Choi Hwan Jun, Lee Young Man, Kim Jun Hyuk, Tark Min Seong, Lee Jang Hyun
Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University, Cheonan, Republic of Korea.
J Craniofac Surg. 2012 Jan;23(1):165-8. doi: 10.1097/SCS.0b013e3182413f19.
Accessory parotid gland tissue has been described as salivary tissue adjacent to the Stensen duct that is distinctly separate from the main body of the parotid gland. Of all parotid gland tumors, 1% to 8% arise from the accessory parotid gland. Little is known about the accessory parotid gland, and it is seldom mentioned in the literature. Between 1999 and 2010, we have treated and followed 8 patients with tumors of the accessory parotid gland. There were 5 males and 3 females with a mean age of 35 years. They all presented with an asymptomatic cheek mass, and 4 of them underwent fine-needle aspiration. Ultrasound or computed tomographic scan was used in all patients. All the patients underwent surgical intervention with standard parotidectomy incision and anterior extension. The mean follow-up time was 44 months (range, 6-120 months). Seven patients had benign disease. Four cases were pleomorphic adenoma, and the remaining 3 benign cases were parotid cyst, basal cell adenoma, and hemangioma. Only 1 patient had a malignant tumor that was a lymphoepithelioma-like carcinoma. In 7 cases, wide excision (excision of mass and accessory lobe of the parotid gland) was done because of the intra-accessory parotid gland lesion. One patient had concomitant superficial parotidectomy because the tumor was located very close to and has involved the parotid gland proper. There was no serious postoperative complication and recurrence. Prudent preoperative diagnostic evaluation and meticulous surgical approach are the keys to successful management of midcheek lesions. A wide excision of the accessory lobe of the parotid gland can be a definitive surgery in case of solitary tumor with an intact parotid fascia, and wide excision with anterior approach through a standard parotidectomy incision is preferred to a direct incision over the mass.
副腮腺组织被描述为紧邻腮腺导管的唾液腺组织，与腮腺主体明显分开。在所有腮腺肿瘤中，1%至8%起源于副腮腺。人们对副腮腺了解甚少，文献中也很少提及。1999年至2010年期间，我们治疗并随访了8例副腮腺肿瘤患者。其中男性5例，女性3例，平均年龄35岁。他们均表现为无症状的颊部肿块，4例患者接受了细针穿刺活检。所有患者均进行了超声或计算机断层扫描。所有患者均采用标准腮腺切除术切口并向前延伸进行手术干预。平均随访时间为44个月（范围6 - 120个月）。7例患者为良性疾病。4例为多形性腺瘤，其余3例良性病例分别为腮腺囊肿、基底细胞腺瘤和血管瘤。只有1例患者患有恶性肿瘤，为淋巴上皮瘤样癌。7例患者因副腮腺内病变进行了广泛切除（切除肿块及腮腺副叶）。1例患者因肿瘤位置非常靠近并累及腮腺本身，同时进行了浅叶腮腺切除术。术后无严重并发症及复发。谨慎的术前诊断评估和细致的手术方法是成功处理颊部病变的关键。对于孤立性肿瘤且腮腺筋膜完整的情况，广泛切除腮腺副叶可以作为一种确定性手术，通过标准腮腺切除术切口从前路进行广泛切除优于在肿块上方直接切口。
