Benign Parotid Tumors Research Articles

Development and validation of CT-based radiomics nomogram for the classification of benign parotid gland tumors.

Accurate preoperative diagnosis of parotid tumor is essential for the formulation of optimal individualized surgical plans. The study aims to investigate the diagnostic performance of radiomics nomogram based on contrast-enhanced computed tomography (CT) images in the differentiation of the two most common benign parotid gland tumors. One hundred and ten patients with parotid gland tumors including 76 with pleomorphic adenoma (PA) and 34 with adenolymphoma (AL) confirmed by histopathology were included in this study. Radiomics features were extracted from contrast-enhanced CT images of venous phase. A radiomics model was established and a radiomics score (Rad-score) was calculated. Clinical factors including clinical data and CT features were assessed to build a clinical factor model. Finally, a nomogram incorporating the Rad-score and independent clinical factors was constructed. Receiver operator characteristics (ROC) curve was generated and the area under the ROC curve (AUC) was calculated to quantify the discriminative performance of each model on both the training and validation cohorts. Decision curve analysis (DCA) was conducted to evaluate the clinical usefulness of each model. The radiomics model showed good discrimination in the training cohort [AUC, 0.89; 95% confidence interval (CI), 0.80-0.98] and validation cohort (AUC, 0.89; 95% CI, 0.77-1.00). The radiomics nomogram showed excellent discrimination in the training cohort (AUC, 0.98; 95% CI, 0.96-1.00) and validation cohort (AUC, 0.95; 95% CI, 0.88-1.00) and displayed better discrimination efficacy compared with the clinical factor model (AUC, 0.93; 95% CI, 0.88-0.99) in the training cohort (p<0.05). The DCA demonstrated that the combined radiomics nomogram provided superior clinical usefulness than clinical factor model and radiomics model. The CT-based radiomics nomogram combining Rad-score and clinical factors exhibits excellent predictive capability for differentiating parotid PA from AL, which might hold promise in assisting radiologists and clinicians in the exact differential diagnosis and formulation of appropriate treatment strategy.

Magnetic resonance imaging of parotid gland tumors: a pictorial essay

Imaging of parotid gland tumors is challenging due to the wide variety of differential diagnoses. Malignant parotid tumors can have very similar features to benign ones, such as slow growth and displacement instead of infiltration of neighboring structures. Malignant and benign tumors may therefore not be clinically distinguishable. Correct characterization of parotid tumors (i.e., benign or malignant) determines preoperative treatment planning and is important in optimizing the individualized surgical plan. Magnetic resonance imaging (MRI) is the imaging modality of choice for evaluation of suspected parotid gland lesions and differentiation between benign and malignant lesions. Certain conventional MRI features can suggest whether a mass is more likely to be a benign or low-grade malignancy or a high-grade malignancy and adding diffusion-weighted imaging or advanced MRI techniques like perfusion can aid in this distinction. Morphological features seen on MRI, such as low signal on T2-w, infiltrative changes or ill-defined margins, change over time and diffusion restriction can point to the malignant nature of the lesion. MRI is useful for detection and localization of the lesion(s), and associated findings like perineural spread of tumor, lymph node involvement and infiltrative changes of the surrounding tissues. In this pictorial essay, we present selected images of a variety of benign and malignant parotid tumors and emphasize the MRI features that may be useful in their characterization.

Minimal Margin Surgery and Intraoperative Neuromonitoring in Benign Parotid Gland Tumors: Retrospective Clinical Study.

Extracapsular dissection (ECD) was introduced for the removal of superficial and small benign parotid tumors. According to a recent proposal, ECD is reserved for tumors that are 3 cm or less, mobile, and close to the parotid borders in cases of pleomorphic adenoma. The aim of the study is to evaluate the effectiveness of ECD for treatment of benign parotid tumors also in cases of tumors that were larger than 3 cm and deeper. All ECD for benign parotid neoplasms conducted between 2007 and 2017 were reviewed. The lesions included were limited to primary parotid tumors and categorized by Quer proposal. Facial nerve monitoring was used in all cases. Facial nerve palsy and local recurrences were assessed. The 88 ECD performed met inclusion criteria. The mean lesion size was 4.26 cm. Of the tumors, 68 were less than 3 cm in diameter and 20 were larger, 64 were superficial, and 24 were deep. The most common lesion types were pleomorphic adenoma (88.6%). There was no significant difference in complication rates between the size of tumor (p = 0.9) and location (p = 0.91). Our results suggest that extracapsular dissection could be considered an option for first-time diagnosed benign parotid tumors, even in cases of large dimensions and deep lobe involvement.

