Parotid Diseases Research Articles

Indications and Outcomes of Parotidectomy in Saudi Children: Experience From Two Tertiary Centers

IntroductionChildren can present with a wide variety of parotid diseases. However, most of them do not require surgical treatment. The indications of parotid surgery in children may differ from those in adults. In this study, we aim to review the indications and outcomes of parotidectomy in our pediatric population.MethodsRetrospective review of the medical records of patients who underwent parotid surgery at age <18 years in two tertiary centers over a 14-year period.ResultsA total of 18 parotidectomies were performed on 18 patients with a mean age of 13.5 years. All patients presented with a parotid mass. The most common procedure was superficial parotidectomy followed by total parotidectomy. Ten patients were diagnosed with a benign parotid disease (55.6%). The most common benign disease was pleomorphic adenoma. There were eight cases of parotid malignancy constituting 44.4% of all patients and 57% of patients presenting in the age range of 12-17 years. Mucoepidermoid carcinoma was the most common malignancy (six patients). Fine needle aspiration biopsy was performed in 12 children with a sensitivity, specificity, and overall accuracy of 62.5%, 50%, and 58.6%, respectively. The most common complication was temporary facial weakness (33.3%) which resolved in a mean time of 2.5 months. No disease recurrences were identified.ConclusionsParotidectomy is uncommon in the pediatric age group. Children with a solid parotid tumor have a higher risk of parotid malignancy when compared to adults. A parotid mass presenting in the second decade of life is more likely to be malignant than benign.

Role of Sialendoscopy in Non-neoplastic Parotid Diseases: A Prospective Study of 241 Patients in Indian Population.

To assess the role of sialendoscopy as a diagnostic modality and in managing cases of non-neoplastic parotid gland diseases. Secondly, to provide descriptive analysis of intraoperative findings. The patients of chronic parotid sialadenitis who presented with complaints of recurrent unilateral or bilateral parotid swelling and pain were included in the study. All patients underwent sialendoscopy, and the findings were noted. Intervention was carried out in the same sitting like dilatation of stenosis, stone removal by basket, combined approach, flushing of mucoid flakes, etc. Failed cases were worked up with radiological investigation and managed accordingly. Two hundred and forty-one cases of parotid sialadenitis who underwent sialendoscopy between 2012 and 2018 were included. Diagnostic sialendoscopy was achieved in 100% cases, while intervention was successful in 96.7% (233/241) cases after the first procedure. On diagnostic sialendoscopy, ductal stenosis was the most common pathology present in 177 (73.4%) patients followed by stones (12%) and debris (11.6%). All cases of stenosis were serially dilated with increasing sizes of sialendoscopes followed by stenting in 75% of the cases. The diagnosis of juvenile recurrent parotitis was confirmed in 17 children (mean age 5.6years) with consistent clinical history and sialendoscopic findings of stenosis along with pale ductal mucosa. There were 18 cases where ductal perforation was seen. One case showed multiple hyperdense foci in bilateral parotid gland along with multiple strictures that underwent repeat sialendoscopy, but the symptoms did not resolve, and finally the patient underwent bilateral superficial parotidectomy. Sialendoscopy is a safe and highly effective modality in managing non-neoplastic parotid gland disorders with low complication rates and resulted in gland preservation in the vast majority of patients. Therefore, it can be concluded that sialendoscopy is the diagnostic and therapeutic modality of choice for parotid obstructive sialadenitis.

