Types Of Parotid Tumors Research Articles

The use of bipolar pure cut mode technology in dissection of parotid tumors: A novel technique

Background The basic concern in parotid surgery is facial nerve preservation. Various methods of dissection have been used to excise the parotid tissue and spare the facial nerve and its branches. Combined (blunt, mosquito tip, monopolar, and bipolar electrocautery, and scissor dissection) procedures are the most widely used techniques. Further new methods were used as an alternative for hemostasis and dissection such as ligasure and ultrasonic devices. New emerging technology of bipolar energy with high voltage and low current gave a benefit of deep coagulation and powerful cutting with less spread of heat to the surrounding tissue. In this study, we tried a new dissection technique with the pure auto-cut bipolar electrodissection with the new versions of bipolar technology to report its effect in parotid tumor surgery. The primary objective of the study was to evaluate the safety and efficacy of new bipolar pure cut electrodissection and weighing its benefits in the preservation of the facial nerve branches and reducing the postoperative complications. The secondary objective of the study was to compare the result of the new technique with the results of the conventional technique that was previously performed in our department and the complication of this new technique if any. Patients and methods This prospective and retrospective study was held in Menoufia University Hospital. Our study included 30 patients with parotid tumors, where 15 retrospective patients underwent conventional parotidectomy (superficial and/or total parotidectomy) and were referred as group B, and 15 prospective patients underwent parotidectomy (superficial or total parotidectomy) and were referred as group A, using the bipolar pure auto-cut electrodissection technique by advanced bipolar technology. Results The mean operative time was significantly lower in group A patients than in group B, where the time for superficial parotidectomy was 100±14 min in group A and 117±11 min in group B and for total parotidectomy was 118±12 min in group A and 139±18 min in group B (P=0.001). Regarding postoperative complications, in group A, we reported one case with temporary nerve affection. However, in group B, we reported two cases of wound infection, one case with salivary fistula, two cases with seroma, two cases of temporary nerve affection, two cases of permanent nerve branch affection, and one case of Frey syndrome. Regarding tumor recurrence, we reported only one case in group B. Conclusions Using the new bipolar pure cut technique in various types of parotid tumors is technically easier for meticulous fast dissection around the facial nerve branches, showing significantly shorter operative time and less incidence of seroma, wound infection, salivary fistula, and facial nerve injury.

A preliminary diagnostic accuracy study of quantitative MRI biomarkers for differentiating parotid tumor types.

Differentiating among the different types of parotid tumors on imaging is useful for guiding clinical disposition, which ultimately may lead to surgical management. The goal of this study was to determine whether quantitative T2 signal characteristics and morphologic features on magnetic resonance imaging (MRI) can serve as predictive biomarkers for distinguishing between tumor types. A retrospective review of T2-weighted MRIs in patients with pathology-proven parotid tumors was performed. Quantitative T2 maps and surface regularity measurements of the tumors were obtained via semi-automated regions of interest (ROI). Linear Discriminant Analysis was used to populate the receiver operating characteristics (ROCs) curves for these variables. A P value of <0.05 was considered to be significant. A total of 35 tumors (21 benign and 14 malignant neoplasms) were included in this analysis. For differentiating the benign versus malignant classes of parotid tumors, T2 signal and surface regularity combined yielded an area under the curve of 0.62 (P value: 0.2) through the ROC analysis. However, for the pleomorphic adenomas versus other types of parotid tumors, using both T2 signal and surface regularity yielded an area under the curve of 0.81 (P value: 0.007) through the ROC analysis. T2 signal and surface regularity combined can significantly differentiate pleomorphic adenomas from other types of parotid tumors and can potentially be used as a predictive imaging biomarker.

Clinico-pathological profile of parotid gland tumors at a tertiary care center in North India.