Clinicopathological profile of salivary gland lesions: a prospective study on parotid gland tumors in Kashmir

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; The parotid gland and the other salivary glands provide a crucial role in the oral cavity by secreting saliva that makes eating, swallowing, speaking, and digesting easier. In order to explore the prevalence of parotid gland tumours by age and gender, clinical modes of presentation, surgical treatments, histological pattern of parotid gland tumours, assess treatment success, and assess consequences, a prospective clinicopathological research was conducted.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; The study was conducted among patients who presented in the outpatient department of ear, nose and throat (ENT) and head and neck surgery (HNS), Government Medical College (GMC), Srinagar with lesions of the salivary glands. The present study was an observational study conducted over a period of 18 months w.e.f. May 2020 up to October 2021. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; A total of 220 subjects were enrolled in the present study. More than half of patients were males. The participants were (33.89±15.7) years old on an average. Males predominated over females among the recruited individuals (59% versus 41%). Sub-mandibular gland lesions were most common in the patients (50.4%), followed by parotid gland lesions (38.6%), minor salivary gland lesions (6%) and sub-lingual gland lesions (5%). Pleomorphic adenoma was the most prevalent neoplastic lesion (29.4%). The most prevalent non-neoplastic lesion was parotitis (21.1%).&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; More often than malignant tumours, benign parotid tumours are more common. Malignant parotid tumours usually present at a later clinical stage and begin to develop at a younger age than other tumour types. Accurate clinical diagnosis, with the use of fine needle aspiration cytology (FNAC) and imaging as needed, is essential for effective therapy. The primary therapeutic option is a safe operation called a parotidectomy.&lt;/p&gt;

Primary Lymphoepithelial Carcinoma of Parotid Gland: Inadequate Preoperative Assessment Resulting in Extensive Surgery

Parotid lymphoepithelial carcinoma is extremely rare, and makes up only 0.4% of cases among the anaplastic variant of salivary gland carcinoma. We present a 63-year-old man who had progressive enlarging right neck swelling for one year. He sought treatment in another centre and underwent superficial parotidectomy, following an ultrasound assessment of the mass that was suggestive of a benign parotid tumour. There was no fine needle aspiration cytology or other radiological imaging performed prior to the surgery. However, the surgeon encountered difficulty intraoperatively and abandoned the surgery. The incisional biopsy of the tumour was reported as lymphoepithelial carcinoma. He then presented to us with the progression of the residual parotid malignant tumour. CT and MRI showed a locally aggressive parotid tumour that had infiltrated the subcutaneous tissue, external auditory canal, facial nerve, and multiple ipsilateral metastatic cervical lymph nodes. Subsequently, the patient underwent total parotidectomy with facial nerve resection, lateral temporal bone resection and ipsilateral modified radical neck dissection. The surgical site defect was reconstructed with anterolateral thigh myocutaneous free flap. Concurrent static facial reanimation with fascia lata sling was performed. The patient received adjuvant chemoradiation following the surgery. The extent of the local infiltration by the tumour and the resulting surgery could have been reduced if the tumour had been properly assessed and excised at the initial stage. A complete preoperative assessment of a parotid mass is essential to avoid misdiagnosis, unexpected intraoperative finding and delay in definitive treatment.

Trend changes in the incidence of benign parotid tumours in the last 30years in a Spanish population.

To study the demographics and clinical characteristics of benign parotid tumours, focusing on the evolution of the incidence of Warthin tumour (WT) in recent years. A retrospective observational study is designed of patients diagnosed with a benign parotid tumour in a single tertiary hospital centre, from 1994 to 2021. The evaluation of the relationship between the different variables, and the changes in tumour incidence, is carried out using an analysis of standardized residuals. The study evaluated 279 patients, and the total of benign parotid tumours was 291. The most frequent type of tumour was pleomorphic adenoma (PA) (52.7%), followed by WT (37.6%). WT was more frequent in men (79%), and PA in women (55.8%). Smoking history is significantly high in patients with WT (83%), as well as mid-age, compared to PA. It seems to be an increase in the proportion of WT compared to PA in recent years. These changes can be concerning tobacco use and older patients at diagnosis in our series.

