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Results for “PAROTID NEOPLASMS”

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At least 19 recordsLinked to original sources
PubMed2004

Use of cross-sectional imaging in predicting facial nerve sacrifice during surgery for parotid neoplasms.

BACKGROUND: Neoplasms of the parotid gland are difficult management issues because of the wide variation in their biological behavior and the potential for sacrifice of the facial nerve during resection. Because of the significant associated morbidity, prediction of facial nerve sacrifice is critically important for planning surgical procedures and preoperative counseling of patients. We hypothesize that along with the knowledge of the tumor type we would be able to accurately predict the likelihood of facial nerve sacrifice using cross-sectional imaging. METHODS: All patients included in this study were previously untreated patients with parotid neoplasms operated on between January 1997 and July 2002. Only those patients with an available preoperative imaging were included and this resulted in 44 patients for review. Nine patients with preoperative deficits in facial nerve function were excluded from this study since these patients would require facial nerve sacrifice regardless of the radiological prediction. The prediction of facial nerve sacrifice was determined using a prediction of tumor location and an algorithm. The predicted results were compared to the operative record. RESULTS: For all lesions, cross-sectional imaging predicted the need for sacrifice of the facial nerve with a sensitivity of 0.83 (95% CI, 0.36-0.99), specificity of 0.90 (95% CI, 0.72-0.97), PPV of 0.63 (95% CI, 0.26-0.90), and NPV of 0.96 (95% CI, 0.79-0.99). For malignant lesions only, prediction of sacrifice of the facial nerve had a sensitivity of 0.83 (95% CI, 0.36-0.99), specificity of 0.80 (95% CI, 0.51-0.95), PPV of 0.63 (95% CI, 0.26-0.90), and NPV of 0.92 (95% CI, 0.62-0.99). CONCLUSION: Cross-sectional imaging and application of our algorithm is a sensitive method for identifying patients with parotid neoplasms who require facial nerve sacrifice. CT and MRI have a high negative predictive value for facial nerve sacrifice.

Algorithms↗
PubMed1993

Subtotal petrosectomy in the management of advanced parotid neoplasms.

Circumferential growth of parotid neoplasms may involve the external auditory meatus posteriorly, the floor of the middle cranial fossa superiorly, and the neurovascular structures of the jugular foramen medially. Inadequate tumor resection in these anatomically complex regions will result in local disease recurrence at the lateral skull base. A subtotal petrosectomy approach has been combined with a standard total parotidectomy in the management of 27 patients with aggressive parotid tumors. Twenty-two patients had malignant lesions and 10 individuals had recurrent disease. The resultant conductive hearing loss is outweighed by the following advantages of this technique: (1) the ability to obtain tumor-free bony margins, (2) proximal intratemporal facial nerve identification, (3) vascular control of the jugular bulb and petrous carotid artery, and (4) the dissection and protection of cranial nerves IX through XII. Our series of 27 patients will be detailed with an emphasis on surgical technique and overall patient results.

Adult↗
PubMedDate not supplied

Synchronous unilateral parotid neoplasms of different histologic types.

Synchronous parotid neoplasms are rare. Unilateral, synchronous neoplasms of two separate and histologically distinct types are extremely unusual. Our review of the literature revealed 31 previously reported cases. We add two additional cases found in 291 parotid neoplasms seen in our institutions over the last 10 years; both including a pleomorphic adenoma and a Warthin's tumor. This combination was found in 15 of 33 cases, while Warthin's tumors were found in association with another tumor in 24 of 33 reported cases (82%).

Adenolymphoma↗
PubMed2002

Parotid neoplasms: diagnosis, treatment, and intraparotid facial nerve anatomy.

The demographics of parotid neoplasms in different populations have been reported by various centres. In this investigation, we reviewed retrospectively all the in-patient and out-patient charts and records of 108 patients who were diagnosed with parotid neoplasms and received parotidectomies in our department from 1 January 1993 to 15 April 2000. Patient age, gender, tumour pathology, fine-needle aspiration cytology results, and the intraparotid anatomy of the facial nerve were noted. We showed that despite the difference between our Taiwanese and previously studied patient populations, both populations had a similar distribution, diagnosis and treatment of parotid neoplasms, although the incidence of parotid tuberculosis was higher in our patient group. In addition, the facial nerve anatomy within the parotid gland had three main branching patterns in the upper and lower division.

