Murugan Raghunath Sambandam, Maniam Raghul, Dhanasekarapandiyan Vembar, Hariharan G
Department of Paediatric Surgery, Institute of Child Health and Hospital for Children, Madras Medical College, Chennai, Tamil Nadu, India.
J Indian Assoc Pediatr Surg. 2023 Sep-Oct;28(5):415-420. doi: 10.4103/jiaps.jiaps_100_23. Epub 2023 Sep 5.
Parotid gland lesions in children requiring surgical management are not common. Neoplastic lesions of the parotid glands are also less common. Parotid tumors in children have different characteristics from those that occur in adults. When they occur in the pediatric age group, malignancy has to be ruled out.
This is a retrospective study of children who presented to our institute, a tertiary care referral hospital for children <12 years, with parotid swellings during the 5-year period between April 2018 and March 2023. The children who underwent surgical management for parotid lesions, in the form of parotidectomy, were included in the study. Children who were treated by nonoperative management were excluded from the study.
Twelve children were included. Of the 12 children, three (25.0%) children had malignancy, four (33.33%) children had benign tumors, three (25.0%) children had vascular malformations, and the remaining two (16.67%) children had inflammatory etiology. All children underwent superficial/total parotidectomy, depending on the involvement of superficial and/or deep lobe. Of the three malignant parotid tumors, two were of mucoepidermoid carcinoma and one was myoepithelial carcinoma. One of the children with mucoepidermoid carcinoma had recurrence.
Facial nerve-sparing parotidectomy is the treatment for neoplastic and inflammatory lesions. Initially, lymphovascular tumors were treated aggressively with parotidectomy. Neck node dissection should be performed only in children with fine-needle aspiration cytology-confirmed nodal metastases during primary surgery. Adjuvant treatment may be required in selected cases.
需要手术治疗的儿童腮腺病变并不常见。腮腺肿瘤性病变也较少见。儿童腮腺肿瘤具有与成人不同的特征。当发生在儿童年龄组时,必须排除恶性肿瘤。
这是一项对2018年4月至2023年3月期间在我院(一家为12岁以下儿童提供三级医疗转诊服务的医院)出现腮腺肿胀的儿童进行的回顾性研究。接受腮腺切除术形式的腮腺病变手术治疗的儿童被纳入研究。接受非手术治疗的儿童被排除在研究之外。
纳入12名儿童。在这12名儿童中,3名(25.0%)儿童患有恶性肿瘤,4名(33.33%)儿童患有良性肿瘤,3名(25.0%)儿童患有血管畸形,其余2名(16.67%)儿童有炎症病因。所有儿童均根据浅叶和/或深叶受累情况接受了浅叶/全腮腺切除术。在3例恶性腮腺肿瘤中,2例为黏液表皮样癌,1例为肌上皮癌。1例黏液表皮样癌患儿出现复发。
保留面神经的腮腺切除术是治疗肿瘤性和炎性病变的方法。最初,对淋巴管瘤积极采用腮腺切除术治疗。仅在初次手术时细针穿刺细胞学确诊有淋巴结转移的儿童中进行颈部淋巴结清扫。在某些病例中可能需要辅助治疗。