Postoperative complications after superficial parotidectomy and extracapsular dissection of benign parotid tumors: an eleven-year Western Sussex experience

article: Postoperative complications after superficial parotidectomy and extracapsular dissection of benign parotid tumors: an eleven-year Western Sussex experience - European Journal of Oral and Maxillofacial Surgery 2022 August;6(2):76-80 - Minerva Medica - Journals

The Role of Fine Needle Aspiration Biopsy in The Diagnosis of Parotis Masses

Objective: The aim of this study is to determine the accuracy and usefulness of fine needle aspiration biopsy(FNAB) in the diagnosis of parotid masses. Materials and Methods: FNAB findings of 123 patients who were operated over a last ten years period were retrospectively analyzed and compared with histopathological findings. We examined the sensitivity, the specificity, the positive predictive value (PPV), the negative predictive value (NPV) of FNAB. Results: FNAB results of the patients who participated in the study are as follow; non-diagnostic for 7 patient (%5.7), atypia of undetermined significance for 7 patients(%5.7), bening neoplasm for 98 patients (79.7%) and malign cytology for 11 patients (%8.9). Histopathological results were maligned found in 1 out of 98 patients with benign neoplasm in cytology results in FNAB. The histopathological result was benign in 2 of 11 patients with malignant neoplasm in the cytology findings with FNAB. The specificity of FNAB in the diagnosis of parotid masses was found as 98% and the sensitivity was 90%. The positive predictive value (PPD) was detected as 86% and the negative predictive value was detected 98%. Conclusion: Since malignant masses of the parotid are rare and diverse, diagnosis with FNAB can be difficult. Another complicating factor is the similarity of low-grade malignant tumor and benign tumor. As a result, FNAB has high accuracy for benign parotid tumors, but low for malignant parotid tumors.

Comparative study between modified blair incision and modified facelift incision for benign parotid tumor

Background: Modified Blair incision is the classical incision for benign parotid lesions, it provides good surgical exposure, but it leaves a visible scar in the neck which bothers a wide range of patients, especially female and young patients. modified facelift incision is the new alternative approach for benign parotid lesions, it cosmetically better than the modified Blair incision because this incision is hidden behind the ear and in the hairline. Materials and Methods:This prospective clinical research comprised 16 individuals who had superficial parotidectomy for benign lesions. Group 1 = 8 patients had a modified facelift incision and Group 2 = 8 had a modified Blair incision. Variables included age, gender, histological diagnosis, operating time, and surgical exposure. The major outcomes were surgical complications and patient satisfaction. Descriptive statistics include mean, median, SD, ranges, frequencies, and proportions. Fisher's exact test compared frequencies, and student's t-test (independent two groups model) compared means P&lt; 0.05 is significant. Results: There were no statistically significant differences in postoperative complications rates between the groups. Of modified blair incisions, 25.0% suffered seroma postoperatively versus12.5 % of modified facelift incisions. Of modified blair incisions, 12.5 % suffered gustatory sweating versus none following modified facelift incisions.

Diffusion-weighted and gadolinium-enhanced dynamic MRI in parotid gland tumors.

To evaluate the value of diffusion-weighted imaging and dynamic contrast-enhanced MRI for the diagnosis of parotid gland tumors. Retrospective review of patients with surgically treated parotid tumors between January 2009 and June 2020, who underwent a preoperative parotid gland MRI including standard morphological sequences, diffusion-weighted echoplanar imaging with apparent diffusion coefficient measurement and T1-weighted gadolinium-enhanced dynamic MRI sequences with Fat Saturation. The lesion was classified between malignant vs benign and precisions regarding its histological type were given when possible. Imaging findings were compared with pathology results. Inclusion of 133 patients (mean age: 53years). Multiparametric MRI had a sensitivity of 90.3%, a specificity of 77.5%, an overall accuracy of 80.5%, a positive predictive value of 54.9% and a negative predictive value of 96.3% to differentiate benign parotid tumor from malignant ones. Specificity (85.5%) and positive predictive value (67.6%) were improved for cases, where anatomical and functional MRI characteristics were conclusive and consistent with clinical findings. Combining diffusion-weighted and gadolinium-enhanced dynamic sequences, in addition to morphological ones enables high (> 90%) sensitivity to detect malignant parotid gland tumors. It also gives the possibility to characterize pleomorphic adenomas and Warthin tumors and to avoid fine-needle aspiration in cases of typical imaging presentation and reassuring clinical findings.