Research on the Practical Classification and Privacy Protection of CT Images of Parotid Tumors based on ResNet50 Model

Parotid gland disease is one of the main causes of facial paralysis, and parotid gland tumor is a great threat to the life of patients. The main diagnostic way of parotid diseases is imaging examination, so it is of great significance for the rapid classification of parotid image. In conclusion, 51 CT images of parotid malignant tumors and 101 CT images of parotid pleomorphic adenomas are selected as the research data set, and an intelligent and efficient machine learning algorithm is proposed for the practical classification of parotid images. At the same time, this paper also explores the privacy protection of medical images. Based on the advantages of deep learning, such as no feature engineering, strong adaptability and easy conversion, ResNet50 model in deep learning is selected as the basic network framework to achieve the purpose of rapid classification of parotid CT images. This is the first time that ResNet50 classification algorithm is applied to the practical classification of parotid tumor CT images. The results show that the accuracy of the test set converges to 90% when the model is iterated 1000 times, which also proves that this study has certain practical significance and application value for the auxiliary diagnosis of parotid gland tumor and other head and neck tumors. Simultaneously, this paper also explores the application of desensitization strategy in CT images of parotid tumors, which improves the performance of the model and also greatly protects the privacy of patients, and has a good application prospect in medical big data.

Oncocytoma of parotid gland: a rare case report

&lt;p class="abstract"&gt;Oncocytoma of parotid gland is a rare tumor that mainly affects the age groups of sixth to eight decades. The treatment of this tumor is mainly surgical with either radical or superficial parotidectomy and&lt;em&gt; &lt;/em&gt;the prognosis is excellent. In our case report, 72 years old female came with complain of slowly growing, painless swelling on right infra auricular area which was diagnosed as oncocytoma of parotid gland. She was successfully treated with superficial parotidectomy. Since the oncocytoma of parotid gland is very rare tumor and may confuse with other parotid diseases like pleomorphic adenoma, mucoepidermoid carcinoma. As the cure rate of the disease is excellent, so it is advised to make the appropriate diagnosis whenever the case is encountered.&lt;/p&gt;

Evaluation of Parotid Glands With Real-time Ultrasound Elastography in Children.

The aim of this study was to determine the strain index for parotid glands in children by using ultrasound elastography. In this prospective study, apparently healthy children were referred from the ear-nose-throat clinic to the radiology clinic for elastographic examinations. Conventional sonographic and elastographic examinations of the parotid glands were performed. A linear 5-12-MHz transducer was used to obtain the images. A total of 54 children were enrolled in this prospective study. The normal mean strain index value ± SD for the parotid glands was 1.24 ± 0.67 (range, 0.29-1.39) regardless of sex. The mean age of girls was 7.42 ± 2.94 years (range, 3-14 years), and the age of boys was 8.50 ± 3.46 years (range, 4-16 years). The strain index values for the parotid glands in boys was 1.25 ± 0.76, and in girls it was 1.22 ± 0.55. There was no statistically significant difference in the strain index values between girls and boys (P= .986). There was no correlation between the strain index and age (r = 0.026) or body mass index (r = 0.066). This study determined the mean strain index values for apparently healthy children. Such information can serve as a baseline from which pathologic parotid diseases can be diagnosed with ultrasound elastography in combination with other sonographic criteria.

Contrast-enhanced ultrasound in the evaluation of parotid gland lesions: an update of the literature.

High-resolution ultrasound is the first line examination for parotid gland diffuse disease and focal lesions, normally using grey-scale and colour-Doppler ultrasound. Unfortunately, grey-scale and colour-Doppler ultrasound features of benign and malignant salivary gland lesions may overlap, particularly with benign tumors, where pleomorphic adenomas are often indistinguishable from malignant lesions. With atypical lesions, contrast-enhanced magnetic resonance imaging is usually the second level imaging modality requested. The introduction of ultrasound contrast agents has opened further possible perspectives to improve the interpretation of parotid diseases, particularly the differentiation between benign and malignant lesions. We present a review of the current literature on contrast-enhanced ultrasound for the assessment of parotid gland lesions, considering all characteristics of the technique, evidence of usefulness, future perspectives and limitations.

