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PubMed2001

Spindle cell lipoma of the parapharyngeal space: first report of a case.

Spindle cell lipomas are usually located in the subcutaneous tissue of the back, shoulders, and neck. To our knowledge, the presence of such a tumor in the parapharyngeal space has not yet been described. We evaluated a 45-year-old man with a tender swelling of the right parotid area that had reached the submandibular area. Clinical examination and magnetic resonance imaging revealed the presence of a tumor that coated the parotid area laterally and extended into the center of the parapharyngeal space, thus causing a dislocation of the pharyngeal muscles and mucosa. We performed a total parotidectomy and submandibulectomy on the right side and extirpated the parapharyngeal tumor. We were able to spare the facial nerve, and no facial paralysis occurred. Histologic examination revealed an atypical lipomatous tumor with a remarkably large portion of spindles.

Biopsy, Needle↗
PubMed1975

[Gas exchange and pulmonary mechanics under anaesthesia and artificial ventilation (author's transl)].

During general anaesthesia with controlled ventilation and normocapnia the A-a DO2 and pulmonary shunt were investigated in a group of 7 patients undergoing a parotidectomy or laryngectomy. In a second group of 21 patients the behaviour of the total, lung- and thorax compliance was investigated. Within the first 1 1/2 hours after induction of anesthesia the A-a DO2 and shunt increased. During the time the thorax compliance did not change, whereas the total and lung compliance decreased significantly. After 1 1/2 hours no further change occured.

Adolescent↗
PubMed2001

[Anticancer chemotherapy, risk factor for infection at the operated site in cervicofacial surgery].

BACKGROUND: In order to evaluate occurrence and risk factors for wound infection (WI) in head and neck uncontaminated surgery, we carried out a prospective study. METHODS: From january 1997 through january 1999, we prospectively evaluated 212 wounds of all patients having uncontaminated head and neck surgery at the Oscar Lambret Cancer Center (neck dissections, parotidectomies, thyroidectomies, explorative cervicotomies, cutaneous resections). No antibiotic prophylaxis was given. WI was defined as a wound with pus. Statistical evaluation was performed using the chi 2 test. In univariate analysis, differences were considered significant p < 0.05. RESULTS: The overall WI rate was 6.6% (14/212). In univariate analysis, previous chemotherapy is the only risk factor for WI were: (p < 0.00001). Multivariate analysis was not performed. CONCLUSION: Like other cancer locations, chemotherapy was a major risk factor for WI. In these cases, a phase ill trial could confirm efficacy of standard antibiotic.

Adult↗
PubMed2001

[Lymph node metastasis of cutaneous epidermoid carcinomas of the head and neck: prognostic factors and therapeutic strategies. Apropos of a series of 13 cases].

UNLABELLED: Squamous cell skin carcinoma has a relatively low rate of metastasis (0.5 to 16%), but the prognosis of these metastases is poor (22% of survival at 5 years). PATIENTS AND METHODS: from a series of 243 patients, we studied 13 patients who were found initially to have metastases or who developed metastases later. Fifty-four percent (54%) of the patients presented initially with regional lymph node and parotid involvement in 54%. RESULTS: All patients underwent surgery with removal of the skin cancer and a neck dissection. Radiotherapy was performed later in 92% of the cases. The 2 years survival rate was 62% and mean survival by Kaplan Meier curve was 47 months. DISCUSSION: Poor criteria of these cutaneous tumors are defined: tumor size, histologic differentiation, perineural spread. Patients with severe criteria must have a neck dissection to control the first lymph node. Along the anatomic area of the cutaneous tumor, a parotidectomy, a submaxillary control or a neck dissection will be performed. Its involvement will be followed by a neck dissection. A comparative study of the literature is made. Poor prognostic criteria of these cutaneous tumors are defined, in addition to the initial management of the cervical and parotid lymph nodes.

Aged↗
PubMed2001

Malignant lymphoepithelial lesion of the parotid gland: a case report and review of the literature.

Malignant lymphoepithelial lesions are rare tumors of the major salivary glands. They most often occur in Asians and Greenland Eskimos and are strongly associated with Epstein-Barr virus infection. We report a case of a malignant lymphoepithelial lesion of the parotid gland that developed in an Italian-American woman whose serology was positive for Epstein-Barr virus antibody. The patient underwent a left total parotidectomy and upper neck dissection, followed by radiation therapy. At the 2-year follow-up, she remained free of disease.

Carcinoma, Squamous Cell↗
PubMed2002

[Diffuse pseudotumorous oncocytosis of the parotid gland. A case report].