Using deep learning to distinguish malignant from benign parotid tumors onplain computed tomography images.

ObjectivesEvaluating the diagnostic efficiency of deep-learning models to distinguish malignant from benign parotid tumors on plain computed tomography (CT) images.Materials and methodsThe CT images of 283 patients with parotid tumors were enrolled and analyzed retrospectively. Of them, 150 were benign and 133 were malignant according to pathology results. A total of 917 regions of interest of parotid tumors were cropped (456 benign and 461 malignant). Three deep-learning networks (ResNet50, VGG16_bn, and DenseNet169) were used for diagnosis (approximately 3:1 for training and testing). The diagnostic efficiencies (accuracy, sensitivity, specificity, and area under the curve [AUC]) of three networks were calculated and compared based on the 917 images. To simulate the process of human diagnosis, a voting model was developed at the end of the networks and the 283 tumors were classified as benign or malignant. Meanwhile, 917 tumor images were classified by two radiologists (A and B) and original CT images were classified by radiologist B. The diagnostic efficiencies of the three deep-learning network models (after voting) and the two radiologists were calculated.ResultsFor the 917 CT images, ResNet50 presented high accuracy and sensitivity for diagnosing malignant parotid tumors; the accuracy, sensitivity, specificity, and AUC were 90.8%, 91.3%, 90.4%, and 0.96, respectively. For the 283 tumors, the accuracy, sensitivity, and specificity of ResNet50 (after voting) were 92.3%, 93.5% and 91.2%, respectively.ConclusionResNet50 presented high sensitivity in distinguishing malignant from benign parotid tumors on plain CT images; this made it a promising auxiliary diagnostic method to screen malignant parotid tumors.

Apparent Diffusion Coefficient (ADC) Histogram Analysis in Parotid Gland Tumors: Evaluating a Novel Approach for Differentiation between Benign and Malignant Parotid Lesions Based on Full Histogram Distributions.

The aim of this study was to assess the diagnostic value of ADC distribution curves for differentiation between benign and malignant parotid gland tumors and to compare with mean ADC values. 73 patients with parotid gland tumors underwent head-and-neck MRI on a 1.5 Tesla scanner prior to surgery and histograms of ADC values were extracted. Histopathological results served as a reference standard for further analysis. ADC histograms were evaluated by comparing their similarity to a reference distribution using Chi2-test-statistics. The assumed reference distribution for benign and malignant parotid gland lesions was calculated after pooling the entire ADC data. In addition, mean ADC values were determined. For both methods, we calculated and compared the sensitivity and specificity between benign and malignant parotid gland tumors and three subgroups (pleomorphic adenoma, Warthin tumor, and malignant lesions), respectively. Moreover, we performed cross-validation (CV) techniques to estimate the predictive performance between ADC distributions and mean values. Histopathological results revealed 30 pleomorphic adenomas, 22 Warthin tumors, and 21 malignant tumors. ADC histogram distribution yielded a better specificity for detection of benign parotid gland lesions (ADChistogram: 75.0% vs. ADCmean: 71.2%), but mean ADC values provided a higher sensitivity (ADCmean: 71.4% vs. ADChistogram: 61.9%). The discrepancies are most pronounced in the differentiation between malignant and Warthin tumors (sensitivity ADCmean: 76.2% vs. ADChistogram: 61.9%; specificity ADChistogram: 81.8% vs. ADCmean: 68.2%). Using CV techniques, ADC distribution revealed consistently better accuracy to differentiate benign from malignant lesions (“leave-one-out CV” accuracy ADChistogram: 71.2% vs. ADCmean: 67.1%). ADC histogram analysis using full distribution curves is a promising new approach for differentiation between primary benign and malignant parotid gland tumors, especially with respect to the advantage in predictive performance based on CV techniques.

