Surgical Management of Parotid Gland Tumors

Gant, Thomas D.; Hovey, Leslie M.; Williams, Camille

doi:10.1097/00000637-198105000-00007

Cited by 17 publications

(7 citation statements)

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“…For these reasons, it has been reported in several studies that Warthin tumors can be safely and adequately removed by extracapsular dissection without altering the recurrence rate [5,6,7,8]. On the other hand, some claim that superficial parotidectomy is the minimal necessary operation because bilateral or multiple onsets are more common in Warthin tumor compared to other types of parotid tumors, while others insist that total parotidectomy is essential because the recurrence rate is still reported to be up to 25% when the condition is treated with superficial parotidectomy [20,21]. It has also been reported that some cases of recurrence were caused by undiscovered tumors rather than by incomplete dissection [22].…”

Section: Discussionmentioning

confidence: 99%

Two-Phase Helical Computed Tomography Study of Salivary Gland Warthin Tumors: A Radiologic Findings and Surgical Applications

Joo

Kim

Park

et al. 2014

Clin Exp Otorhinolaryngol

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ObjectivesThe goal of this study was to define the radiologic characteristics of two-phase computed tomography (CT) of salivary gland Warthin tumors and to compare them to pleomorphic adenomas. We also aimed to provide a foundation for selecting a surgical method on the basis of radiologic findings.MethodsWe prospectively enrolled 116 patients with parotid gland tumors, who underwent two-phase CT preoperatively. Early and delayed phase scans were obtained, with scanning delays of 30 and 120 seconds, respectively. The attenuation changes and enhancement patterns were analyzed. In cases when the attenuation changes were decreased, we presumed Warthin tumor preoperatively and performed extracapsular dissection. When the attenuation changes were increased, superficial parotidectomy was performed on the parotid gland tumors. We analyzed the operation times, incision sizes, complications, and recurrence rates.ResultsAttenuation of Warthin tumors was decreased from early to delayed scans. The ratio of CT numbers in Warthin tumors was also significantly different from other tumors. Warthin tumors were diagnosed with a sensitivity of 96.1% and specificity of 97% using two-phase CT. The mean operation time was 38 minutes and the mean incision size was 36.2 mm for Warthin tumors. However, for the other parotid tumors, the average operation time was 122 minutes and the average incision size was 91.8 mm (P<0.05).ConclusionSalivary Warthin tumor has a distinct pattern of contrast enhancement on two-phase CT, which can guide treatment decisions. The preoperative diagnosis of Warthin tumor made extracapsular dissection possible instead of superficial parotidectomy.

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Section: Discussionmentioning

confidence: 99%

Two-Phase Helical Computed Tomography Study of Salivary Gland Warthin Tumors: A Radiologic Findings and Surgical Applications

Joo

Kim

Park

et al. 2014

Clin Exp Otorhinolaryngol

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“…The incidence depends on several factors, including the will of the physician to identify minimum postoperative motor deficits. Some series report 16% to 47% temporary facial palsy and zero to 9% permanent facial paralysis from parotidectomies 16,17 . Paralysis of one or more branches of the facial nerve is more common during the realization of total parotidectomy.…”

Section: Results Results Results Resultsmentioning

confidence: 99%

Tumor de Warthin da glândula parótida: estudo de 70 casos

Chedid

Rapoport

Aikawa

et al. 2011

Rev. Col. Bras. Cir.

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OBJETIVO: Relatar as características clínicas, tratamento e complicações.dos tumores de Warthin. MÉTODOS: Estudo retrospectivo com 70 pacientes submetidos à ressecção de cistoadenoma papilífero linfomatoso,. Variáveis analisadas: idade, sexo, etnia, presença ou não de tabagismo, sítio primário do tumor, tamanho do tumor em centímetros, presença de bilateralidade, tipo de operação, multicentricidade, complicações do tratamento, presença de recidiva no seguimento e tempo de seguimento.. RESULTADOS: Quarenta e quatro pacientes (62,8%) eram do sexo masculino e 26 (37,2%), do sexo feminino, com média etária de 56,7 anos, O tabagismo estava presente em 55 (78,6%) pacientes, (94,3%) dos tumores eram unilaterais e quatro (5,7%) bilaterais, com tamanho médio de 4,1cm ao exame físico. As complicações foram 14 (19%) casos de paresia e/ou paralisia facial, seroma em 10 (13,8%), síndrome de Frey em três (4%), hematoma em dois (2,7%) e infecção de ferida operatória em um (1,5%) caso. CONCLUSÃO: O tumor de Warthin tem maior incidência no sexo masculino, em tabagistas e localização unilateral predominante na glândula parótida. A parotidectomia superficial com preservação do nervo facial mostrou-se eficaz em 100% casos. As complicações encontradas foram paresias ou paralisias transitórias, seroma, síndrome de Frey, hematoma e infecção de ferida operatória.

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“…Reports have suggested enucleation 6,14 , partial / selective parotidectomy 20,26 , superficial parotidectomy 13,25 and total parotidectomy 1 as the treatment of choice. The recurrence rates following these various treatment modalities has been reported to vary between 0 and 25% and has often been analysed with respect to the extent of surgical excision.…”

Section: Discussionmentioning

confidence: 99%

“…Warthin's tumour (adenolymphoma, papillary cystadenoma lymphamatosum) has long attracted considerable attention, especially in relation to its aetio-pathogenesis and management [1][2][3]5,13,14,20,[24][25][26][27] . It is the second most common parotid neoplasm and its frequency has been increasing in the last few decades 8,11 .…”

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confidence: 99%