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1.
Artigo em Chinês | MEDLINE | ID: mdl-34304476

RESUMO

Angiosarcoma of the scalp is an aggressive tumor with a high rate of local recurrence and distant metastasis. We present two cases of metastasis in parotid region at the time of one year after radical surgery of scalp angiosarcoma. It is suggested that regional lymph nodes should be treated more aggressively at the first treatment, which may achieve better results or, at least, prolong the time to local recurrence and distant metastasis.


Assuntos
Neoplasias de Cabeça e Pescoço , Hemangiossarcoma , Neoplasias Cutâneas , Neoplasias de Cabeça e Pescoço/cirurgia , Hemangiossarcoma/cirurgia , Humanos , Recidiva Local de Neoplasia/cirurgia , Região Parotídea , Couro Cabeludo , Neoplasias Cutâneas/cirurgia
2.
BMJ Case Rep ; 14(6)2021 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-34140333

RESUMO

Dermatofibrosarcoma protuberans (DFSP) is a rare cutaneous tumour, accounting for less than 1% of malignant tumours of the head and neck region. This tumour rarely presents metastatic disease, but has a high recurrence rate. Therefore, wide surgical excision with microscopically free margins is the therapeutic gold standard. Only five cases are described in literature of this tumour arising in the parotid region, a site that presents challenges both in achieving a wide demolition and in reconstructing the resulting defect. Here we describe two cases of DFSP arising in the parotid region that were treated surgically, achieving microscopically free margins. Reconstruction of the vast skin defect was achieved by means of a supraclavicular artery island flap, with good functional and aesthetic results.


Assuntos
Dermatofibrossarcoma , Neoplasias Cutâneas , Dermatofibrossarcoma/cirurgia , Humanos , Margens de Excisão , Recidiva Local de Neoplasia , Região Parotídea , Neoplasias Cutâneas/cirurgia
3.
J Craniofac Surg ; 32(5): 1894-1897, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33538449

RESUMO

ABSTRACT: Osteolipoma is a benign neoplasm originating from the mesenchymal fat tissue cells and characterized by the presence of bone formation. In the head and neck district osteolipoma has been described as parapharyngeal, nasopharinx, submandibular gland, eyelid, floor of the mouth, and skull base lesion. Only 1 case of osteolipoma was reported as a neoplasm of the parotid region. Considering the rarity of the osteolipoma, our purpose was to describe the first case of totally intraparotid gland localization of osteolipoma and summarize and review the actual literature concerning the presence of this tumor in the region of major salivary glands. A 56-years-old male patient was treated for intraparotid osteolipoma. Surgical removal of tumor was done with a standard preauricular/cervical incision and blunt dissection. The facial nerve was identified and preserved completely. In the reviewed series, all cases were reported in adult patients with a relative long history of slow progression. According to our paper and the review of the literature, we can assess that Osteolipoma is an extremely rare lesion affecting the major salivary glands, which should be considered along with common salivary gland tumors in the differential diagnosis.


Assuntos
Lipoma , Tecido Adiposo , Adulto , Diagnóstico Diferencial , Nervo Facial , Humanos , Lipoma/diagnóstico por imagem , Lipoma/cirurgia , Masculino , Pessoa de Meia-Idade , Região Parotídea
4.
Auris Nasus Larynx ; 48(5): 1023-1025, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32536499

RESUMO

Migratory foreign body appeared to be bird feather, caused peritonsillar and periparotid abscess in a nine-month-old infant. Patient presented painful, tender and fluctuating red neck mass on the left neck region II, and refusal of oral intake, with no fever. Azithromycin was introduced four days before presentation for suspected urinary tract infection. ENT examination revealed left peritonsillar abscess; ultrasound confirmed periparotid abscess, MSCT verified both diagnoses. Under general anaesthesia, we performed abscess incision, after pus drainage, small foreign body spontaneously came through the wound. After washing it with saline, it appeared like a bird feather. Subsequently, peritonsillar abscess was incised and drained. After 24-hour postoperative care on pediatric intensive care unit, the patient continued three-day parenteral antibiotic treatment on the otolaryngology department; it was discharged with a recommendation to continue seven days of oral antibiotic therapy. Suggested mechanism was ingestion of bird feather from stuffed bedding, that got trapped in the tonsillar crypt. Afterwards, it started to migrate through the neck tissue. Households with children younger than three years should not have feather stuffed clothes or beddings.


