Disease Of Parotid Gland Research Articles

Stenson's duct deformities as the etiology of parotid gland disease

Stenson's duct deformities as the etiology of parotid gland disease

Parotid and neck metastases from cutaneous squamous cell carcinoma of the head and neck

Approximately 5% of cutaneous squamous cell carcinomas (SCC) metastasize to regional nodes. Nodal involvement may be more common for cutaneous squamous cell carcinomas of the head and neck, but few large series have reported clinical outcome after treatment of parotid gland and neck metastases from these cancers. A combined retrospective/prospective study of patients treated between 1983 and 1994 was performed. There were 69 men and 6 women, with a median age of 67 years. Twenty-nine patients had neck metastases, and 33 had parotid gland metastases, while 13 patients had involvement at both sites. Of the 75 patients, 68 were treated surgically and 50 received postoperative radiotherapy. The facial nerve was sacrificed totally in 6 patients and partially in 9. Histologic extranodal spread was present in 48 (71%) of all surgically treated patients. Among 61 patients followed up to recurrence, or for greater than 12 months, 26 (43%) developed recurrence--12 in the parotid gland, 7 in the neck, and 7 in both sites. Multiple recurrences were common and occurred at a median of 8 months after surgery. Positive surgical margins were associated with poorer local disease control (P < 0.05). Cumulative survival at 5 years was 61%, but only 15 of 70 evaluable patients (21%) were eligible for follow-up at this time. Neck involvement with or without parotid gland disease was associated with an increased risk of distant metastases, but this was not statistically significant. Postoperative radiotherapy was not associated with improved disease control. Cutaneous, metastatic SCC involving the parotid gland and neck is an aggressive disease with a tendency to an infiltrative growth pattern and multiple recurrences. More aggressive surgery may be justified to reduce the incidence of regional failure after parotidectomy and neck dissection.

Characterization of parotid gland tissue: A description of an MRI protocol set-up and results of in-vivo applications

A reliable protocol for proton T2 mapping of the parotid region was set up for future characterization of parotid gland disease. A Carr-Purcell-Meiboom-Gill sequence, phase compensated, available on our 1.5 T imager, was selected and acquisition parameters were chosen on the basis of tests performed on phantoms (agarose-doped gels with T2 in the physiological range). Some experiments were carried out to evaluate the accuracy of T2 calculations for selective and nonselective refocussing pulses, for image uniformity corrections, and for different situations of slice shift and repetition times. The chosen protocol was then applied to in vivo evaluations to check the long-term precision by means of repeated measurements performed on the same subject over a 2-month period. Two or more reference gels were positioned both in the phantom and volunteer at the edge of the field-of-view (FOV). Image postprocessing consisted of an automatic procedure, written by the authors in Fortran 77, that selected the best fit for each pixel between mono- and biexponential decay models, and prepared four parametric images (T2 and Rho slow and fast contribution, Rho being a function of proton density and of T1) that may be used for future elaborations. The phantom experiment results showed an accuracy of 2.5% if a linear correction was performed using the reference gels at the edge of the FOV. No significant differences in accuracy were found between selective and nonselective refocussing pulse, and a homogeneity correction was not demonstrated necessary. The measurements performed on four volunteers showed that the best decaying model for healthy parotid tissue was monoexponential. Evaluated T2 resulted 80.18 +/- 6.11 ms (72.96 +/- 4.97 ms for uncorrected results). Long-term reproducibility of the group of measurements from one volunteer, summarizing all the measurement errors, ranged from 0.9 to 8.5%. The two-way ANOVA that was carried out considering the two classes of volunteers and of parotid positions (right or left) showed that differences found between the two parotids were not significant, while T2 differences among individuals are significant if a probability level higher than 1.1% is accepted. As in this case, the main source of error can be attributed to the biological variations among individuals. Future statistics collected on patients for the T2 evaluations of the pathologic tissue will clarify whether the T2 relaxation is a sufficient parameter for T2 discrimination of healthy and pathologic tissue.