Adenolymphoma↗
PubMed2003

Parotid neoplasms in children: experience of diagnosis and management in a district general hospital.

Parotid neoplasms are uncommon in children and the available literature is predominantly from specialized centres. This paper highlights our experience at a district general hospital, in the diagnosis and management of parotid neoplasms in children. The case records of all parotidectomies performed in a 26-year period between 1974-1999 were scrutinized and patients aged 18 years and below identified. The demographic data, histology, presentation, investigations, treatment, outcomes and complications were analysed. 545 parotidectomies were performed in 536 patients, in whom 569 neoplasms were diagnosed. Only 12 patients aged 18 and under were identified (2.2%). The relative frequency of individual tumours differed markedly from that in adults. 75% of the tumours were benign. Pleomorphic adenoma and mucoepidermoid carcinoma were the most common tumours. A painless mass was the most frequent clinical presentation and CT sialogram was the most common investigation. Parotidectomy with preservation of the facial nerve was performed in all cases, and adjuvant radiotherapy employed in the case of malignant tumours. All patients were alive and well at the time of last follow up. Transient facial nerve palsy and hypertrophic scars were the most common complications.

Adenoma, Pleomorphic↗
PubMed2003

Patients' perspectives on the short- and long-term outcomes following surgery for benign parotid neoplasms.

Surgery for benign parotid gland salivary neoplasms is associated with sequelae: scar and divot defect and complications, facial nerve paresis/paralysis and Frey's syndrome. These potential sequelae and complications are discussed with all patients prior to operation. We contacted 212 patients who had undergone surgery for benign parotid disease during 1988-1997, by postal questionnaire. We enquired about their perception and recollection of the information they had received pre-operatively and to document and comment upon what problems they had experienced in the early and late post-operative period. The usable return rate was 75.5 per cent (173/212). Most patients (90 per cent) were satisfied with the information they had received pre-operatively. The complication and/or sequelae rates for facial nerve palsy (temporary 26.3 per cent, permanent 1.9 per cent), Frey's syndrome (12.5 per cent) and sensory deficit about the cheek and ear (30.6 per cent), are comparable to other published studies.

Follow-Up Studies↗
PubMed1980

Treatment of parotid neoplasms.

Over a 25-year period 124 patients were admitted to St. Joseph's Hospital, Toronto with parotid neoplasms; 102 had benign and 22 had malignant lesions. Of 75 pleomorphic adenomas, 26 were enucleated and 11 of them (42%) recurred; no instances of recurrence followed parotidectomy. In 19 patients with Warthin's tumour there were no recurrences following any of the methods of excision. Mucoepidermoid carcinoma occurred in nine patients; eight tumours were of low-grade malignancy. All were treated by parotidectomy and there were no recurrences. Four patients had malignant mixed tumour--two with long-standing parotid masses; in three patients this malignant tumour occurred years after regional radiotherapy. Facial weakness was permanent in three patients after total parotidectomy. The correct treatment of parotid neoplasms is superficial parotidectomy or, for deep lobe tumours, total parotidectomy. Radiotherapy is used for unresectable or suspected residual carcinoma.

Adenolymphoma↗
PubMed1990

Increased expression of the enzyme beta 1-4-galactosyltransferase is associated with human parotid neoplasms.

Human biopsy samples of parotid gland neoplasms were examined for the level of enzyme activity of the glycosyltransferase, beta 1-4-galactosyltransferase. An analysis of an adenoid cystic carcinoma, Warthin's tumor, mucoepidermoid carcinoma, and five pleomorphic adenomas all revealed elevated levels of enzyme activity. Evidence for plasma membrane beta 1-4-galactosyltransferase activity was provided by membrane fractionation as well as intact cell enzyme assays. On the other hand, the major protein of human saliva, salivary alpha-amylase, was substantially reduced in the same tissue compared with adjacent normal parotid gland tissue. The trichloroacetic acid-soluble proteins isolated from gland homogenates were also reduced in two of the carcinoma samples but increased in the pleomorphic adenomas. Additionally, the proliferation of these cells, in vitro, could be retarded by culturing in media containing the galactosyltransferase specific modifier protein, alpha-lactalbumin, or the nucleotide sugar, UDP-galactose.

