OMFS-IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, University of Leuven, Leuven, Belgium; Oral and Maxillofacial Surgery Department, University Hospitals Leuven, Leuven, Belgium.
Oral and Maxillofacial Surgery Department, University Hospitals Leuven, Leuven, Belgium; Oral and Maxillofacial Surgery, AZ Nikolaas, Moerlandstraat 1, 9100 Sint-Niklaas, Belgium.
Int J Oral Maxillofac Surg. 2020 Feb;49(2):149-156. doi: 10.1016/j.ijom.2019.03.963. Epub 2019 Jul 31.
A clinicopathological review of parotid tumours treated surgically in two oral and maxillofacial surgery departments was conducted. The performance of fine needle aspiration cytology (FNAC) was also assessed. This retrospective study included 250 consecutive patients treated surgically for parotid gland-related tumours. Benign tumours (n=211, 84.4%) were more prevalent than malignancies (n=39, 15.6%). A predominance of pleomorphic adenoma (48.8%) was identified, and epithelial-myoepithelial carcinoma (3.6%) was the most common malignant tumour. Overall, the sensitivity and specificity of FNAC were 64% and 99%, respectively. Subgrouping resulted in sensitivity and specificity of 50% and 100% for clinically assisted FNAC versus, 72% and 99% for ultrasound guidance. Surgically, 31.6% underwent complete superficial parotidectomy and 28.4% underwent extracapsular dissection. Overall, facial nerve palsy was the most prevalent postoperative complication, affecting 29.2% (70/240); loss of function was transient in 21.2% (51/240) and permanent in 7.9% (19/240). Extracapsular dissection and superficial parotidectomy with facial nerve preservation were the treatments of choice when a benign tumour was suspected. Facial nerve palsy was quite frequent; treatment options however are scarce. Preoperative diagnostic workup using imaging and ultrasound-guided FNAC was essential in identifying malignancy so that surgical planning could be adapted.
对两个口腔颌面外科部门手术治疗的腮腺肿瘤进行了临床病理回顾。还评估了细针穿刺细胞学检查（FNAC）的性能。这项回顾性研究包括 250 例连续接受手术治疗腮腺相关肿瘤的患者。良性肿瘤（n=211，84.4%）比恶性肿瘤（n=39，15.6%）更为常见。多形性腺瘤（48.8%）占主导地位，上皮-肌上皮癌（3.6%）是最常见的恶性肿瘤。总体而言，FNAC 的敏感性和特异性分别为 64%和 99%。亚组分析显示，临床辅助 FNAC 的敏感性和特异性分别为 50%和 100%，超声引导的敏感性和特异性分别为 72%和 99%。手术方面，31.6%的患者行完整腮腺浅叶切除术，28.4%的患者行囊外解剖。总的来说，面神经瘫痪是最常见的术后并发症，影响 29.2%（70/240）；21.2%（51/240）的功能丧失是暂时的，7.9%（19/240）是永久性的。当怀疑为良性肿瘤时，囊外解剖和保留面神经的腮腺浅叶切除术是首选治疗方法。面神经瘫痪很常见；然而，治疗选择有限。术前使用影像学和超声引导 FNAC 进行的诊断性检查对于识别恶性肿瘤至关重要，以便调整手术计划。
