Daniel Sam J, Al-Sebeih Khalid, Al-Ghamdi Saleh A, Manoukian John J
Department of Pediatric Otolaryngology, Montreal Children's Hospital, McGill University, Montreal, PQ.
J Otolaryngol. 2003 Feb;32(1):51-4. doi: 10.2310/7070.2003.35392.
Nonmalignant parotid masses in children can have protean etiologies ranging from infective parotitis to a benign neoplastic, vascular, or congenital origin. We review the 10-year experience of a tertiary care pediatric centre with respect to the surgical management of nonmalignant parotid masses. In total, 15 patients with nonmalignant masses of the parotid gland region underwent surgery. Five children were diagnosed with lymphoepithelial cyst or first branchial cleft cyst. Three children were diagnosed with parotid abscess, one of whom had atypical mycobacteria. Other diagnoses included lymphangioma (three cases), chronic inflammation (two cases), and epidermoid cyst (one case). One patient who presented with a parotid cyst was diagnosed postoperatively with plexiform neurofibroma of the facial nerve. She was the only patient with postoperative facial nerve paresis, affecting the orbital branch. Presentation and postoperative complications of these surgically managed nonmalignant parotid masses are reviewed. The history and physical examination are of the utmost importance in predicting the diagnosis, although ultrasonography and computed tomography can be useful. Fine-needle aspiration cytology was not well tolerated by children and appears of little use as the accurate diagnosis was provided by the surgical pathology specimen.
儿童腮腺非恶性肿块病因多样，从感染性腮腺炎到良性肿瘤、血管性或先天性起源。我们回顾了一家三级儿科中心在腮腺非恶性肿块手术治疗方面的10年经验。共有15例腮腺区非恶性肿块患者接受了手术。5名儿童被诊断为淋巴上皮囊肿或第一鳃裂囊肿。3名儿童被诊断为腮腺脓肿，其中1例为非典型分枝杆菌感染。其他诊断包括淋巴管瘤（3例）、慢性炎症（2例）和表皮样囊肿（1例）。1例腮腺囊肿患者术后被诊断为面神经丛状神经纤维瘤。她是唯一出现术后面神经麻痹的患者，影响眶支。本文回顾了这些经手术治疗的腮腺非恶性肿块的临床表现及术后并发症。尽管超声和计算机断层扫描可能有用，但病史和体格检查对预测诊断至关重要。细针穿刺细胞学检查儿童耐受性差，由于手术病理标本能提供准确诊断，故其作用不大。