Value of visualization of the intraparotid facial nerve and parotid duct using a micro surface coil and three-dimensional fast imaging with steady state precession with fat-suppression sequence

Objective To explore the value of small surface coil combine with three-dimensional fast imaging with steady state precession and fat-suppression (3D-FISP-FS) sequence in displaying intra-parotid facial nerves segment and parotid ducts. Methods The parotid regions of 18 healthy volunteers who were excluded any parotid diseases were scanned by head & neck coil (36 sides) and 4 cm small surface coil (32 sides) combined with 3D-FISP-FS sequence prospectively. The obtained original images were treated through MIP, MPR and CPR, The MRI signal characteristics of parotid region structure, the subjective score of image quality, the signal intensity ratio (SIR) of facial nerve/parotid tissue (SIRN) and parotid duct/parotid tissue (SIRD) was calculated, and the displaying rates of the facial nerves and parotid ducts were observed. Wilcoxon matched-samples signed rank sum test was used to compare the scores of head & neck coil and small coil 3D-FISP-FS sequence images, paired t test was used to compare SIRN, SIRD of the two groups, Chi-square test was used to compare of the displaying rate of the facial nerves and parotid ducts in two groups. Results Eighteen volunteers were successfully performed MRI scan of parotid gland. On 3D-FISP-FS sequence images, the parotid gland was showed slightly low signal intensity, muscle tissue was showed medium signal intensity, the vessels were showed slightly high or high signal, parotid segment of facial nerve was showed tortuous line-like high signal intensity, and parotid duct was showed curve high signal intensity, lymph nodes were showed kidney shaped, oval or spindle shaped high signal intensity structures. The subjective scores for head and neck coil and coil images were (2.0±0.9) and (1.5±0.7) respectively, and the difference was statistically significant (Z=-2.714, P=0.007), image quality of small coil group was better than that of head and neck coil group. The SIRN of the two groups was 1.7±0.8 and 2.1±1.2 respectively, and the SIRD was 1.8±0.7 and 2.5±1.7 respectively, which showed a statistically significant difference between the two groups (t value was 2.978, 2.427 respectively, P value was 0.006, 0.031 respectively).All facial nerve trunks could be displayed by head and neck coil and small coil. On head and neck coil images, 25 sides of temporofacial truck, 15 sides of cervicofacial truck, 17 sides of temporofacial branches, 11 sides of cervicofacial branches, 16 sides of the parotid duct could be displayed. On small coil images, 30 sides of temporofacial truck, 28 sides of cervicofacial truck, 26 sides of temporofacial branches, 23 sides of cervicofacial branches, 27 sides of the parotid duct could be displayed, which showed a statistically significant difference (P<0.05). Conclusion Small surface coil performed better in parotid MR imaging with 3D-FISP-FS sequence than that of head and neck coil, which can simultaneous clearly display the trunk and branches of the intra-parotid facial nerves and parotid ducts. Key words: Parotid gland; Facial nerve; Parotid duct; Magnetic resonance imaging; Small surface coil

The Extended Indication of Parotidectomy Using the Modified Facelift Incision in Benign Lesions: Retrospective Analysis of a Single Institution

Recently, the modified facelift incision (FLI) has gained increasing popularity for its cosmetic benefits in parotidectomy. However, many surgeons remain concerned with the adequacy of the exposure and are unwilling to use the FLI for anterior or superior tumors of the parotid gland because these tumors are closer to the superficially positioned facial nerve branch. To evaluate the changing trends in parotidectomy incisions for benign lesions at a single institute, and to compare the surgical outcomes between the modified Blair incision (BI) and FLI, and determine the adequacy and possible indications or limitations of the FLI, especially for tumors located in the anterior or superior parotid gland. Retrospective study analyzed 357 patients who had various benign parotid diseases and underwent parotidectomy at Severance Hospital between January 2005 and December 2009. Revisions or recurrences and histologically confirmed malignancies were excluded. Tumor location was divided into superficial and deep lobes. The superficial lobe was subdivided into anterior, superior, inferior, and middle portions. Patients' profiles, surgical outcomes, and cosmetic satisfaction score on a scale of 0 (extremely dissatisfied) to 10 (extremely satisfied) were compared. In all, 344 patients underwent BI or FLI. The FLI was performed increasingly each year. For anterior (n = 58) or superior tumors (n = 32), there was no significant difference between the type of incision and tumor size or complications. No facial nerve palsy occurred in either group. For deep-lobe tumors (n = 67), the mean tumor size was significantly larger in the BI group (p = 0.025). There was a significant difference between facial nerve palsy and tumor size (p < 0.001) but no significant difference between facial nerve palsy and tumor location (p = 0.145) or the type of incision (p = 0.530). The mean scar satisfaction score was significantly higher in the FLI group (p <0.001). There was a positive correlation between the scar and deep hollow satisfaction score (Pearson coefficient of correlation = 0.547; p < 0.001) The modified facelift incision is feasible for most benign parotid lesions regardless of tumor location, even for anterior or superior tumors. Using the modified facelift incision may be extended with a surgeon's accumulated experience, but for a large deep-lobe tumor, the modified Blair incision is still considered useful.

