Lee Esther, Badger Christopher, Mamidi Ishwarya S, Benito Daniel A, Li Lilun, Goodman Joseph F, Thakkar Punam G, Joshi Arjun
Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, DC and Western University of Health Sciences, Pomona, CA, USA.
Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, DC, USA.
Ultrasound. 2022 May;30(2):158-161. doi: 10.1177/1742271X211030302. Epub 2021 Jul 21.
Warthin's tumor, also known as papillary cystadenoma lymphomatosum, is one of the most common benign salivary gland neoplasms. The current first-line treatment for Warthin's tumor is parotidectomy. However, surgical resection has the risk of complications including facial nerve weakness and Frey's syndrome. Recently, ultrasound-guided ethanol sclerotherapy (UGES) has been found to be efficacious in the treatment of a variety of head and neck lesions.
We present a patient with multifocal Warthin's tumor who was managed with partial parotidectomy and two cycles of ultrasound-guided ethanol sclerotherapy.
Ethanol sclerotherapy has been used as a minimally invasive alternative to surgical excision or observation alone for a variety of head and neck masses. To our knowledge, this is the first case presented in the literature where sclerotherapy was used in conjunction with a partial parotidectomy. Minimizing the extent of surgical resection can reduce the risk of facial nerve weakness and Frey's syndrome and negate the need for fat grafting for defect reconstruction.
UGES may serve as a safe and reliable procedure that can be performed in conjunction with partial parotidectomy for patients who wish to achieve definitive diagnosis while also minimizing the risk of complications associated with extensive parotidectomy.
沃辛瘤，又称乳头状囊腺瘤淋巴瘤，是最常见的涎腺良性肿瘤之一。目前沃辛瘤的一线治疗方法是腮腺切除术。然而，手术切除有包括面神经麻痹和味觉出汗综合征等并发症的风险。最近，超声引导下乙醇硬化治疗（UGES）已被发现对多种头颈部病变的治疗有效。
我们报告一例多灶性沃辛瘤患者，该患者接受了腮腺部分切除术和两个周期的超声引导下乙醇硬化治疗。
乙醇硬化治疗已被用作多种头颈部肿块手术切除或单纯观察的微创替代方法。据我们所知，这是文献中首例将硬化治疗与腮腺部分切除术联合应用的病例。尽量减少手术切除范围可降低面神经麻痹和味觉出汗综合征的风险，并消除缺损重建所需的脂肪移植。
对于希望获得明确诊断同时将广泛腮腺切除术相关并发症风险降至最低的患者，超声引导下乙醇硬化治疗可作为一种安全可靠的方法，与腮腺部分切除术联合进行。