Assuntos
Plumas , Migração de Corpo Estranho/diagnóstico por imagem , Tonsila Palatina/diagnóstico por imagem , Abscesso Peritonsilar/diagnóstico por imagem , Abscesso/diagnóstico por imagem , Abscesso/etiologia , Abscesso/terapia , Animais , Antibacterianos/uso terapêutico , Drenagem , Feminino , Corpos Estranhos/complicações , Corpos Estranhos/diagnóstico por imagem , Corpos Estranhos/terapia , Migração de Corpo Estranho/complicações , Migração de Corpo Estranho/terapia , Humanos , Lactente , Região Parotídea , Abscesso Peritonsilar/etiologia , Abscesso Peritonsilar/terapia , Tomografia Computadorizada por Raios X , Ultrassonografia
5.
J Reconstr Microsurg ; 37(3): 282-291, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33142333

RESUMO

BACKGROUND: Cancer involving the parotid gland region may originates from parotid parenchyma itself or from locoregional organs and in rare cases, the facial nerve (FN) has to be sacrificed during tumor resection. In these cases, cancer extension often goes beyond the parotid compartment and requires extensive local resection responsible for complex multitissular defects. The goals of reconstruction may be summarized in the following two components: (1) restoration of the volumetric tissue defect and (2) FN reconstruction. The aim of this study is to describe our surgical technique and our cosmetic results using the chimeric scapulodorsal vascularized nerve (SDVN) flap to reconstruct extensive maxillofacial defects associated with FN sacrifice. METHODS: All patients undergone an extensive maxillofacial resection with FN sacrifice and primarily reconstructed with a SDVN flap were included. We classified the maxillofacial defects into six groups based on the type of resection. Intraoperative data including flap composition, topography of FN injury, length of nerve gap, and number of nervous anastomosis were recorded. RESULTS: Twenty-nine patients were included. Mean follow-up was 38.7 months. The harvested flaps included the SDVN combined with different components according to the defect group. A satisfactory volumetric restoration was obtained in 93% of cases. The mean number of distal nervous anastomosis was 4.5. The length of the vascularized grafted nerve ranged from 7 to 10 cm. CONCLUSION: This is largest series presented in literature on primary FN reconstruction utilizing a vascularized nerve graft. We believe that the chimeric SDVN flap should be highly considered for these cases due to its versatility. The surgeon is able to use single donor site available soft and hard tissues components along with a vascular motor nerve graft, which offers a great length and number of distal branches, and easily matches with the extracranial FN trunk and its peripheral ramifications.


Assuntos
Retalhos de Tecido Biológico , Procedimentos Cirúrgicos Reconstrutivos , Face , Nervo Facial/cirurgia , Humanos , Região Parotídea
6.
JNMA J Nepal Med Assoc ; 59(244): 1307-1309, 2021 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-35199797

RESUMO

Eccrine acrospiroma is a benign tumor of skin and adnexa arising from eccrine sweat gland epithelium. It is usually solitary, slow growing tumor commonly affecting extremities. Rarely it affects head and neck region, and extremely rare in parotid region. Females are affected more often. Treatment of choice is wide local excision with adequate skin margins. Although benign this tumor is very notorious for recurrence after inadequate resection. We describe here a case of young male patient with recurrent eccrine acrospiroma over parotid region which was managed by wide local excision with primary repair with excellent results.


Assuntos
Acrospiroma , Neoplasias das Glândulas Sudoríparas , Acrospiroma/patologia , Acrospiroma/cirurgia , Feminino , Humanos , Masculino , Região Parotídea/patologia , Neoplasias das Glândulas Sudoríparas/diagnóstico , Neoplasias das Glândulas Sudoríparas/patologia , Neoplasias das Glândulas Sudoríparas/cirurgia
7.
Arq. bras. med. vet. zootec. (Online) ; 72(6): 2245-2251, Nov.-Dec. 2020. ilus
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1142291