The objective of this study was to know the various types of parotid tumors and their clinical presentations, surgical management, and post-operative outcome. Data of 102 patients assessed from hospital records who underwent parotid surgery between the years 2013 and 2018 were obtained. Parameters included age, sex, socio-demographic profile, presenting complaints, examination findings, and cytopathology. Surgical techniques, post-operative complications such as a facial scar, retro-mandibular and pre-auricular depression, facial palsy, Frey's syndrome, and numbness over the ear lobule were analyzed. Out of a total of 102 patients, 54.0% of patients were male, and 45.1% were female. The mean age of patients was 33.30 ± 13.87 years ranging from 7 to 65 years. The most common clinical presentation was swelling in the parotid region (95.1%), and associated symptoms with swelling were pain (17.5%), facial palsy (4.9%), discharging sinus (4.9%), and ulcerative lesions (1%) at the time of presentation. Pleomorphic adenoma was the most common benign neoplasm (76.5%), followed by Warthin's tumors (2.9%). Mucoepidermoid carcinoma was the most common malignant neoplasm (3.9%). After parotid surgery, 35% of patients had a sensory impairment or hypoesthesia of the ear lobule, and 23.28% had temporary facial nerve weakness. 5.0% of patients had permanent facial weakness, and 2.06% of patients had weakness of the marginal mandibular nerve. Pleomorphic adenoma and mucoepidermoid carcinoma are the most common benign and malignant tumors, respectively, and parotidectomy is the treatment of choice, depending on the tumor location. Successful treatment depends on early diagnosis and histopathological and radiological investigations. Sensory impairment and temporary facial nerve paralysis are the most common post-operative complications, which are minimized by proper knowledge of anatomy and meticulous dissection of the facial nerve during parotid surgery.

Case Series-An Overview of Extracapsular Dissection of Parotid Tumours

Extra Capsular Dissection (ECD) differs markedly from classic surgical approaches to the parotid neoplasm because facial nerve dissection is not performed. Factors noted to favor this approach include mobility of the tumor within the gland, a thin covering of capsule and glandular tissue, and a tumor large enough to allow digital manipulation during dissection. Imaging, fine needle aspiration cytology, and neuron-monitoring play a heightened role in ECD [1]. The AIM of this article is to report case series on surgical management of few types of parotid tumors by extra capsular dissection and to assess longterm results after the treatment of Parotid tumors using surgical technique ECD. This case series includes five different parotid tumors such as Warthin’s tumor, Pleomorphic adenoma, Sialadenoma papilliferum of parotid, chronic sialoadenitis, Parotid cystadenoma, out of 30 cases operated in our hospital. All the patients in this study received appropriate surgical treatment (ECD) and done a follow up evaluation every month. Extra capsular dissection is a safe, reliable and recommended technique to manage the small benign superficial parotid tumors if the case is selected properly.

Case series-an overview of extracapsular dissection of parotid tumours

&lt;p&gt;Extra capsular dissection (ECD) differs markedly from classic surgical approaches to the parotid neoplasm because facial nerve dissection is not performed. Factors noted to favor this approach include mobility of the tumor within the gland, a thin covering of capsule and glandular tissue, and a tumor large enough to allow digital manipulation during dissection. Imaging, fine needle aspiration cytology, and neuron-monitoring play a heightened role in ECD. The aim of this article is to report case series on surgical management of few types of parotid tumors by extra capsular dissection and to assess long-term results after the treatment of parotid tumors using surgical technique ECD.This case series includes five different parotid tumors such as Warthin’s tumor, Pleomorphic adenoma, Sialadenoma papilliferum of parotid, chronic sialoadenitis, parotid cystadenoma, out of 30 cases operated in our hospital. All the patients in this study received appropriate surgical treatment (ECD)&lt;strong&gt; &lt;/strong&gt;and done a follow up evaluation every month.&lt;/p&gt;

A reliable multiclass classification model for identifying the subtypes of parotid neoplasms constructed with variable combination population analysis and partial least squares regression based on Raman spectra

