial lobe of the gland. Histologic diagnosis prior to surgery is not possible, as incisional biopsies are contraindicated due to the possibility of facial nerve injury or incomplete tumor resection. Thus, the biopsies tend to be perioperative. OBJECTIVE: To compare the results of frozen section examination with the definitive pathological diagnosis. DESIGN: Accuracy study by retrospective analysis. SETTING: Head and Neck Surgery Service of Heliópolis Hospital, São Paulo, Brazil. SAMPLE: 153 cases of parotid gland tumors treated between 1977 and 1994. DIAGNOSTIC TEST: Frozen section and pathological diagnosis. MAIN MEASUREMENTS: Sensibility and specificity of the frozen section examination. RESULTS: Frozen section study diagnosed 19 (12.4%) malignant and 127 (83.7%) benign tumors. Sensitivity of the frozen sections for malignancy was 61.5% (95% CI 54 to 69%) and specificity was 98% (95% CI 94 to 100%), and this result is comparable to the literature. CONCLUSIONS: We consider that frozen section examination for salivary gland tumors is not sufficient on its own for deciding on the best management. Their interpretation must be correlated with clinical and intraoperative findings, in association with the surgeon's experience.

Adolescent↗
PubMed1998

A case of basal cell adenocarcinoma of the parotid gland.

We present a 73-year-old female with an enlarged mass in the right parotid gland. Fine-needle aspiration cytology suggested pleomorphic adenoma. Diagnostic imaging revealed that the tumour had a well-defined margin arising from the deep lobe of the parotid gland. A total parotidectomy with preservation of the facial nerve was performed. The final histopathological diagnosis including immunohistochemical studies was basal cell adenocarcinoma, which is a recently defined entity and a rare epithelial neoplasm. No sign of local recurrence or metastasis 24 months postoperatively has been observed.

Adenocarcinoma↗
PubMed2002

A case of solitary fibrous tumor of the parotid gland: review of the literatures.

We report a rare case of solitary fibrous tumor of the parotid gland. A 47-year-old woman presented with a 3-year-history of left-sided subauricular swelling. Computed tomographic scans and magnetic resonance images revealed a well-defined and dumbbell-shaped mass, measuring about 30 mm in its greatest dimension, in the left parotid gland. Because the tumor occupied both superficial and deep lobes of the gland, she underwent total parotidectomy with preservation of the facial nerve. The microscopic finding showed short-spindle and ovoid cells arranged in a haphazard pattern with interspersed thin collagen fibrils. Immunohistochemically, the tumor cells were strongly positive for CD34, bcl-2 and vimentin, whereas stains for S-100, cytokeratin, smooth muscle actin, collagen type IV and CD117 (KIT) were negative. On the basis of these findings, the tumor was diagnosed as solitary fibrous tumor. Her post-operative course was uneventful, and she is currently free from disease 14 months after surgery. Diagnosis, clinical behavior and treatment of solitary fibrous tumor are reviewed from perusal of the literature.

Antigens, CD34↗
PubMed2005

Abducens nerve palsy and Horner syndrome due to metastatic tumor in the cavernous sinus.

A 41-year-old man was diagnosed as having primary parotid carcinoma on the right side. After radical parotidectomy, radiation therapy and systemic chemotherapy, the primary parotid carcinoma was completely remitted. Two years later, right abducens nerve palsy and Horner syndrome appeared. Neuroimaging demonstrated a gadolinium-enhanced lesion in the posterior portion of the right cavernous sinus, and metastasis of parotid carcinoma was suspected. After radiosurgery and systemic chemotherapy, the intracavernous lesion disappeared. This is the first case of combination of abducens nerve palsy and ipsilateral Horner syndrome due to metastasis from parotid carcinoma to the cavernous sinus.

Abducens Nerve Diseases↗
PubMed1975

Aggressive surgery in treatment for parotid cancer: the role of adjunctive postoperative radiotherapy.

A 7 year follow-up of 120 patients with malignant parotid cancers revealed parotidectomy to be an adequate procedure for low-grade, nonaggressive lesions. The addition of radiation therapy postoperatively will improve local and regional control of high-grade, aggressive lesions. Postoperative radiation therapy may also make the removal of the facial nerve unnecessary in certain clinical presentations.

Adenocarcinoma↗
PubMed2003

Anatomic landmarks for locating parotid lesions in relation to the facial nerve: cross-sectional radiologic study.