Bildgebende Diagnostik bei Parotiserkrankungen - ein Methodenvergleich

Thirty-five patients with parotid gland disorders were ultrasonographically examined with a "small parts" scanner, as well as with high-resolution computed tomography, and conventional and digital subtracted sialography. The results were compared with clinical, surgical, and pathomorphological data. In cases of parotid gland masses, the sensitivity of sonography, CT, and sialography was 100%, 81%, and 70% respectively, while in cases of sialadenitis, sensitivity was 38%, 50%, and 75%. The image-quality of digital subtracted sialography was superior to conventional sialography in 94% of cases, the same in 6%, and inferior in none of the cases. It is concluded that in all cases of parotid gland diseases ultrasound should be the first imaging method. If a tumor is confirmed, no further pretherapeutic imaging will be necessary in most cases. If a tumor is not confirmed, digital subtracted sialography should be employed to visualize inflammatory changes.

Kernspintomographie bei Erkrankungen der Parotis*

The clinical experience with Magnetic Resonance Imaging in parotid gland diseases of 13 patients in discussed. An excellent visualization of the surrounding anatomy, the intrinsic structures of the gland. such as the facial nerve and the lesion, which can be achieved by MRI only, will provide more detailed information for the surgeon and thus for the prognosis. On the other hand, the differentiation of the diseases is not yet improved and MRI will certainly not replace the clinical examination including aspiration cytology.

Lactoferrin concentration in the parotid saliva of patients with chronic pancreatitis.

Lactoferrin is present in pancreatic juice, and greatly increased concentrations are found in the pancreatic juice of patients with chronic pancreatitis. It is not known whether these high levels of lactoferrin represent a genetically determined defect predisposing to the later development of chronic pancreatitis or are simply a consequence of the disease. In view of the morphological and functional similarities between the pancreatic and parotid glands, we have measured the immunoreactive lactoferrin concentration in pure parotid saliva of 30 patients with chronic calcific pancreatitis, 26 controls, 5 patients with proven pancreatic cancer, 2 patients with Sjögren's disease and 2 patients with chronic recurrent parotitis. No difference in the lactoferrin concentration was detected between control subjects and patients with chronic pancreatitis or pancreatic cancer. Raised levels were found in the 4 patients with parotid gland disease. These findings suggest that increased lactoferrin secretion is confined to the exocrine pancreas in patients with chronic pancreatitis and is thus probably a phenomenon secondary to the disease.

Clinical and surgical considerations of parotid and submaxillary gland disease

Summary Because of the high incidence of malignancy of parotid neoplasms, excision biopsy of the parotid should not be delayed. The differential diagnosis of diseases of the parotid and surgical attitudes related to these diseases are discussed. A technic of parotidectomy which utilizes Stensen's duct is described and discussed. The anatomy of the facial nerve and parotid gland is related to the operation of parotidectomy. Results of this operation over a four year period are given. Similarly, the use of Wharton's duct is advocated as the most feasible approach to excision of the submaxillary gland.

Clinical and surgical considerations of parotid and submaxillary gland disease

Summary Because of the high incidence of malignancy of parotid neoplasms, excision biopsy of the parotid should not be delayed. The differential diagnosis of diseases of the parotid and surgical attitudes related to these diseases are discussed. A technic of parotidectomy which utilizes Stensen's duct is described and discussed. The anatomy of the facial nerve and parotid gland is related to the operation of parotidectomy. Results of this operation over a four year period are given. Similarly, the use of Wharton's duct is advocated as the most feasible approach to excision of the submaxillary gland.

Mikulicz's disease of parotid glands: Report of a case: N. W. Wawro and W. Fairweather. J. of Surg. 28: 767, 1950

Mikulicz's disease of parotid glands: Report of a case: N. W. Wawro and W. Fairweather. J. of Surg. 28: 767, 1950