A case of salivary duct carcinoma possibly arising from pleomorphic adenoma

Objective: We report a rare case of salivary duct carcinoma possibly arising from the malignant component of carcinoma ex pleomorphic adenoma.&#x0D; Methods: A 56-year-old Japanese male complained of swelling in the left side of jaw for 2 years which was painless until 2 days ago. On extraoral examination, the face was bilaterally asymmetrical. An ultrasonography revealed hypoechoic mass of size 1.5x2.5x2.5 cm on left parotid gland. Computed tomography (CT) revealed a slight irregular mass on left parotid gland with no infiltration to adjacent tissues. Based on these findings, a clinical diagnosis of left parotid benign tumor was made.&#x0D; Results: A surgical excision was performed under general anesthesia. On histopathological examination, the connective tissue was rich in fibrous components and was accompanied by hyaline. Epithelial cells with high atypia proliferating invasively as cords into connective tissue were observed. The intraductal component had Roman-bridge-like architecture with central portion undergoing comedonecrosis. Based on these findings, a final diagnosis of salivary duct carcinoma possibly arising from pleomorphic adenoma was made. p16 hypermethylation is a known phenomenon in oral malignancy. We also checked the methylation status of p16 gene and found high level of methylation in this tumor.&#x0D; Conclusion: We reported a rare case of salivary duct carcinoma possibly arising from pleomorphic adenoma and also demonstrated high methylation level of p16 gene in the tumor.

A modified method for minimizing damage to the marginal mandibular branch (MMB) during partial superficial parotidectomy(PSP): A retrospective study

The aim of this study was to compare modified partial superficial parotidectomy (MPSP) with conventional partial superficial parotidectomy (CPSP) in a retrograde approach, and to determine whether MPSP can reduce the risk of injury to the MMB of the facial nerve and the rate of postoperative facial palsy.Patients with benign parotid gland tumors of the superficial lobe were included retrospectively in two groups: one group was treated with CPSP; the other group was treated with MPSP, in which the MMB was dissected in an anterograde direction or not dissected. The patients’ sex and age, location of tumor, size of tumor (maximum tumor diameter), histopathological distribution, operative time, and incidence of postoperative facial nerve weakness were compared.There was no significant difference in operative time between the two groups (p = 0.913). There was a significant difference (p = 0.008) in postoperative facial nerve weakness, with temporary facial nerve weakness observed in 19 and five patients in the CPSP and MPSP groups, respectively. Furthermore, there was a significant difference (p = 0.009) in MMB weakness, with temporary MMB weakness observed in 15 and three patients in the CPSP and MPSP groups, respectively. There was no significant difference (p = 0.564) in the weakness of other branches between the two groups. All cases of paresis scored ≤3 on the House-Brackmann scale, and all cases of temporary facial nerve weakness resolved within 6 months of surgery. No patient developed permanent paralysis.Within the limitations of the study, it seems that modified partial superficial parotidectomy (MPSP) should be preferred over conventional partial superficial parotidectomy (CPSP) whenever appropriate.

Evaluating the results of the surgery of benign parotid tumors

Background: Benign tumors account for 80% of parotid salivary gland tumors, early diagnosis and effective treatment will contribute to reducing complications of surgery. Objective: To evalutate surgical results of benign parotid tumors on facial paralysis and other complications. Research Methodology: including 51 patients with benign parotid salivary gland tumors at Hue University of Medicine and Pharmacy Hospital from June 2019 to October 2021 were operated on and monitored for facial paralysis after 1 week, 1 month, 3 months, and 6 months according to the House-Brackmann facial nerve grading system and noted other complications. Results: Pleomorphic adenoma and Warthin tumors are the two most common types of benign tumors. The rate of facial paralysis at the time points after 1 week, 1 month, 3 months, and 6 months gradually decreased by 56.9%, 35.3%, 19.6%, 0%, respectively. Most temporary facial paralysis grade II (mild) and grade III (moderate) (classification of House - Brackmann). The surgical method was significantly related to facial paralysis (p &lt; 0.05). Other complications such as numbness around the ear, hemorrhage, sialocele, salivary fistula, depression of facial contour, bad scars. Nevertheless, no cases of tumor recurrence and Frey’s syndrome were recorded after 6 months. Conclusion: Surgery is an effective and safe treatment for benign parotid salivary gland tumors. Facial paralysis accounts for a high incidence after surgery, but it will fully recover after 6 months. Choosing the appropriate treatment method helps to minimize complications and recurrence after surgery of parotid salivary gland tumors. Key words: benign parotid tumors, facial paralysis, parotidectomy.

Single incision-plus approach for gasless endoscopic parotidectomy: a seven-step procedure.