RESUMO

The present report aimed to describe the main characteristics of the parotid salivary mucocele in an adult male rabbit, which presented with a painless fluctuating mass with fluid content. Owing to the need for repeated fluid drainage, surgical excision was the chosen mode of treatment. Preoperative evaluation included radiography and blood analysis. The patient underwent surgical excision of the affected gland. Inhalation anesthesia was maintained by means of isoflurane and the cardio-respiratory parameters were monitored throughout the surgery. A bipolar electrocautery was used to assist in the incision and polyglactin 910 and nylon were the suture materials used in the wound closure technique. Post-operative medications included analgesics, anti-inflammatory agents and antibiotics. Histopathology of the excised glandular tissue revealed a mixed inflammatory infiltrate, fibroblasts, hemorrhage and hyperemia. The observations in this case suggest that surgical excision of the affected gland is the treatment of choice for the management of mucocele in companion rabbits, which has already been identified for other animals. Periodic acid-reactive Schiff staining confirmed the diagnosis of salivary mucocele. The complementary investigations helped to rule out the differential diagnosis and indicated a favorable prognosis, in view of the fact that the case was successfully resolved without complications or recurrence.(AU)


O presente relato teve como objetivo descrever as principais características da mucocele salivar parotídea em um coelho macho adulto, que apresentou uma massa flutuante indolor e com um conteúdo líquido em seu interior. Devido à necessidade de repetidas punções deste fluido, optou-se pela excisão cirúrgica como forma de tratamento. A avaliação pré-operatória incluiu radiografias e análises sanguíneas. O paciente foi submetido ao tratamento cirúrgico com excisão da glândula afetada. A anestesia inalatória foi mantida com isoflurano e os parâmetros cardio-respiratórios foram monitorados durante a cirurgia. Um eletrocautério bipolar foi utilizado para auxiliar na incisão e os fios poliglactina 910 e nylon foram utilizados na técnica de sutura. As medicações pós-operatórias incluíram agentes analgésicos, anti-inflamatórios e antibióticos. A histopatologia do tecido glandular removido revelou infiltrado inflamatório misto, fibroblastos, hemorragia e hiperemia. As observações neste caso sugerem que a remoção cirúrgica da glândula afetada seja o tratamento de escolha no manejo da mucocele em coelhos de companhia, o que já vem sendo identificado para outros animais. A coloração do ácido periódico reativo de Schiff confirmou o diagnóstico da mucocele salivar. Os exames complementares ajudaram a excluir as doenças que fazem parte do diagnóstico diferencial e indicaram um prognóstico favorável, tendo em vista o fato que este caso foi resolvido com sucesso, sem complicações ou recorrência.(AU)


Assuntos
Animais , Masculino , Coelhos , Glândulas Salivares/cirurgia , Região Parotídea/cirurgia , Mucocele/veterinária , Reação do Ácido Periódico de Schiff/veterinária
8.
Artigo em Chinês | MEDLINE | ID: mdl-33254303

RESUMO

Objective:To observe the disease spectrum of the parotid region lesions in children, and clarify the outcome and prognosis of the disease by analyzing of clinical data. Method:The basic information, clinical symptoms, diagnosis results, treatment, prognosis and follow-up of 170 cases with parotid region lesions were analyzed. Result:Among 170 cases of the parotid region lesions, 83 cases(48.82%) were congenital disease, 62 cases(36.47%) were vascular mass, 17 cases(10.00%) were benign or malignant tumor, and 8 cases(4.71%) were infectious disease; 108 cases of the patients were treated with surgery, 34 of them were treated with local bleomycin injection while 28 cases were treated with both surgery and local bleomycin injection. Two cases was cured by reoperation after recurrence and 1 case had facial paralysis but recovered after 3 months of follow-up. Conclusion:The most common diseases of parotid region lesions in children were congenital disease and vascular mass. Surgery combined with bleomycin local treatment is the main therapy in parotid area and has achieved remarkable results. Oral propranolol has certain therapeutic value for parotid region hemangioma.


Assuntos
Hemangioma , Neoplasias Parotídeas , Bleomicina , Criança , Humanos , Recidiva Local de Neoplasia , Glândula Parótida , Neoplasias Parotídeas/diagnóstico , Neoplasias Parotídeas/terapia , Região Parotídea , Estudos Retrospectivos
9.
Otolaryngol Pol ; 74(5): 1-5, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-33028736

RESUMO

<b>Objective:</b> The feasibility, surgical outcomes and possible risks and complications encountered during a facelift procedure for patients with parapharyngeal space (PPS) tumor were analyzed. <br><b>Method:</b> This retrospective analysis examined 10 patients who underwent surgery for PPS tumor using a facelift incision at our institutes between April 2015 and August 2019. <br><b>Results:</b> This study included four retro-styloid (benign nerve sheath tumor) and six pre-styloid tumors (pleomorphic adenoma). Mean tumor dimensions were 4.1 x 4.2 x 3.8 cm respectively. None of the patients needed conversion to conventional open resection. Transient sensory changes in the auricle occurred in 30% of the patients; however, all recovered within four months. In all the patients, postoperative scars were fully concealed by the auricle and hair. No recurrences were detected during a mean follow-up period of 16.6 months. <br><b>Conclusion: </b>The facelift procedure provides adequate visualization, workspace and excellent cosmetic results in properly selected cases.


