RESUMEN
OBJECTIVE: To assess the feasibility and advantages of submandibular sialoadenectomy under local anesthesia. STUDY DESIGN: Retrospective clinical study. SUBJECTS AND METHODS: Twenty patients with benign submandibular masses underwent submandibular sialoadenectomy. The procedure was carried out under local anesthesia (LA) in 12 patients and general anesthesia (GA) in 8 patients. The patient and tumor characteristics, as well as treatment outcome or complications, were compared between the two groups. RESULTS: There was no conversion from LA to GA. Nine patients in the LA group could be discharged as day-case surgery versus none in the GA group, P = 0.001. The postoperative hospital stay was also much shorter in the LA group: 0.4 day vs 2.0 days, P < 0.001. Postoperative vomiting occurred in only two of the eight patients of the GA group. Complication rate was similar. CONCLUSION: Submandibular sialoadenectomy under local anesthesia is feasible. It can shorten the hospital stay and facilitate day-case surgery.
Asunto(s)
Adenoma/cirugía , Anestesia Local , Procedimientos Quirúrgicos Otorrinolaringológicos/métodos , Neoplasias de la Glándula Submandibular/cirugía , Adenoma/patología , Adulto , Anciano , Estudios de Cohortes , Femenino , Hemangioma Cavernoso/patología , Hemangioma Cavernoso/cirugía , Humanos , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Estudios Retrospectivos , Sialadenitis/patología , Sialadenitis/cirugía , Neoplasias de la Glándula Submandibular/patología , Resultado del TratamientoRESUMEN
BACKGROUND: High-dose radioiodine therapy following total thyroidectomy is standard for patients suffering from differentiated thyroid carcinoma and contributes significantly to their favourable prognosis. Due to active iodine accumulation, high focal radiation doses are received by the salivary glands. PATIENTS/RESULT: Report on two patients, who received multiple high-dose radioiodine treatments because of a differentiated metastatic thyroid carcinoma. A few years later, they developed a mucoepidermoid carcinoma of the salivary glands. Due to the high cumulative radiation dose, radiation-induced secondary malignancies following radiation-induced sialadenitis appears likely, although no causal connection could be proven. CONCLUSION: Consistent protection of the salivary glands during radioiodine therapy as well as the follow-up of the many long-term survivors of differentiated thyroid carcinomas is desirable to further lower the salivary gland-related side effects and to detect secondary malignancies as early as possible.
Asunto(s)
Carcinoma Mucoepidermoide/diagnóstico , Neoplasias Inducidas por Radiación/diagnóstico , Neoplasias Primarias Secundarias/diagnóstico , Neoplasias de la Parótida/diagnóstico , Neoplasias de la Glándula Submandibular/diagnóstico , Neoplasias de la Tiroides/diagnóstico por imagen , Adulto , Carcinoma Mucoepidermoide/cirugía , Estudios de Seguimiento , Humanos , Masculino , Neoplasias Inducidas por Radiación/cirugía , Neoplasias Primarias Secundarias/cirugía , Glándula Parótida/efectos de la radiación , Glándula Parótida/cirugía , Neoplasias de la Parótida/cirugía , Radiografía , Radioterapia de Alta Energía , Reoperación , Glándula Submandibular/efectos de la radiación , Glándula Submandibular/cirugía , Neoplasias de la Glándula Submandibular/cirugíaRESUMEN
Case report of a 42 year old female, who received 14th-20th year of life six radioiodine therapies with altogether 19.2 GBq131I because of a papillary thyroid carcinoma. 17 years after the last therapy, she developed a histologically proven chronic radiogenic sialadenitis of the left submandibular gland. Further four years later, the right submandibular gland has been extirpated because of a mucoepidermoid carcinoma with infiltration of a regionary lymphatic node. Review of the previous published secondary-malignancies of the salivary glands after high-dose radioiodine therapies.