이하선 양성종양에서 제한적 부분 이하선 절제술의 유용성

Role of Limited Partial Parotidectomy in the Management of Benign Parotid Tumors

  • 정성도 (단국대학교 의과대학 이비인후과학교실) ;
  • 안세영 (단국대학교 의과대학 이비인후과학교실) ;
  • 박병건 (건양대학교 의과대학 이비인후과학교실) ;
  • 이상준 (단국대학교 의과대학 이비인후과학교실) ;
  • 정필상 (단국대학교 의과대학 이비인후과학교실)
  • Jung, Sung-Do (Department of Otolaryngology, Head & Neck Surgery, College of Medicine, Dankook University) ;
  • An, Se-Young (Department of Otolaryngology, Head & Neck Surgery, College of Medicine, Dankook University) ;
  • Park, Byung-Kuhn (Department of Otorhinolaryngology, College of Medicine, Konyang University) ;
  • Lee, Sang-Joon (Department of Otolaryngology, Head & Neck Surgery, College of Medicine, Dankook University) ;
  • Chung, Phil-Sang (Department of Otolaryngology, Head & Neck Surgery, College of Medicine, Dankook University)
  • 발행 : 2011.05.27

초록

Objectives : There are many reports on attempts to minimize complications and recurrences of tumor by several techniques for benign parotid tumor resection. The purpose of our study is to find out meaning of procedure without identifying main trunk of facial nerve compared to conventional parotidectomy. Material and Methods : We classified 121 patients into two groups. Patients who were underwent superficial parotidectomy or partial superficial parotidectomy were included in idenitification group(IF group), and patients who were treated with conservative partial parotidectomy or extracapsular dissection without identification of main trunk of facial nerve were included in the non-identification group(NF group). We analyzed the location of tumor, operation time, mean drainage duration, complication, recurrence and cosmetic satisfaction in two groups. Results : NF group has shorter operation time and mean drainage duration than IF group, however there is no significant difference in complication and recurrence between two surgical techniques. The Cosmetic satisfaction was similar between two groups. Conclusion : Limited parotidectomy without finding main trunk of facial nerve may be reliable option for benign parotid tumors because it has advantages such as less operation time and mean drainage duration without increasing in recurrence or complication rate.