THE PAROTID glands and nutritional diseases.

Journal Article The Parotid Glands and Nutritional Diseases Get access Nutrition Reviews, Volume 15, Issue 9, September 1957, Pages 264–266, https://doi.org/10.1111/j.1753-4887.1957.tb00590.x Published: 01 September 1957

Anatomy of the Facial Nerve and its Implication in the Surgical Procedures

SUMMARY : Facial palsy, parotid diseases and others are a relatively common clinical condition with a variety of causes.Irrespective of its etiology, facial palsy always represents a very serious problem for the patient. Parotid gland diseases also are verycommon occurrence. In this particular case, the knowledge of surgical anatomy of the facial nerve and its correlations with the parotidgland is very important for an adequate preservation in the cases of surgery of benign and malignant diseases of the parotid gland.Although the surgical anatomy of the facial nerve has been well documented, the concept of surgical treatment for parotid tumors, facialpalsy (neurorraphy techniques) and submandibular surgical approach are rarely challenged now. KEY WORDS: Facial nerve; Surgical anatomy; Facial palsy; Parotid gland. INTRODUCTION The facial nerve consists of the facial nerve properand the intermedius nerve. The former originates frommotoneurons in the facial nucleus situated ventrolaterally inthe caudal portion of the pons. The motor axons first turndorso-medially towards the abducens nucleus round the dor-sal side of this nucleus and then course ventrolaterally. Boththe facial nerve proper and the intermedius nerve emergefrom the CNS in the cerebellopontine angle at the caudalborder of the pons, between the abducens nerve and the stato-acoustic nerve (Machado, 1998).As it exits through the stylomastoid foramen, theextracranial portion of the facial nerve may be located 5 cmbelow the skin. Here, it immediately gives off branches tothe auricular muscles, the posterior belly of the digastricmuscle and the stylohyoid muscle. It supplies sensory (vagal)fibers to parts of the external auditory canal and some areasto the auricle, including the lobulus (Ranson & Clark, 1959;Barr & Kiernan, 1983; May & Schaitkin, 2000). The nervethen courses ventrally and at the posterior edge of the parotidgland, it splits into upper and lower divisions. Within theparotid gland, there is further branching with many indivi-dual variations (Davis

Macroamilasemia en pediatría

Macroamylasaemia should be considered in any patient with high plasma amylase, no clinical signs and negative additional investigations for pancreatic or parotid diseases. It is characterised by an increase in serum amylase due to circulating high molecular mass macrocomplexes, most often formed due the binding of the amylase to an immunoglobulin. With a normal renal function, a hyperamylasaemia without an increase in urine amylase suggests the diagnosis, and is confirmed by identifying the macromolecular components. It is an uncommon entity in paediatrics. It has been described as a casual finding associated to abdominal pain and to celiac disease. We report two paediatric cases of macroamylasaemia, and a review of the tests needed for its diagnosis. The better understanding of this biochemical anomaly allows us to differentiate it from other situations associated to hyperamylasaemia, in order to avoid additional invasive explorations and unnecessary treatments.