Adenolymphoma↗
PubMed1986

Electron beam therapy in treatment of parotid neoplasm.

In a retrospective analysis, 42 patients with malignant primary tumor of the parotid gland were evaluated considering survival, local recurrence and tolerance of treatment. All patients referred to radiotherapy were treated by electron beam (10-15 MeV) and followed for more than 5 years. Postoperative radiotherapy after radical operation, with no macroscopic disease, was performed in 18 patients, 7 of whom were treated by radical re-operation and radiation of a recurrent parotid neoplasm. In these groups, the local recurrence rate was 4/18 (22%) and 2/7 (29%), the 5-year survival rate was 9/18 (50%) and 5/7 (71%). In 17 patients, radiotherapy started with gross tumor left behind. This group showed a local recurrence rate of 10/17 (59%) and a 5-year survival of 7/17 (41%). Treatment was well tolerated with no major sequelae. Local tumor control and its impact on survival is discussed.

Adult↗
PubMedDate not supplied

Preoperative cytology in the management of parotid neoplasms.

BACKGROUND: This study evaluates the diagnostic role of preoperative cytology of parotid neoplasms. The method is particularly useful in the evaluation of the parotid diseases in which the same clinical features may be treated variously. Fine-needle aspiration biopsy is a simple and well-tolerated diagnostic tool, which provides accurate information for diagnosis and follow-up of the disease. The accuracy of the method partly depends on the operator skill. MATERIALS AND METHODS: From a series of 452 subjects who underwent parotidectomy, preoperative cytological evaluation was available in 310 and compared with histological diagnosis in a retrospective review. RESULTS: The agreement between histotype determination using fine-needle aspiration biopsy and final histological diagnosis was 79%, specificity was 100%, sensitivity was 83%, and diagnostic accuracy was 97%. CONCLUSION: These findings demonstrated that, given the low complication rate, preoperative cytology is particularly useful in diagnosing parotid disease and in planning the surgical strategy and approach.

Biopsy, Fine-Needle↗
PubMed1980

Bilateral parotid neoplasms.

We are reporting what we believe to be the second case of bilateral parotid neoplasm occuring synchronously with differing histologies. We believe that this neoplasm may represent a specific propensity of parotid tissue in a given individual to develop neoplasia in a multipotential glandular organ subject to many neoplastic diseases. There also exists the possibility that this condition may represent an immune deficiency specific to the parotid gland. The case reports that have been reviewed demonstrate that a secondary neoplasm may arise from benign mixed tumors. We question whether this is an example of monistic origin of acinic cell tumor from a mixed-cell tumor or, perhaps, dualistic expression for this salivary gland to develop a multiplicity of anaplastic and metaplastic growth variants. In approaching a case with bilateral parotid involvement, the physician must be aware of the rare possibility that benign and malignant tumors may coexist. He must be prepared to proceed with more radical extirpation than simple superficial parotidectomy.

Adenocarcinoma↗
PubMed2000

[The effects of CDFI and CDE high-frequency ultrasonography on diagnosis of parotid neoplasm].

OBJECTIVE: To evaluate the effects of high-frequency color ultrasonography on diagnosis of parotid tumors. METHODS: 36 cases of parotid benign or malignant tumors were observed from margin to inner with color Doppler flow imaging (CDFI) and color Doppler energy (CDE) according to tumors' two dimention. RESULTS: The features of benign tumors included round or round-like shapes, clear margins and inner balanced echogram. The margin feature of CDFI was star-like images, and the peak systolic celocity was up to 18.6 and 16.2 cm/s. The coincidence of diagnosis was 90%. Meanwhile, the shapes of malignant tumors showed irregular and incomplete mass and asymmetrical inner echogram. The primary characteristics of CDFI were branch-like or basket-like images, and the peak systolic velocity was much higher (35.2 and 32.4 cm/s) than that of benign tumors. There was significant difference between these two groups (P < 0.05). It indicated richer flow signals in CDE than in CDFI. CONCLUSION: CDFI and CDE show an important clinical value in diagnosing parotid neoplasm.