Assuntos
Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Região Parotídea/cirurgia , Neoplasias Faríngeas/cirurgia , Ritidoplastia/métodos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
10.
Eur J Surg Oncol ; 46(11): 2035-2041, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32800595

RESUMO

INTRODUCTION: Data regarding regionally metastatic cutaneous squamous cell carcinoma of the head and neck (cSCCHN) is limited and derived almost exclusively from Australian and United States (US) institutions. We report the first United Kingdom perspective, with the aims of benchmarking survival outcomes and identifying clinically relevant prognosticators. MATERIALS AND METHODS: Ninety-one patients with regionally recurrent cSCCHN treated with curative intent over a ten-year period (2009-2018) were studied retrospectively. Time-to-event analyses were used to estimate oncological outcomes, and log-rank statistics and Cox proportional hazards models used to examine potential prognosticators. Receiver operating characteristics were also used to analyse the influence of nodal disease burden. RESULTS: Parotid involvement (with or without neck involvement) was most common (79.2%), and time to recurrence in those with parotid disease alone significantly shorter than for any other disease distribution (p = 0.034). Respective five-year overall, disease-specific, and disease-free survival estimates were 43.8%, 63.8%, and 36.2%. Extracapsular spread (ECS) portended reduced DFS and DSS (p = 0.012 and p = 0.005 respectively). Increasing nodal burden (≥4 involved nodes) also reduced DSS (p = 0.020), while parotid disease alone predicted more favourable DSS (p = 0.008). ECS and isolated parotid involvement remained significant on multi-variate analysis (p = 0.014 and p = 0.028 respectively). CONCLUSIONS: Oncological outcomes were unfavourable but broadly consistent with previous reports, notionally lending support to a more proactive approach in managing the clinically node negative neck/parotid in selected high-risk cases. Our data also support distinct parotid classification and consideration of involved lymph node number in future staging systems.


Assuntos
Extensão Extranodal/patologia , Linfonodos/patologia , Esvaziamento Cervical , Recidiva Local de Neoplasia/cirurgia , Procedimentos Cirúrgicos Otorrinolaringológicos , Radioterapia Adjuvante , Neoplasias Cutâneas/cirurgia , Carcinoma de Células Escamosas de Cabeça e Pescoço/cirurgia , Idoso , Idoso de 80 Anos ou mais , Intervalo Livre de Doença , Feminino , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Pescoço , Recidiva Local de Neoplasia/mortalidade , Recidiva Local de Neoplasia/patologia , Região Parotídea , Prognóstico , Modelos de Riscos Proporcionais , Neoplasias Cutâneas/mortalidade , Neoplasias Cutâneas/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/mortalidade , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Reino Unido
11.
J Equine Vet Sci ; 88: 102968, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32303329

RESUMO

The present study was performed on 12 heads of donkey's cadavers of both sexes for different anatomic techniques and on 20 live adult donkeys for ultrasonographic approaches of local anesthetic techniques. The aim was to achieve safe desensitization of the ear canal and tympanic membrane in addition to measuring different parameters of the structures occupying the infra-auricular parotid region. The internal auricular nerve was divided into two fine branches and constituting, at its origin, a characteristic V-shape with the caudal auricular nerve. The styloid process of auricular cartilage was an adequate landmark for ultrasonographic needle-guided anesthesia for internal auricular and auriculopalpebral nerves, whereas the great auricular nerve was easily palpated subcutaneously that showed safety and success in all cases. The auricular branch of mandibular nerve joined the auriculopalpebral branch of facial nerve. The maxillary vein was descending, partially embedded within the texture of the parotid glandular tissue. The parotid gland divided into five segments was clearly demarcated by maxillary vein tributaries with three main collecting radicles pouring into the parotid duct. The mandibular duct received about 12-15 fine radicles and supplied with a separate branch from the external carotid artery. Using the Doppler sonographic technique in donkeys for diagnosis of ear affections, evaluation of retrograde sialography to salivary glands with their blood vasculature and their indices might be helpful for the detection of different critical abnormalities, such as stenosis, thrombosis, and other vasopathological affections through measuring their resistivity and pulsatility indices.