OBJECTIVES: To determine the accuracy of using surrogate anatomic structures radiologically to predict the relation of parotid lesions to the intraparotid facial nerve. SETTING: Tertiary centre. DESIGN: Retrospective. PATIENTS AND METHODS: All patients with parotid masses over a 5-year period who undertook parotidectomy were considered. A radiologist and an otolaryngologist reviewed the images. Their decision regarding the location of the lesions using four surrogate structures was compared with intraoperative documentation. OUTCOME MEASURE: We determined the sensitivity and the specificity of using the external carotid artery, retromandibular vein, posterior belly of the digastric muscle, and tragal pointer. RESULTS: Thirty films were examined (24 magnetic resonance images [MRIs] and 6 computed tomographic [CT] scans). The sensitivity and the specificity of the retromandibular vein were 0.85 and 0.57, respectively, whereas for the external carotid artery, they were 0.94 and 0.3, respectively. It was too impractical to relate the other two structures to the lesions. CONCLUSIONS: The retromandibular vein is the most accurate surrogate structure to use on MRI or CT for predicting the location of a parotid lesion to the facial nerve. However, the substantial proportion of deep lesions misjudged limits the benefit of performing the imaging.

Facial Nerve↗
PubMed1988

Evidence for insulinotropic effect from rat parotid glands.

Previous observations have suggested that the salivary glands exercise a regulatory role on insulin secretion and/or glucose metabolism. We have challenged the issue by studying in unanesthetized, unrestrained rats the short- and long-term effect of selective sialoadenectomy on the animals' ability to meet an intra-arterial glucose challenge. Ten-minute intra-arterial glucose tolerance tests were carried out in chronically catheterized adult rats before and after sialoadenectomy. Eighty-five to 100 days postsurgery, the parotidectomized rats experienced a 45% reduction in plasma immunoreactive insulin output (P less than .001) compared with the sham-operated animals; the plasma glucose levels of the test subjects remained 19% higher (P less than .001) than those of the control group. In younger rats, similar observations were made; however, the difference in insulin and glucose responses between treatments was less than in the adult rats. Our findings suggest that the insulinotropic effect resides primarily with the parotids, and the role of the submandibular glands seems to be permissive at best. We hypothesize that parotidectomy deprives the beta-cells of a humoral principle that appears to be essential for optimizing the immediate insulin response to a glucose challenge. These results suggest that the insulinotropic effect of the parotids is of particular importance when aging changes insulin secretion and action.

Animals↗
PubMed1993

Facial nerve palsy as a complication of parotid gland surgery and its prevention.

The incidence of postoperative facial palsy in 73 patients who had under-gone surgery for parotid gland tumor is reported. Slight facial palsy occurred in 9 (14%) of 66 benign tumors but recovered completely within 3 months following surgery. However, in 7 patients with malignant tumors, 3 (43%) developed permanent palsy and 1 (14%) temporary palsy. The incidence of benign tumors depends on the tumor size and localization. However, the incidence decreased considerably in the last 6 years compared to the first 6 years. This is considered to be due to routine use of computed tomography with sialography and microsurgery during parotidectomy.

Adenocarcinoma↗
PubMed1997

Unilateral multiple adenolymphomas originating in the parotid gland: a clinicopathological study.

The validity of Seifert's hypothesis about growth pattern of adenolymphomas has been evaluated in three of five patients with adenolymphomas of the parotid gland, who at the time of a parotidectomy, were found to have multiple unilateral adenolymphomas in the intraglandular lymph nodes. This evaluation, which was based on assessing the epithelial: lymphoid tissue ratio in excised adenolymphomas and the growth in tumor size, showed that there was no association between the histological changes in the epithelial:lymphoid tissue and the tumor size. Adenolymphomas seem to have no consistent growth pattern and develop independently. However, as multiple tumors were detected histopathologically in lymph nodes as small as 5 mm in diameter the importance of a detailed examination of patients with adenolymphomas is stressed, so that other tumours are not overlooked.

Adenolymphoma↗
PubMed1997

Adenolymphomas of the parotid and neck with a coexistent pleomorphic adenoma. Case report.

An 82-year-old man presented with multiple adenolymphomas of the parotid and neck (Warthin's tumours) with a coexistent pleomorphic adenoma. Two Warthin's tumours were within the parotid gland as was the adenoma, and four were in the neck region. The patient made an uneventful recovery from excision of the neck tumours and superficial parotidectomy. We know of no similar previous case, and emphasise the importance of confirming the histological diagnosis so that the correct treatment may be planned.

Adenolymphoma↗