Endoscopic parotidectomy has the potential to become a reliable procedure for benign and low-grade malignant parotid gland tumors. Based on the previous literature review and our own clinical experience, we introduced in detail the surgical procedure of single incision-plus approach for gasless endoscopic parotidectomy. This method contributes a logical approach to achieving endoscopic resection of parotid gland tumor and preservation of facial nerve, which can be summarized into the following seven-step method: preoperative preparation; design of retroauricular-hairline incision and plus-incision; surgical cavities creation and coalescence; separation of surgical boundaries; separation and protection of the facial nerve trunk; processing of the branches of facial nerve; en bloc resection of the superficial parotid gland and tumor. Endoscopic parotidectomy is a more difficult procedure than conventional parotid surgery, requiring more precision as well as more experience and equipment. The learning curve of time and frequency is influenced by many factors, like anatomy, instruments, procedures and patience. We contribute our clinical exploration of anatomical precautions, feasible instruments, and surgical procedures and summarize precautions under single incision-plus in gasless endoscopic parotidectomy. Given the growing interest in the aesthetic process of the parotid region, the seven-step method may have the potential to be a method for teaching gasless endoscopic parotidectomy.

Multiphasic CT-Based Radiomics Analysis for the Differentiation of Benign and Malignant Parotid Tumors.

ObjectiveThis study aims to investigate the value of machine learning models based on clinical-radiological features and multiphasic CT radiomics features in the differentiation of benign parotid tumors (BPTs) and malignant parotid tumors (MPTs).MethodsThis retrospective study included 312 patients (205 cases of BPTs and 107 cases of MPTs) who underwent multiphasic enhanced CT examinations, which were randomly divided into training (N = 218) and test (N = 94) sets. The radiomics features were extracted from the plain, arterial, and venous phases. The synthetic minority oversampling technique was used to balance minority class samples in the training set. Feature selection methods were done using the least absolute shrinkage and selection operator (LASSO), mutual information (MI), and recursive feature extraction (RFE). Two machine learning classifiers, support vector machine (SVM), and logistic regression (LR), were then combined in pairs with three feature selection methods to build different radiomics models. Meanwhile, the prediction performances of different radiomics models based on single phase (plain, arterial, and venous phase) and multiphase (three-phase combination) were compared to determine which model construction method and phase were more discriminative. In addition, clinical models based on clinical-radiological features and combined models integrating radiomics features and clinical-radiological features were established. The prediction performances of the different models were evaluated by the area under the receiver operating characteristic (ROC) curve (AUC) and the drawing of calibration curves.ResultsAmong the 24 established radiomics models composed of four different phases, three feature selection methods, and two machine learning classifiers, the LASSO-SVM model based on a three-phase combination had the optimal prediction performance with AUC (0.936 [95% CI = 0.866, 0.976]), sensitivity (0.78), specificity (0.90), and accuracy (0.86) in the test set, and its prediction performance was significantly better than with the clinical model based on LR (AUC = 0.781, p = 0.012). In the test set, the combined model based on LR had a lower AUC than the optimal radiomics model (AUC = 0.933 vs. 0.936), but no statistically significant difference (p = 0.888).ConclusionMultiphasic CT-based radiomics analysis showed a machine learning model based on clinical-radiological features and radiomics features has the potential to provide a valuable tool for discriminating benign from malignant parotid tumors.

CLINICO PATHOLOGICAL STUDY OF TUMOURS OF PAROTID GLAND IN TERTIARY CARE HOSPITAL , PENCHIKALAPADU, KURNOOL

purpose: The objective of the study was to study age and sex pattern in parotid gland tumors, and determine the accuracy of ne needle aspiration cytology in diagnosing parotid gland tumors, and also analyze different modes of surgeries for parotid gland tumors. Detailed study of thirty cases of parotid gland tumors admitted to viswabharathi medical college, penchikalapadu,Design: Kurnool from January -2021 to January 2022, Out of 30 cases , 23 were benign tumors , 19, pleomporphic adenoma , 2 warthin's tumor,Results: 2 basal cell adenoma, while of 19 pleomorphic adenoma , male being 10 as compared to 9 female . The maximum of cases were seen in fourth and sixth decade followed by third and then fth decade. Malignant tumors has male to female ratio of 4:3 with predominance of third and sixth decade. All 23 cases of benign parotid tumors, i.e., 19 pleomorphic adenomas, 2 warthin's tumor and 2 basal cell adenomas were correctly diagnosed by FNAC. Hence the accuracy of FNAC in diagnosing benign parotid tumors in this series was 100%. In malignant tumors, ve of seven cases were correctly diagnosed by FNAC. The accuracy of FNAC in diagnosing malignant parotid tumors is 71.4 %. All pleomorphic adenomas were offered supercial parotidectomy except one where a total parotidectomy with conservation of facial nerve was done due to involvement of deep lobe. Of the other 4 benign tumors, all underwent supercial parotidectomy. In malignant tumors supercial parotidectomy with irradiation was offered in 3 cases, total conservative parotidectomy with irradiation in 1 case , total radical parotidectomy was offered in 3 cases. parotid gland tumors, has a male preponderance in both benign and malignant tumors, with 10:9 and 4:3 respectively. TheConclusion: accuracy of FNAC is 100% in benign tumors as compared to 71.4%. FNAC is a good tool in diagnosing benign parotid gland tumors, but should be cautiously interpreted in malignant tumors.