Assuntos
Glândula Parótida , Região Parotídea , Animais , Equidae , Nervo Facial/diagnóstico por imagem , Feminino , Cabeça , Masculino , Glândula Parótida/diagnóstico por imagem
12.
Rev. esp. cir. oral maxilofac ; 42(1): 4-11, ene.-mar. 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-195292

RESUMO

INTRODUCCIÓN: La cirugía parotídea es una técnica muy habitual y presenta múltiples tipos de abordajes y métodos de reconstrucción. Las distintas opciones de reconstrucción primarias empleadas son el colgajo del sistema músculo aponeurótico superficial (SMAS), la rotación del músculo esternocleidomastoideo (ECM), injertos libres/microvascularizados o la utilización de biomateriales tipo Alloderm, entre otros. Se presenta nuestra experiencia en la utilización de injerto de grasa libre abdominal periumbilical para la reconstrucción primaria del defecto parotídeo. MATERIAL Y MÉTODOS: Se realiza un estudio observacional de las reconstrucciones con injerto de tejido graso libre abdominal en pacientes que precisaron la realización de una parotidectomía (superficial, total o radical) debida a una neoplasia parotídea primaria o a una recidiva tumoral. Los pacientes fueron intervenidos por el mismo cirujano entre mayo de 2013 y enero de 2019. El estudio analiza aspectos epidemiológicos y clínicos de los pacientes, los abordajes y el tiempo quirúrgico, la estancia hospitalaria, las complicaciones postquirúrgicas, las secuelas, el seguimiento clínico y el resultado estético de los pacientes. RESULTADOS: Un total de 22 pacientes fueron intervenidos con utilización de injertos de grasa abdominal tras una parotidectomía superficial conservadora, total o radical. Fueron trece hombres y nueve mujeres de edades entre 13 y 79 años (46 años de media), con el diagnóstico inicial realizado mediante punción aspiración por aguja fina (PAAF) y tomografía computerizada (TC) o resonancia magnética (RM). El resultado estético en todos los pacientes fue muy bueno o excelente. No secuelas a largo plazo ni síndrome de Frey. No complicaciones de interés, salvo leves hematomas y seromas postquirúrgicos. CONCLUSIÓN: Se presenta una técnica muy sencilla y con muy pocas complicaciones para la reconstrucción primaria de defectos postparotidectomía a través de mínimas incisiones con unos excelentes resultados estéticos


INTRODUCTION: Parotid surgery is a common technique with multiple approaches and reconstruction options. Primary reconstruction options are the superficial musculoaponeurotic system (SMAS) flap, the sternocleidomastoid muscle flap, free or microvascular grafts and biomaterials (Alloderm), among others. We present our experience in periumbilical abdominal free fat graft for primary reconstruction of the parotid defect. MATERIAL AND METHODS: A observational study was performed in patients requiring a parotidectomy (superficial, total or radical) due to a primary parotid neoplasm or tumor recurrence. In all cases were used a free abdominal fat graft. The patients were operated by the same surgeon between May 2013 and January 2019. The study analyzes epidemiological and clinical aspects, approach, surgical time, hospital stay, post-surgical complications, sequelae, clinical follow-up and aesthetic results. RESULTS: A total of 22 patients were incluyed after a conservative, total or radical superficial parotidectomy. Thirteen men and nine women aged between 13 and 79 years (46 years on average), with the initial diagnosis made by fine water aspiration puncture (FNA) and Computerized Tomography (CT) or Magnetic Resonance Imaging (MRI). Aesthetic result in all patients was excellent or very good. No long-term sequelae or syndromes Frey. No complications interest except minor postsurgical hematomas and seroma. CONCLUSIONS: A very simple technique with few complications is presented for the primary reconstruction of postparotidectomy defects with excellent aesthetic results


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Região Parotídea/cirurgia , Neoplasias Parotídeas/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Retalhos de Tecido Biológico , Gordura Abdominal/transplante , Resultado do Tratamento , Sudorese Gustativa/prevenção & controle
13.
Rev. esp. cir. oral maxilofac ; 42(1): 36-39, ene.-mar. 2020. ilus
Artigo em Inglês | IBECS | ID: ibc-195298

