Yaşar Hüsamettin, Ozkul Haluk, Verim Ayşegül, Ilhan Emre, Kökten Numan, Dereci Gökçe
Department of Otolaryngology, Bezm-i Alem Valide Sultan Vakif Gureba Training and Research Hospital, Istanbul, Turkey.
Kulak Burun Bogaz Ihtis Derg. 2007;17(2):70-4.
We retrospectively evaluated patients who underwent surgery for parotid gland masses.
A total of 50 patients (25 females, 25 males; mean age 48.5 years; range 18 to 76 years) who underwent surgery for parotid gland masses were evaluated with regard to age, sex, preoperative diagnostic methods, histopathologic diagnoses, and surgical techniques.
Preoperative diagnostic studies included ultrasonography, fine-needle aspiration biopsy, computed tomography, and magnetic resonance imaging. Histopathological diagnoses were benign in 33 patients (66%), malignant in nine patients (18%), and tumor-like pathologies in eight patients (16%), the most common being pleomorphic adenoma (n=28, 56%), Warthin's tumor (n=4, 8%), and squamous cell carcinoma (n=4, 8%). Superficial and total parotidectomies were performed in 40 (80%) and 10 (20%) patients, respectively. Nine patients with malignant tumors also had neck dissection and postoperative radiotherapy. Mortality occurred in one patient with metastasis to the parotid gland. One patient with lipoma developed recurrence two years after surgery. Follow-up was five years in 28 patients (56%), three years in 12 patients (24%), and two years in five patients (10%). Complete and transient facial paralysis developed in 10 patients and five patients following total and superficial parotidectomy, respectively.
Superficial parotidectomy is the minimal surgery for parotid gland masses. If the deep lobe of the gland is involved, total parotidectomy should be performed with preservation of the facial nerve. In malignant tumors, neck dissection and postoperative radiotherapy should be added.
我们回顾性评估了接受腮腺肿块手术的患者。
对50例接受腮腺肿块手术的患者(25例女性,25例男性;平均年龄48.5岁;范围18至76岁)进行了年龄、性别、术前诊断方法、组织病理学诊断和手术技术方面的评估。
术前诊断研究包括超声检查、细针穿刺活检、计算机断层扫描和磁共振成像。组织病理学诊断为良性的有33例患者(66%),恶性的有9例患者(18%),肿瘤样病变的有8例患者(16%),最常见的是多形性腺瘤(n = 28,56%)、沃辛瘤(n = 4,8%)和鳞状细胞癌(n = 4,8%)。分别有40例(80%)和10例(20%)患者接受了浅叶和全腮腺切除术。9例恶性肿瘤患者还进行了颈部清扫和术后放疗。1例腮腺转移患者死亡。1例脂肪瘤患者术后两年复发。28例患者(56%)随访5年,12例患者(24%)随访3年,5例患者(10%)随访2年。全腮腺切除术后10例患者出现完全性和暂时性面瘫,浅叶腮腺切除术后5例患者出现面瘫。
浅叶腮腺切除术是腮腺肿块的最小手术方式。如果腺体深叶受累,应在保留面神经的情况下进行全腮腺切除术。对于恶性肿瘤,应增加颈部清扫和术后放疗。