Rising incidences of Warthin's tumors may be linked to obesity: a single-institutional experience.

PURPOSE: Recently, there has been an increase in the number of reported Warthin's tumors, but few risk factors have been described for this benign tumor. Yet, smoking is the only evidently identified risk factor. Obesity and the metabolic syndrome are causally linked to or a risk factor for a variety of diseases. Therefore, we analyzed whether metabolic syndrome, including obesity, might influence the incidence of Warthin's tumors. METHODS: In this retrospective study, we evaluated 197 patients with Warthin's tumor. We assessed the tumor size, the body mass index (BMI), comorbidities related to the metabolic syndrome, and cigarette and alcohol consumption. Additionally, we evaluated several blood parameters and their influence. RESULTS: Warthin's tumor patients had a significantly higher BMI in comparison to patients with other benign parotid gland tumors (29.1 versus 26.2, p < 0.0001). The rate of metabolic syndrome-associated comorbidities was higher in Warthin's tumor patients (62.4% versus 35.2%, p < 0.0001). CONCLUSION: Our results might be the first step to recognize obesity and its consequences as a co-driver in the formation of Warthin's tumors. Nevertheless, further studies are requested to validate our results and to answer the question whether obesity or the metabolic syndrome are integrally linked to Warthin's tumors.

Cross-sectional study on the occurrence of Frey's syndrome following superficial parotidectomy or extracapsular dissection.

BACKGROUND: Most studies that examine postoperative outcomes after parotidectomy in patients with benign parotid gland tumors are based on retrospective chart reviews. Data about long-term results in patients with parotid gland surgery with patient contact are still sparsely published. METHODS: During the period of 1960-2005, a total of 127 patients underwent either extracapsular dissection (ECD) or superficial parotidectomy (SP) and were available for interview. Patients were questioned about their postoperative outcome after parotid gland surgery. RESULTS: The mean follow-up was 21.5 years. A total of 42 and 85 patients underwent ECD and SP, respectively. No significant differences were observed in the rates of permanent facial paralysis (SP 1.2% vs. ECD 7.1%; p = 0.1053) or recurrence (SP 4.7% vs. ECD 11.9%; p = 0.1557), and Frey's syndrome was diagnosed only after SP (10.6% vs. 0% after ECD, p = 0.0293). Frey's syndrome was detected more often compared to retrospective chart analysis. CONCLUSION: We conclude that Frey's syndrome is underdiagnosed after SP without standardized follow-up examinations. Long-term follow-up should be applied to detect and treat gustatory sweating.

Extracapsular dissection versus superficial parotidectomy in benign parotid gland tumors: The Vienna Medical School experience.

BACKGROUND: The purpose of this study was to evaluate the clinical outcome in patients with benign parotid gland tumors after extracapsular dissection or superficial parotidectomy (SP). METHODS: Eight hundred ninety-four patients with primary pleomorphic adenoma or Warthin's tumor were included from this study. Type and length of surgery, tumor size, resection margins, and complication rates were assessed. RESULTS: Three hundred ninety-five (44.2%) extracapsular dissections and 499 SPs (55.8%) were performed. The rate of positive margins was significantly higher in the extracapsular dissection compared to the SP group (29.4% vs 10.2%; p < .0001). Recurrent disease (extracapsular dissection = 7.2% vs SP = 2.2%; p = .0003) and permanent facial palsy were significantly more frequent after extracapsular dissection than SP (2.2% vs 0.6%; p = .0396). Significant prolonged surgery time was observed after SP (146 vs 94 minutes; p < .0001). CONCLUSION: Because extracapsular dissection led to a significantly higher percentage of permanent facial palsy, recurrent disease, and positive resection margins compared to SP, we recommend SP for treating benign parotid gland tumors. © 2016 Wiley Periodicals, Inc. Head Neck 39: 356-360, 2017.

Influence of a revision course and the gender of examiners on the grades of the final ENT exam--a retrospective review of 3961 exams.

UNLABELLED: Revision courses should repeat already acquired knowledge and skills and mostly provide a basis for passing the following exam. AIM: The aim of the study is to investigate the influence of a previously attended revision course on the grades achieved in a final exam (Ear, Nose and Throat Diseases). Additionally we ask the question whether the gender of the examiners plays a role concerning the marks or not. METHODS: 3961 exams at the Department of Ear, Nose and Throat (ENT) Diseases in Vienna were investigated, 725 with revision course (experimental group) and 3236 without previous revision course (comparison group). The revision courses were performed in a standardized way concerning form and content, interactive and case based. Both groups were examined uniform in regard to topics and time duration. 16 male and 6 female examiners were involved. The grading followed a five-level scale. The examination marks were calculated in the arithmetic mean and median value for the entire sample, gender dependence was calculated according to the Wilcoxon-Mann-Whitney-Test. The inferential statistics included single- and multiple factorial analyses of variance as well as uni- and multivariate regression models. RESULTS: The experimental group achieved a grade average of 2.54 compared with 2.46 for the comparison group. Splitting up into male and female examiners, an average of 2.54 and 2.58 resp. for the experimental group and 2.44 and 2.61 resp. for the comparison group resulted. Female examiner marked significantly lower grades in comparison to their male colleagues (P= 0.001926). CONCLUSIONS: The ENT revision course did not improve the grade averages of the final ENT exam. Female examiners grade stricter than male examiners. There was no difference concerning grades 4 (pass) and 5 (fail) but female examiners grade less with mark 1.