RESUMO

MASC is a salivary gland tumour which shares histological, immunologic and genetic characteristics with mammary secretory carcinoma including an ETV6 translocation and immunocytochemical positivity for S-100 protein, CK7, and mammaglobin as well as negativity for DOG1. This is a rare tumour with uncommon characteristics when compared to other salivary gland tumours. The case reported here is of a 28-year-old female patient who presented in the ER due to a palpable mass in the left parotid region. She underwent a superficial parotidectomy with using a mini-lifting approach, with tumour resection, followed by radiotherapy. The identified tumour shared most of the clinical characteristics with other cases of MASC described in the literature


CSAM es un tumor de glándula salival que comparte características histológicas, inmunológicas y genéticas con el carcinoma secretor mamario, que incluye una translocación ETV6 y positividad inmunocitoquímica para la proteína S-100, CK7 y mamaglobina, así como negatividad para DOG1. Este es un tumor raro con características poco comunes en comparación con otros tumores de glándulas salivales. El caso referido aquí es el de una paciente de 28 años de edad que se presentó en la sala de emergencias debido a una masa palpable en la región parotídea izquierda. Se sometió a una parotidectomía superficial con un abordaje de mini-lifting, con resección tumoral, seguida de radioterapia. El tumor identificado compartía la mayoría de las características clínicas con otros casos de CSAM descritos en la literatura


Assuntos
Humanos , Feminino , Adulto , Carcinoma Secretor Análogo ao Mamário/patologia , Neoplasias das Glândulas Salivares/patologia , Região Parotídea/patologia , Biópsia/métodos , Secretoglobinas/análise , Proteínas S100/análise , Fator de Transcrição GATA3/análise
14.
Eur Arch Otorhinolaryngol ; 276(11): 3185-3193, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31338575

RESUMO

PURPOSE: Periauricular sensory deficit occurs frequently after parotidectomy even in cases with preservation of the greater auricular nerve (GAN). This study was performed to evaluate the effects of antiadhesive agent in functional recovery of the GAN after parotidectomy. METHODS: Ninety-eight patients undergoing partial parotidectomy for benign parotid tumors were prospectively enrolled in this multicenter, double-blind randomized controlled study and randomly assigned to either the study or control group. Antiadhesive agent was applied in the study group. The results of sensory tests (tactile, heat, and cold sensitivity) and a questionnaire on quality of life (QoL) were acquired at postoperative 1, 8, and 24 weeks after surgery. Clinical parameters, and the results of the sensory tests and the questionnaire, were compared between the two groups. RESULTS: A total of 80 patients were finally enrolled. On sensory evaluation, tactile sensation and warm sensation in the ear lobule, and warm sensation in the mastoid area, showed significant improvement at 24 weeks postoperatively in the study group. There were no significant differences between the two groups on any questions in the QoL questionnaire, at any follow-up time point. CONCLUSIONS: Antiadhesive agents have some positive effects on functional recovery of the GAN after parotidectomy. Therefore, applying antiadhesive agents after parotidectomy can reduce discomfort in patients.


Assuntos
Agnosia , Plexo Cervical/lesões , Dissecação , Glândula Parótida/cirurgia , Neoplasias Parotídeas/cirurgia , Traumatismos dos Nervos Periféricos , Aderências Teciduais , Agnosia/diagnóstico , Agnosia/etiologia , Agnosia/terapia , Dissecação/efeitos adversos , Dissecação/métodos , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Glândula Parótida/patologia , Neoplasias Parotídeas/patologia , Região Parotídea/inervação , Região Parotídea/cirurgia , Traumatismos dos Nervos Periféricos/diagnóstico , Traumatismos dos Nervos Periféricos/etiologia , Traumatismos dos Nervos Periféricos/terapia , Recuperação de Função Fisiológica/fisiologia , Aderências Teciduais/etiologia , Aderências Teciduais/prevenção & controle , Resultado do Tratamento
15.
J Craniofac Surg ; 30(4): 1009-1011, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30882571