Pseudotumorous oncocytosis of the parotid gland is very uncommon and frequently misdiagnosed since it generally presents as a true tumor. The clinical presentation and imaging features of a 6-cm diameter left parotid mass led to the diagnosis of a tumor in a 73-year-old man. At pathology examination of the partial parotidectomy specimen the "tumor" was found to be a metaplastic oncocytic lesion. We discuss the diagnostic criteria, differential diagnosis, and etiopathogeny of this lesion.

Adenoma, Oxyphilic↗
PubMed2002

Langerhans' cell histiocytosis in the parotid gland.

Langerhans' cell histiocytosis presenting as a parotid gland mass is extremely rare. We report a case of Langerhans' cell histiocytosis in the parotid gland that occurred in a 34-year-old Korean male. The patient underwent parotidectomy followed by adjuvant chemotherapy. There has been no evidence of local recurrence or disease progression during 20 months after the lesion was first diagnosed. Differentiation of Langerhans' cell histiocytosis from Kimura's disease was crucial in this clinical setting.

Adult↗
PubMed2002

[Rhabdomyosarcoma of parotid gland in 4 years old boy].

The author described the case of parotid gland rhabdomyosarcoma in 4 years old boy. As there was no parents agreement to initial, radical surgical treatment, the patient underwent chemo- and radiotherapy, after which temporary remission of the disease was observed. The surgical treatment was performed for local recurrence, but despite radical parotidectomy, which was done, the progression of disease was occurred (with local recurrence and bone metastases). The patient died 3 years after initial diagnosis.

Bone Neoplasms↗
PubMed2002

[The case of gigantic pleomorphic adenoma of the parotid gland].

The authors describe case of big size pleomorphic adenoma of the parotid gland. This tumor lead to cachexia and to elimination of life in society. Attention was paid on the surgical treatment of pleomorphic adenomas by superficial or total parotidectomies. Possibility of the post operative complications avoidance, even in such big cases was emphasized. Recurrence was not observed during 10 months follow up. Use of surgical treatment make that the patient was able to return to her previous job.

Activities of Daily Living↗
PubMed2002

[Traumatic neuroma of the great auricular nerve. A clinical case].

A clinical case of neuroma resulting from an amputation which occurred following parotid surgery is reported. The present paper discusses the importance of differential diagnosis relating to this pathology and the surgical techniques that may contribute to setting a limit on its onset. Traumatic neuroma is a possible complication of parotid surgery together with motor deficiencies and Frey's syndrome and the less frequent salivary fistulas. It may also occur following oncological or plastic-reconstructive surgery. During parotidectomy operations, section of the great auricular nerve may be required to facilitate access to the parotid region. This manoeuvre may, however, also be associated with the onset of a neuroma during a time period varying from 2 to 10 years, according to the various authors who have examined the subject. The laterocervical tumefaction associated with neuroma poses a number of diagnostic problems as it has to be differentiated from a likely relapse or possibly from more complex inflammatory or metastatic lymphnodal pathology. A correct clinical and diagnostic multidisciplinary approach is fundamental if the pathology is to be classified in the right way and contributes to alleviating a state of mental unease in the patient that is associated with the sudden appearance of the tumefaction. Sectioning the nervous trunk by means of thermocautery and its subsequent sinking below the main trunk of the sternocleidomastoid muscle, are simple surgical manoeuvres that are useful for preventing the onset of traumatic neuroma.

Amputation Stumps↗
PubMed2002

[Multifocal nodular oncocytic hyperplasia of the parotid: case report].

Multifocal nodular oncocytic hyperplasia of salivary glands is a tumor-like lesion that occurs predominantly in the parotid gland. The differential diagnosis of the clear cell variant includes many malignant salivary gland tumors. We report the case of a 66-year-old woman who was referred for a left total parotidectomy allowing the final diagnosis of clear cell multifocal nodular oncocytic hyperplasia. The differential diagnoses and histopathogenesis of this rare entity are discussed.

Adenoma, Oxyphilic↗
PubMedDate not supplied

[Study of the facial nerve in parotid surgery].

The Authors, basing on cadaveric dissections and 40 parotidectomies performed, accurately describe relations between facial nerve and surrounding tissues in its extracranial tract, with particular reference to parotid surgery. They underline Schwalbe's apophysis as the sole safe and constant anatomic landmark in the dissection of the facial nerve trunk.

Facial Nerve↗
PubMed2002

[Value of of fine-needle aspiration cytology and MRI in parotid gland masses].

