[Evaluation of harmonic scalpel assisted extracapsular dissection for benign parotid tumors].

PURPOSE: To investigate the clinical outcomes and prognosis of harmonic scalpel assisted extracapsular dissection for benign parotid tumors. METHODS: A total of 132 patients with full medical archives who were diagnosed as benign parotid tumors from 3 medical centers were retrospectively analyzed. The included patients were divided into 3 groups according to tumor positions, namely, superficial pre-auricular, superficial tail, and deep lobe. The intra- and peri-operative variables, complications, functional outcomes and recurrence rates were analyzed with SPSS 16.0 software package. RESULTS: The surgical and drainage time were longer and the blood loss and drainage amount were significantly greater in deep lobe group (P<0.01). Facial nerve damage occurred more frequently in deep lobe group (P=0.022), while damages of great auricular nerve and parotid fascia, as well as capsule rupture were similar among 3 groups (P>0.05). More patients with decreased sensation or sialocele were observed in deep lobe group (P=0.004, 0.043, respectively), and no significant differences were found for wound infection and Frey's syndrome among 3 groups (P>0.05).Transient facial nerve paralysis occurred more frequently in deep lobe group (P<0.01), while permanent facial nerve paralysis was similar (P=0.052). No significant difference was observed for tumor recurrence (P=1.000). CONCLUSIONS: HS-ECD displays good outcomes and prognosis for benign tumor of parotid gland, with improved esthetic and functional results as well as fewer complications and recurrence rate postoperatively.

[Clinical treatment and prognosis of 52 cases of neurinoma in parotid region].

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.