RESUMO

BACKGROUND: Superficial parotidectomy is standard surgical procedure for parotid gland tumor, and Frey syndrome and depressed deformity of the region are often seen as complications. In this study, we performed prevention of Frey syndrome by covering the residual parotid gland defect with the parotid gland fascia flap. METHOD: The subjects were 5 patients with parotid gland tumor. Tumor was localized in the inferior and superior poles of the parotid gland in 3 and 2 patients, respectively, and it was confirmed on preoperative diagnostic imaging that the tumor and parotid gland fascia were not present in close proximity. Through Lazy-S incision, main trunk of facial nerve was identified and conserved following the surgical procedure of normal superficial parotidectomy, and the superficial parotid gland containing tumor was elevated. A parotid gland fascia flap with a pedicle on the nasal side was prepared and the defect after superficial parotidectomy was covered with it. RESULTS: The facial nerve and resected parotid gland stump could be sufficiently covered with the parotid gland fascia flap in all patients. The mean duration of postoperative follow-up was 36 months (10 months-4 years and 5 months), and there were no complications such as tumor recurrence, Frey syndrome, salivary gland fistula, or severe concavity in the parotid region. CONCLUSION: Although application of the present procedure is limited to patients in whom the parotid gland fascia and tumor are not located in close proximity, it may be useful to prevent Frey syndrome because extension of incision is not necessary, the surrounding tissue is not sacrificed, the flap can be easily elevated, and the parotid gland stump can be sufficiently covered.


Assuntos
Fáscia/transplante , Glândula Parótida/cirurgia , Neoplasias Parotídeas/cirurgia , Complicações Pós-Operatórias/prevenção & controle , Retalhos Cirúrgicos , Sudorese Gustativa/prevenção & controle , Idoso , Nervo Facial/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Região Parotídea/patologia , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Sudorese Gustativa/etiologia
16.
Rev. odontol. Univ. Cid. São Paulo (Online) ; 31(2): [125-133], abr/jun 2019. il.
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1021708

RESUMO

A glândula parótida é uma glândula salivar maior, que abriga um feixe vasculonervoso e está situada no espaço parotídeo, um arcabouço ósseo e muscular. Ela pode ser avaliada por diferentes exames de imagem, principalmente pela ultrassonografia (USG), a tomografia computadorizada (TC) e a ressonância magnética (RM). Faz-se necessário o conhecimento de sua condição de normalidade para compará-la à de afecção, pois procedimentos cirúrgicos são frequentemente requeridos como meio de tratamento. A maioria dos pesquisadores e profissionais que manejam essa glândula referem a necessidade de estudos mais aprofundados, visto que o conhecimento acerca do assunto é limitado e suas patologias e manejo são pouco explorados e contraditórios na literatura


The parotid gland is a major salivary glands, which houses a neurovascular bundle and is situated in the parotid space, a bone and muscular framework. It can be assessed by different imaging tests, mainly by ultrasonography (USG), computed tomography (CT) and magnetic resonance imaging (MRI). Is knowledge necessary of its normal condition to compare it to the condition, since surgical procedures are often required as a means of treatment. Most researchers and professionals who handle this gland refer the need for further studies, since knowledge on the subject is limited and its pathologies and management are underexplored


Assuntos
Humanos , Masculino , Feminino , Adulto , Glândula Parótida , Ultrassonografia , Região Parotídea
18.
Rom J Morphol Embryol ; 59(3): 917-926, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30534834

RESUMO

Pilomatricoma is a benign skin tumor originating from the matrix cells of the hair follicles. Sometimes, its diagnosis can be difficult, especially in the preauricular region, where in the differential diagnosis, in addition to other dermal and subcutaneous masses, primary and secondary parotid gland tumor lesions must be also considered. A 34-year-old female was referred to our Institution with a right preauricular swelling over 12 months, which enlarged in the last two months. The ultrasonography confirms the origin of the tumoral mass in the skin of the preauricular region and not from the superficial lobe of the right parotid gland. The patient underwent complete tumor excision and the histopathology and immunohistochemical exams confirmed the diagnosis of a conventional pilomatricoma evolving to a late regressive lesion. She was discharged considered as cured and no recurrences were reported within a period of eight months of follow-up. This is the first reported case in the last 30 years, in this location, in the Department of Oral and Maxillofacial Surgery our Institution. Regarding the rarity of these tumors, especially in this location, we must keep in mind to consider a broader differential diagnosis that includes both tumoral and non-tumoral skin lesion and also parotid gland lesions.