Retrospective Analysis of 136 Patients Operated for a Parotid Global Tumor.

Background:While salivary gland tumors constitute 5-6% of all head and neck tumors, they constitute 2-3% of all trunk tumors. About 3.8 per 100,000 of parotid tumors are diagnosed in the US each year, about 1300 to 1600 cases. The salivary gland cancer rate is 0.9 per 10000. The frequency of salivary gland tumors varies according to localization.Objective:In our study, we aimed to evaluate retrospectively the histopathological results, incidence, surgical treatment modalities and complications of parotid tumors operated in our clinic.Methods:We examined the patients who were operated for parotid gland tumor. The files of 136 patients who were admitted to the Otorhinolaryngology department of Dicle University Medical Faculty Hospital between January 2010 and April 2020 due to a parotid mass and underwent parotidectomy and whose pathology results were reported as benign or malignant parotid tumors were retrospectively scanned and included in the study. Patients’ age, gender, FNAB cytology result, type of surgery, histopathological results after surgery and complications after surgical treatment were recorded.Results:A total of 136 patients, 73 (53.7%) male and 63 (46.3%) female, were included in the study. The mean age of the patients was 48.26±17.37 (min=14, max=83) years. Superficial parotidectomy was performed in 108 (79.4%) patients and total parotidectomy was performed in 28 (20.6%) patients. According to the histopathological results after surgery, 108 (79.4%) benign tumors and 28 (20.6%) malignant tumors were diagnosed. Accordingly, pleomorphic adenoma (47.8%) was the second most common with 65 patients, followed by Whartin tumor (25.7%) with 35 patients. The sensitivity (sensitivity) of FNAB was 85.2%, and the specificity (specificity) was 96.2%. The accuracy of FNAB was found to be 94.0%.Conclusion:Good identification of the parotid mass preoperatively, together with both FNAB and radiological imaging methods, gains much more value in differentiating malignant and benign pathologies. While superficial parotidectomy is mostly sufficient in benign tumors, total parotidectomy-radical parotidectomy in malignant tumors and neck dissection should be considered in high-grade tumors even if there is no neck metastasis. Patients should be evaluated for RT and CT according to the tumor type after surgery.

Diagnosis of parotid gland tumours with Contrast-Enhanced Ultrasound: a systematic review and meta-analysis.

Contrast-enhanced ultrasound (CEUS) appears to be a promising application for the diagnosis of parotid glandtumours. We aimed to systematically review and meta-analyse the ability of CEUS in distinguishing benign from malignantparotid gland tumours. PubMed was searched for relevant studies. Data on area under time intensitycurve (AUC) in arbitrary unit (AU), and mean transit time (MTT) in seconds (sec) were analysed using the Cochrane ReviewManager Software. Nine studies met the eligibility criteria comprising a total number of 498 parotid gland tumours(benign, number (n)=423; malignant, n=75). Descriptive evaluation of parotid gland tumours following CEUS administrationshowed overlap characteristics in benign and malignancies. Two publications assessed AUC and MTT in 72 and 60 parotidgland tumours, respectively. AUC was significantly lower in benign compared to malignant tumours following contrast administration(AUC, mean difference (MD) -266.77 AU, 95% confidence intervals (CI) -433.22, -100.33, p=0.002). No significantdifferent in MTT between benign and malignant tumours (p=0.12). Heterogeneity was statistically significant in AUC (p=0.04)and MTT (p<0.00001). Descriptive evaluation of parotid gland tumours showed overlap CEUS characteristics.Perfusion related CEUS parameters analysis is promising in differentiating benign parotid tumours from malignancies.