Adult↗
PubMedDate not supplied

Use of cross-sectional imaging in predicting surgical location of parotid neoplasms.

OBJECTIVE: The purpose of this study was to determine the diagnostic accuracy of using the retromandibular vein as seen on cross-sectional imaging to help differentiate superficial lobe from deep lobe tumors. METHODS: Of the patients who had parotid neoplasms between January 1997 and July 2002, we were able to identify 44 patients with preoperative imaging studies that were available for evaluation. The films were reviewed by a single head and neck radiologist to determine whether the neoplasms involved the superficial, deep, or both lobes of the parotid gland (total). The lateral margin of the retromandibular vein was used as a marker for the facial nerve, since the nerve is not always visible on CT and MRI scans. The radiologist's findings were then compared with the findings during surgery. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of predicting the location of neoplasms were then calculated. RESULTS: For lesions in the superficial lobe, cross-sectional imaging was able to predict the location of the neoplasm with a sensitivity of 0.91 (95% CI, 0.70-0.98), specificity of 0.86 (95% CI, 0.63-0.96), PPV of 0.88 (95% CI, 0.67-0.97), and NPV of 0.90 (95% CI, 0.67-0.98). For lesions in both lobes (total), cross-sectional imaging was able to predict the location of the neoplasm with a sensitivity of 0.94 (95% CI, 0.68-0.99), specificity of 0.89 (95% CI, 0.71-0.97), PPV of 0.83 (95% CI, 0.58-0.96), and NPV of 0.96 (95% CI, 0.78-0.99). CONCLUSION: Use of the retromandibular vein as a marker for the facial nerve is a sensitive method for identifying the location of parotid gland neoplasms on cross-sectional imaging. This supports the accuracy of using preoperative imaging to detect the position of parotid neoplasms with respect to the facial nerve.

Adult↗
PubMedDate not supplied

The management of parotid neoplasms.

In recent years, the management of parotid gland neoplasms has changed considerably, to include a more aggressive surgical approach and multimodality therapy. An organized approach to surgical management and the rationale for postoperative irradiation for selected tumors are presented. A review of several studies supporting the efficacy of postoperative irradiation is included. The principles of palliative management of adenoidcystic carcinoma are unlike those for most other malignancies, and include repeated use of limited procedures to control local and regional disease over extended periods of time, and delayed treatment of distant disease until the patient becomes symptomatic.

Antineoplastic Agents↗
PubMedDate not supplied

Lymphangioma presenting as a primary parotid neoplasm in an adult. Report of a case with the diagnosis suggested by fine needle aspiration biopsy.

A 38-year-old man presented with a unilateral, asymptomatic parotid gland mass. A fine needle aspiration biopsy of the mass, consisting predominantly of small lymphocytes, suggested the possibility of a lymphangioma. Microscopic examination of the subsequent parotidectomy specimen revealed a cystic lymphangioma involving the parotid gland and periparotid soft tissue. Although the presentation of a lymphangioma as a primary parotid neoplasm in an adult is a rare event, the differential diagnosis of a parotid gland aspirate containing small lymphocytes should include a lymphangioma.

Adult↗
PubMed2005

Integrin receptors and extracellular matrix components in parotid neoplasms.

In the review, the role of integrin receptors as well as of some of their ligands of the extracellular matrix in cases of parotid neoplasms is discussed, in particular, the data concerning the expression of various types of integrin adhesion molecules in benign and malignant tumors of the parotid, the expression of fibronectin, tenascin, and collagen type IV etc. The role of dysregulation of the expression of these proteins in invasion and metastasis of parotid tumors is discussed.

Animals↗