Assuntos
Região Parotídea/anormalidades , Pilomatrixoma/diagnóstico , Adulto , Feminino , Humanos , Imuno-Histoquímica , Região Parotídea/patologia , Pilomatrixoma/patologia
19.
Shanghai Kou Qiang Yi Xue ; 27(4): 411-414, 2018 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-30483711

RESUMO

PURPOSE: To investigate the clinical features, diagnosis, and treatment, as well as prognosis of neurinoma in parotid region, in order to provide references for clinical treatment. METHODS: Fifty-two cases of neurinoma in parotid region treated between June 2000 to December 2013 were retrospectively investigated, including their clinical characteristics, imaging examination, diagnosis, therapies and prognosis. SPSS13.0 software package was used for Fisher's exact test. RESULTS: Nine cases (17.31%) in all had facial paralysis, discomfort and other neural symptoms before operation. Eleven cases(21.15%) was preoperatively diagnosed. All patients were treated with surgery, pathologically diagnosed and followed up for 42 months to 206 months. No recurrence and malignant transformation were found. Twenty-eight cases (53.85%) had symptoms of facial nerve injury postoperatively, but 18 cases (64.29%) were improved functionally. When there was no obvious correlation between the tumor and facial nerve, no facial nerve paralysis was found. When the tumor was located on the facial nerve, the rate of preserving facial nerve function was 22.22%, the rate of intracapsular enucleation of the neurinoma was 85.71%, and the effective rate of excision followed by facial nerve reconstruction was 85.71%. CONCLUSIONS: The diagnosis of neurinoma in parotid region is difficult and needed to be confirmed by postoperative pathology. The preservation of facial nerve function should be the utmost procedure during operation while intracapsular enucleation is the first choice. However, in order to restore the function of facial nerve, nerve reconstruction should be performed as soon as possible.


Assuntos
Neurilemoma , Neoplasias Parotídeas , Nervo Facial , Paralisia Facial/etiologia , Humanos , Recidiva Local de Neoplasia , Neurilemoma/complicações , Neurilemoma/terapia , Neoplasias Parotídeas/complicações , Neoplasias Parotídeas/terapia , Região Parotídea , Prognóstico , Estudos Retrospectivos
20.
Otolaryngol Pol ; 72(4): 9-16, 2018 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-30190441

RESUMO

INTRODUCTION: Parapharyngeal space (PPS) is the anatomical area lateral to the upper pharynx and clinically important due to PPS tumors. They account for less than 1% of head and neck neoplasms. Both benign and malignant neoplasms may arise there and typical for this localization is diversity of histological origin. Complete surgical excision is still the basis of treatment. AIM OF THE STUDY: Evaluation of the results of surgical treatment of PPS tumors in the Department of Otolaryngology at the Medical University over the period 2015-2017. MATERIAL AND METHODS: A retrospective analysis of medical records including complaints, physical examination, results of imaging studies, surgical approach, postoperative complication and histopathological results in 22 patients with a diagnosis of a PPS tumors. RESULTS: The most frequent complaints reported by the patients were: discomfort in the throat, dysphagia, hearing disorders and a palpable tumor on the neck. Asymptomatic course of the disease was demonstrated in 4 cases. All patients were treated surgically: 2 with transoral approach, 9 with transparotid-transcervical approach, 11 with transcervical approach. In most cases the tumor was removed radically. In 2 patients intracapsular tumor resection was performed. Based on histopathological examination the benign lesions dominated (18/22). In 4 cases malignant neoplasms were diagnosed: carcinoma ex pleomorphic adenoma, adenoid cystic carcinoma and two cases of squamous cell carcinoma. The most common origin of PPS tumors was deep lobe of parotid gland and for this group 11 patients had diagnosis of pleomorphic adenoma. Other diagnosis included: paraganglioma, neurofibroma, hemangioma, lymphangioma and rhabdomyoma. Postoperative complications occurred in 9 patients and presented as hoarseness and dysphagia due to paresis of the lower group of cranial nerves (IX, X, XII). Significant intraoperative bleeding during surgery occurred in 2 cases and ligation of the external carotid artery was necessary. CONCLUSION: Due to the anatomical topography of PPS and its content with the essential vessels and the lower group of cranial nerves, the surgical treatment of pathology of this area is still a challenge for head and neck surgeons. The decrease of voice quality and impaired speech and swallowing should always be considered as complications post the surgical resection in PPS.


Assuntos
Região Parotídea/cirurgia , Neoplasias Faríngeas/cirurgia , Complicações Pós-Operatórias/etiologia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pescoço/cirurgia , Procedimentos Cirúrgicos Otorrinolaringológicos , Neoplasias Faríngeas/patologia , Faringe/cirurgia , Estudos Retrospectivos , Resultado do Tratamento
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