Minimal incision in parotidectomy

Conservative parotidectomy has been for years an effective and well-established technique. Recently, aesthetic considerations have been reviewed. A minimal pre- and retroauricular incision is proposed that does not extend to the hair-bearing skin. This reduces the length of the scar and the extent of the dissection improving aesthetic results. This is a retrospective study of 32 parotidectomies performed through this incision because of benign parotid diseases and diagnosed by fine needle aspiration cytology. The minimal incision is mainly indicated in small and medium-sized tumours located in the superficial lobe of the parotid gland. Neither operating time nor the morbidity associated with parotidectomy is increased with this safe and effective technique for the treatment of benign parotid masses.

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.

Selective IgA Deficiency in Children With Recurrent Parotitis of Childhood

Recurrent parotitis of childhood is defined as the relapsing form of juvenile (idiopathic) parotitis and represents a rare inflammatory disorder of the parotid gland with potentially significant morbidity. We reviewed the charts of patients who were diagnosed with inflammatory parotid diseases in our institution between 1992 and 2002. There were 91 patients presenting with juvenile parotitis (1 of 6117 of all clinical visits). Of these 91 cases, 23 patients (28%) had the relapsing form of juvenile parotitis, and the median number of episodes was 5 (range, 2-20). Laboratory investigations revealed that 5 patients had selective IgA deficiency. The prevalence (22%) is different from the cumulative prevalence of IgA deficiency in a healthy population (0.3%; P < 0.001).

Role of open incisional biopsy in parotid tumors

ObjectiveParotid gland enlargement due to diffuse pathologic processes represents a diagnostic challenge for the surgeon. In such cases, fine-needle aspiration is inconclusive and superficial parotidectomy is usually performed.Material and MethodsThe authors treated eight patients who underwent open incisional biopsy of the parotid gland with continuous monitoring of the facial nerve.ResultsIn all cases, fine-needle aspiration cytology did not provide a definitive diagnosis while open incisional biopsy provided an accurate diagnosis of a lymphoproliferative disorder, with no operative complications.ConclusionIn certain infiltrative parotid diseases such as lymphoepithelial or lymphoproliferative diseases, when fine-needle aspiration biopsy is insufficient as tissue architecture is an important component of the pathological diagnosis, an open incisional biopsy can be considered. This procedure can provide an accurate histological diagnosis while avoiding superficial parotidectomy.

Tumor-associated lymphoid proliferation in the parotid gland: A potential diagnostic pitfall

A substantial proportion of neoplastic and nonneoplastic parotid diseases have a prominent lymphoid component. The lymphoid element in lesions such as papillary cystadenoma lymphomatosum, sebaceous lymphadenoma, and lymphoepithelial carcinoma are readily recognized as a required diagnostic element. However, when other types of benign and malignant salivary gland neoplasms demonstrate tumor-associated lymphoid proliferation, the tumor may be either misclassified or misinterpreted as metastatic disease. Examples of primary benign and malignant parotid neoplasms exhibiting tumor-associated lymphoid proliferation are documented and illustrated. Other parotid lesions that may have a lymphoid element include sialadenitis, cysts with associated lymphoid tissue, parenchymal neoplasms with an expected lymphoid component or those that arise within an intraparotid lymph node, autoimmune disease, malignant lymphoma, and metastatic disease. An approach to recognition and separation of these entities is discussed.

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.

Benign parotid diseases of childhood.

A 25-year retrospective study of 63 pediatric surgical cases of benign parotid disease was done. Inflammatory disorders accounted for 34 of the cases. The remaining 29 non-inflammatory conditions included vasoformative, solid, and cystic lesions and were nearly always asymptomatic.

Zur Klinik und Therapie der Parotistumoren

The authors report on their cases of parotid tumours between 1972-1982. Not only benign and malignant neoplasms but also inflammatory "tumours" were included, since they often exhibit signs of real neoplasms. The patient material and the results obtained agree well with the literature. The great value of computed tomography is underlined especially in cases with hidden parapharyngeal tumours. Hopefully, recently performed measurements of serum isoamylase will be a valuable diagnostic test for parotid diseases, particularly in differentiating between real neoplasms and chronic inflammatory diseases.