TRATAMIENTO QUIRÚRGICO DE LOS TUMORES DE PARÓTIDA: EXPERIENCIA DE 10 AÑOS

Ricardo Yáñez M,Cristóbal Maíz H,Francisco Javier Loyola B,Raúl Martínez R,Pablo Mariangel P,Mariana Valenzuela G,Jorge Cornejo F

doi:10.4067/s0718-40262014000300010

Ricardo Yáñez M, Cristóbal Maíz H + Show 5 more

Open Access

https://doi.org/10.4067/s0718-40262014000300010

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Abstract

Abstract Surgical treatment of parotid neoplasms: A 10 years experience Background: Parotid neoplasms correspond to 3% of head and neck tumors. Most are benign, treatment is parotidectomy. Aims: To analyze the results of treatment, histology, complications and recurrence. Patients and Methods: Retrospective analysis of patients with parotid tumors treated in our center among 2001-2010. Results: The series consisted of 82 patients, 52 (63%) women. Average age: 46 years (range, 17-77), 73 (89%) had benign tumors, 7 (8.5%) were malignant and 2 (2.4%) had chronic inflammatory disease.The most common benign tumors were pleomorphic adenoma (55%) and Warthin’s tumor (20%). The most common malignant tumors were mucoepidermoid carcinoma (5%) and acinar cell carcinoma (4%).The technique was total parotidectomy in 10 patients (12%), total suprafacial 53 (64.6%) and partial in 19 (23%). The most com-mon complication was transient facial nerve dysfunction in the immediate postoperative period in 38 cases (46.3%), 14 (17%) had surgical bed depression, 15 (18.3%), dysesthesia periauricular, 2 (2.4%) permanent paralysis of the facial nerve (tumor) and 6 (7.3%) Frey Syndrome. No patient had a disagreement with his scar and pain periauricular, there were no recurrences. There was lesser transient facial nerve paralysis with partial suprafacial parotidectomy than with total suprafacial parotidectomy (21% and 53%), RR 0.4 IC 95% (0.16-0.99).

Highlights

Parotid neoplasms correspond to 3% of head and neck tumors
Patients and Methods: Retrospective analysis of patients with parotid tumors treated in our center among 2001-2010
There was lesser transient facial nerve paralysis with partial suprafacial parotidectomy than with total suprafacial parotidectomy (21% and 53%), RR 0.4 IC 95% (0.16-0.99)

Summary

Background

Parotid neoplasms correspond to 3% of head and neck tumors. Most are benign, treatment is parotidectomy. Discusión: La aplicación de técnicas quirúrgicas menos agresivas como la parotidectomía suprafacial parcial permite obtener resultados comparables en patologías benignas, con bajas tasas de morbilidad, sin aumentar la recurrencia. De esta forma, la cirugía parotídea se inicia a principios de 1800 con la enucleación de las masas tumorales, presentando baja tasa de complicaciones postoperatorias pero una alta recidiva, explicada principalmente por la permanencia de la cápsula tumoral in situ del tumor más frecuente, el adenoma pleomorfo, de naturaleza benigna[7]. Este hecho dio paso a cirugías más radicales como la parotidectomía total y suprafacial, logrando disminuir la recidiva tumoral, pero al mismo tiempo aumentando las complicaciones como la parálisis del nervio facial, el síndrome de Frey y las alteraciones cosméticas. En este estudio analizamos los resultados del tratamiento quirúrgico de los tumores parotídeos en nuestro centro

Pacientes y Métodos

Findings

Depresión del lecho quirúrgico