키워드

참고문헌

  1. Senn N. The pathology and surgical treatment of tumors. Philadelphia, PA: W.B. Saunders:1895. p.173.
  2. McFarland J. Three hundred mixed tumors of the salivary glands of which 69 recurred. Surg Gynecol Obstet. 1936;63:457-468.
  3. Bailey H. Treatment of tumours of the parotid gland with special reference to total parotidectomy. Br J Surg. 1941;28:237-246.
  4. Bailey H. Parotidectomy: Indications and results. BMJ. 1947; 1:404-407. https://doi.org/10.1136/bmj.1.4499.404
  5. Janes R. The treatment of tumours of the salivary glands by radical excision. CMAJ. 1940;43:554-559.
  6. Patey D, Thackray A. The treatment of parotid tumours in the light of a pathological study of parotidectomy material. Br J Surg. 1958;45(193):477-487. https://doi.org/10.1002/bjs.18004519314
  7. Helmus C. Conservative vs superficial parotidectomy for benign lesions of the parotid tail. Arch Otolaryngol Head Neck Surg. 1999;125(10):1166-1167. https://doi.org/10.1001/archotol.125.10.1166
  8. Iizuka K, Ishikawa K. Surgical techniques for benign parotid tumors: Segmental resection vs extracapsular lumpectomy. Acta Otolaryngol Suppl. 1998;537:75-81.
  9. Myssiorek D. Removal of the inferior half of the superficial lobe is sufficient to treat pleomorphic adenoma in the tail of the parotid gland. Arch Otolaryngol Head Neck Surg. 1999;125(10): 1164-1165. https://doi.org/10.1001/archotol.125.10.1164
  10. O'Brien CJ. Current management of benign parotid tumorsthe role of limited superficial parotidectomy. Head Neck. 2003; 25(11):946-952. https://doi.org/10.1002/hed.10312
  11. Papadogeorgakis N, Skouteris CA, Mylonas AI, Angelopoulos AP. Superficial parotidectomy: Technical modifications based on tumour characteristics. J Craniomaxillofac Surg. 2004;32 (6):350-353. https://doi.org/10.1016/j.jcms.2004.05.004
  12. Roh JL, Kim HS, Park CI. Randomized clinical trial comparing partial parotidectomy versus superficial or total parotidectomy. Br J Surg. 2007;94:1081-1087. https://doi.org/10.1002/bjs.5947
  13. Shemen LJ. Conservative vs superficial parotidectomy. Arch Otolaryngol Head Neck Surg. 1999;125(10):1166. https://doi.org/10.1001/archotol.125.10.1166
  14. Upton DC, McNamar JP, Connor NP, Harari PM, Hartig GK. Parotidectomy: Ten-year review of 237 cases at a single institution. Otolaryngol Head Neck Surg. 2007;136(5):788-792. https://doi.org/10.1016/j.otohns.2006.11.037
  15. Witt RL. Minimally invasive surgery for parotid pleomorphic adenoma. Ear Nose Throat J. 2005;84(5):308-311.
  16. Yamashita T, Tomoda K, Kumazawa T. The usefulness of partial parotidectomy for benign parotid gland tumors. A retrospective study of 306 cases. Acta Otolaryngol Suppl. 1993;500: 113-116.
  17. Dallera P, Marchetti C, Campobassi A. Local capsular dissection of parotid pleomorphic adenomas. International journal of oral and maxillofacial surgery. 1993;22:154-157. https://doi.org/10.1016/S0901-5027(05)80241-3
  18. Donovan DT, Conley JJ. Capsular significance in parotid tumor surgery: Reality and myths of lateral lobectomy. Laryngoscope. 1984;94(3):247-257.
  19. Gleave EN, Whittaker JS, Nicholson A. Salivary tumours-experience over thirty years. Clin Otolaryngol Allied Sci. 1979;4(4): 247-257. https://doi.org/10.1111/j.1365-2273.1979.tb01897.x
  20. Hancock BD. Clinically benign parotid tumours: Local dissection as an alternative to superficial parotidectomy in selected cases. Ann R Coll Surg Engl. 1999;81(5):299-301.
  21. McGurk M, Renehan A, Gleave EN, Hancock BD. Clinical significance of the tumour capsule in the treatment of parotid pl-eomorphic adenomas. Br J Surg. 1996;83:1747-1749. https://doi.org/10.1002/bjs.1800831227
  22. McGurk M, Thomas BL, Renehan AG. Extracapsular dissection for clinically benign parotid lumps: Reduced morbidity without oncological compromise. British journal of cancer. 2003;89:1610-1613. https://doi.org/10.1038/sj.bjc.6601281
  23. Natvig K, Soberg R. Relationship of intraoperative rupture of pleomorphic adenomas to recurrance: An 11-25 ear follow-up study. Head Neck. 1994;16(3):213-217. https://doi.org/10.1002/hed.2880160302
  24. Spiro RH, Koss LG, Hajdu S. Tumors of minor salivary origin. A clinicopathologic study of 492 cases. Cancer. 1973;31(1):117-129. https://doi.org/10.1002/1097-0142(197301)31:1<117::AID-CNCR2820310116>3.0.CO;2-7
  25. Spiro RH. Salivary neoplasms: Overview of a 35-year experience with 2,807 patients. Head Neck Surg. 1986;8(3):177-184. https://doi.org/10.1002/hed.2890080309
  26. Sungur N, Akan IM, Ulusoy MG, Ozdemir R, Kilinc H, Ortak T. Clinicopathological evaluation of parotid gland tumors: A retrospective study. The Journal of craniofacial surgery. 2002; 13:26-30. https://doi.org/10.1097/00001665-200201000-00004
  27. Woods JE, Chong GC, Beahrs OH. Experience with 1,360 primary parotid tumors. American journal of surgery. 1975;130: 460-462. https://doi.org/10.1016/0002-9610(75)90484-5
  28. Comoretto R, Barzan L. Benign parotid tumor enucleation a reliable oeration in selected cases. The Journal of laryngology and otology. 1990;104:706-708. https://doi.org/10.1017/S0022215100113684
  29. David M. Removal of the inferior half of the superficial lobe is sufficient to treat pleomorphic addenoma in the tail of the parotid gland. Acta Otolaryngol Head Neck Surg. 1999;125:1164-1165. https://doi.org/10.1001/archotol.125.10.1164
  30. Helmus C. Subtotal parotidectomy: A 10-year review(1985 to 1994). Laryngoscope. 1997;107:1024-1027. https://doi.org/10.1097/00005537-199708000-00003
  31. Wennmo C, Spandow O, Emgard P, Krouthen B. Pleomorphic adenomas of the parotid gland: Superficial parotidectomy or limited excision? The Journal of laryngology and otology. 1988; 102:603-605. https://doi.org/10.1017/S0022215100105845
  32. Gordon AB, Fiddian RV. Frey's syndrome after parotid surgery. American journal of surgery. 1976;22:154-157.
  33. Kim KW, Chang YH, Park CW, Lee HS, Kim SK. A Clinical study of salivary gland tumors. Korean J Head Neck Oncol. 1994;10:171-177.
  34. Yoo GH, Eisele DW, Askin FB, Driben JS, Johns ME. Warthin's tumor: A 40-year experience at The Johns Hopkins Hospital. Laryngoscope. 1994;104:799-803.
  35. Yu GY, Ma DQ, Liu XB, Zhang MY, Zhang Q. Local excision of the parotid gland in the treatment of Warthin's tumour. The British journal of oral & maxillofacial surgery. 1998;36:186-189. https://doi.org/10.1016/S0266-4356(98)90495-8
  36. Choi JW, Ju EJ, Kim WJ, Choi HY, Chu HR, Choi G, et al. Selection of surgical treatment for Warthin's tumors parotid: Experience in 20 cases. Korean J Otolaryngol. 1999;42:501-504.