Pleomorphic adenoma (PA), Warthin's tumor (WT) and mucoepidermoid carcinoma (MEC) are three common subtypes of salivary gland tumors, for which the occurrence site is located in the parotid gland. Accurately diagnosing the subtypes of parotid tumors plays a vital role in the surgical treatment. Unfortunately, the current studies mainly focus on the binary classification of parotid tumors. The preoperative multi-classification of them has still been underexplored. For the purpose of broadening the application area of the predictive models and facilitating the clinical preoperative diagnosis, we suggested a multi-classification model, which was constructed by combining the variable combination population analysis (VCPA) algorithm with the partial least squares regression (PLSR), to simultaneously discriminate the three subtypes of parotid tumors as well as the normal parotid gland tissue based on the Raman spectra of the tissue samples. In addition, we investigated the impact of generating Raman spectra from different sampling locations on the reliability of the predictive models. For the validation set, the overall accuracy in predicting the subtypes of parotid tumors and the normal parotid gland tissue was 0.867. Similarly, the accuracies achieved by the models constructed with the Raman spectra from two different sampling locations were 0.877 and 0.883, respectively, indicating the minor influence of the sampling locations on the predictive models. Our findings can be helpful for establishing the method of rapidly diagnosing the salivary gland tumors preoperatively in clinics. Moreover, the characteristic wavenumbers used in model construction were highly associated with the variations of the structures and contents of nucleic acids, collagen, proteins, lipids and DNA/RNA in gland tissue, which revealed the mainly difference among three types of parotid tumors and can be conductive to better understanding the molecular mechanisms of them.

Value of apparent diffusion coefficient calculation in the differential diagnosis of parotid gland tumors

The differential diagnosis of parotid gland tumors is often difficult with conventional magnetic resonance imaging. To determine whether the calculation of the apparent diffusion coefficient (ADC) is valuable for making the differential diagnosis of parotid tumors. Thirty parotid masses in 28 patients and 24 healthy parotid glands in 12 controls were examined in this prospective study. Diffusion-weighted magnetic resonance imaging with echo-planar spin-echo sequences was used to evaluate each subject. The ADC of each tumor and each healthy parotid gland was calculated. Tumor diagnoses were confirmed by the results of histopathologic analysis. The following types of masses were identified: 11 Warthin tumors, nine pleomorphic adenomas, seven malignant tumors, one basal cell adenoma, and two benign cysts. The mean ADC value for the Warthin tumors was 0.97+/-0.16 x 10(-3) mm(2)/s, for the pleomorphic adenomas was 1.74+/-0.37 x 10(-3) mm(2)/s, for the malignant tumors was 1.04+/-0.35 x 10(-3) mm(2)/s, and for the normal parotid glands was 0.34+/-0.20 x 10(-3) mm(2)/s. The respective ADC value for the single basal cell adenoma was 1.40 x 10(-3) mm(2)/s. Statistically significant differences were identified between the subjects with pleomorphic adenoma and those with another type of parotid tumor, and between subjects with healthy parotid glands and those with a tumor. Calculating the ADC appears to be useful in differentiating pleomorphic adenomas from other types of parotid gland tumors.

Principles of treatment of different types of parotid tumors.

AbstractThe prerequisite for an adequate treatment of a parotid tumor is a correct diagnosis — a diagnosis based on well delimited histological types of tumor. A classification with a clear delimitation between benign and malignant types of tumor is presented. The prognosis, relation to the facial nerve and the radiosensitivity of the different types of tumor in this classification have been studied in a series of about 2,000 parotid tumors. The extent of the surgical intervention — subtotal or total parotidectomy, radical neck dissection, sacrificing of the facial nerve — and the decision to perform preoperative irradiation are determined by the type of tumor; therefore, a correct diagnosis of the tumor before treatment is important as the primary diagnostic method aspiration biopsy has been routinely employed during the last decade.

Facial nerve paralysis. A criterion of malignancy in parotid tumors.

In a series of 2,261 patients with parotid tumors, peripheral facial nerve paralysis developed spontaneously in 46 patients. These 46 patients all had malignant parotid tumors, which implies that facial nerve paralysis must be considered as a criterion of malignancy. The correlation between the incidence of this symptom and the grade of malignancy of the different types of parotid tumors has been settled. As all patients with malignant parotid tumors and concomitant facial nerve paralysis died of the tumor disease regardless of the radicality of the surgery, it seems that a tumor invading the facial nerve is beyond our present therapeutic procedures. In six patients the facial nerve paralysis was the first and only symptom of the malignant parotid tumor, which implies that an occult malignant parotid tumor always must be taken into consideration in patients with spontaneously developing peripheral facial nerve paralysis.