INTRODUCTION: The objective of our study was to discuss the valve of fine-needle aspiration cytology (FNAC) and magnetic resonance imaging (MRI) in the diagnosis and treatment of parotid gland masses. MATERIALS AND METHODS: Forty patients were included in the prospective study. They had undergone clinical examination, FNAC and MRI before parotidectomy. The results of these examinations were compared with the corresponding histopathological diagnosis. RESULTS: When it is positive, FNAC is a good examination of malignant tumours (sensitivity 67%, specificity 79%, positive predictive value 86%, negative predictive value 100%). The MRI allows a good assessment of the tumoural mass and its anatomical relationships (sensitivity 55%, specificity 86%, positive predictive value 89%, negative predictive value 75%). If the T2 sequence shows reduced density (p < 0.05) or in case of bad limitation (p = 0.004), a malignant character is strongly suspected. CONCLUSION: In cases of parotid gland mass, where surgical intervention is necessary, there is no need of special investigations: however FNAC and MRI allow us to anticipate what operation will be required.

Adult↗
PubMed2002

Surgical treatment of parotid tumors in the general community hospital.

We reviewed 51 consecutive parotidectomies done at a general community hospital and gathered data on age and sex of the patients, length of stay in the hospital, perioperative outcome, complications, and surgical pathology. Statistical method included logistic regression and ANOVA to determine relationship and dependence of the variables. There were 24 male and 27 female patients. Thirty-six (70.6%) of the parotid tumors were benign. There were no major complications. Treatment of parotid tumors in the community hospital is feasible and safe if basic guidelines are implemented. The epidemiology of parotid tumors in the relatively smaller hospital should resemble that reported in the literature. Our data suggest that parotid malignancy may occur more frequently in elderly men and that length of stay in the hospital may be longer for patients having surgery for malignant than for benign parotid tumors.

Aged↗
PubMed2002

Anaplastic carcinoma of the parotid gland: a case report of a patient disease free after nine years. Follow-up.

A case of massive anaplastic carcinoma of the left parotid gland in a 29-year old female Nigerian, of Yoruba tribe, for which radical left parotidectomy with external carotid artery ligation and post-operative radiotherapy was performed is presented Nine years post-operatively, no evidence of recurrence or metastasis was found. The patient is in apparent good health, despite the amount of tumour spillage that was experienced intra-operatively. As far as we have been able to check, it is to our knowledge the first of such from Nigeria.

Adult↗
PubMed1975

[The free dermis fat transplantation as adjunct in the surgery of the parotid gland (author's transl)].

In order to overcome the short comings of a total parotidectomy in reference to appearance and the possible Frey syndrom, the author proposes the free dermis fat transplant directly after the extirpation of the gland. This diminishes the formation of serous fluid in the operated area. Long term observations showed no signs of the Frey syndrome. Further experimental research and clinincal observations will determine if the free fat transplantation is a workable method to prevent the Frey syndrom.

Adipose Tissue↗
PubMed1992

[A contralateral external carotid-middle cerebral artery bypass operation--a new procedure of vascular reconstruction in the treatment of head and neck carcinoma requiring carotid resection].

In the treatment of head and neck carcinoma involving the carotid artery, resection of the carotid artery and direct reconstruction using a vein graft has commonly been employed to reduce the incidence of cerebral ischemic complications. But the procedure of carotid grafting itself carries the risk of preventing complete tumor clearance. And contamination due to salivary fistula, particularly in cases of meso or hypopharyngeal carcinoma, may result in graft rupture or thrombosis. To overcome these difficulties, the authors have developed a new surgical procedure, namely, a contralateral external carotid-middle cerebral artery bypass operation. This bypass system is designed at directly supplying the cerebral hemisphere on the carotid ligation side through a vein graft running entirely outside the cervical operative field. The vein graft is anastomosed end-to side to the external carotid artery of the opposite side. Then it is placed subcutaneously in front of the auricle, above the zygomatic arch, frontal subgaleal space and anastomosed end-to-side to the recipient artery, the ascending branch of the middle cerebral artery, in the Broca area of the carotid ligation side. The neck is incised almost the same manner as in parotidectomy, with a slightly longer cervical extension, and the scalp by bilateral coronal incision of Sutta. A frontotemporal osteoplastic craniotomy of the involved side is performed. The length of the saphenous vein used is about 50cm. This surgical procedure requires no transient internal or external shunt. The common carotid artery can be ligated safely after confirming good post-anastomotic bypass flow using an electro-magnetic blood flow meter.(ABSTRACT TRUNCATED AT 250 WORDS)

Antineoplastic Combined Chemotherapy Protocols↗