• Korean Journal of Head & Neck Oncology
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• v.37 no.2
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• pp.51-55
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• 2021

Background/Objectives: Extracapsular dissection has the advantage of reducing complications by minimizing tissue loss of the parotid without intentionally exposing the facial nerve in patients with benign parotid tumor. However, there has been controversy over the surgical results. Thus, the surgical outcomes of extracapsular dissection for benign parotid tumor was compared to those of superficial parotidectomy. Materials & Methods: A retrospective chart review was conducted with 132 patients who received surgery for benign parotid tumor in our center from January 2014 to December 2018 retrospectively. Results: A total of 132 people were enrolled, with 62 people receiving extracapsular dissection, 38 people receiving partial superficial parotidectomy and 32 people receiving superficial parotidectomy. No significant difference was found between the three groups regarding complications such as facial nerve palsy, Frey's syndrome, or first bite syndrome. Operation time and hospital stay was significantly short in extracapsular dissection group. Conclusion: For well-selected cases, extracapsular dissection can be considered as an option for surgery of benign parotid tumor.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.2
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• pp.170-177
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• 2005

The pleomorphic adenoma is well recognized as the most common salivary neoplasm. We examined 49 patients who had received surgical excision of the pleomorphic adenoma from 1989 to 1998 with over 5 years follow-up period. We retrospectively evaluated the patients' age, sex, chief complaints, surgical methods, and recurrence or complication rates after analysis of one's clinical and surgical records. The results are as follows : 1. There were 15 cases in parotid gland, 23 cases in palate, 8 cases in submandibular gland, and 3 cases in cheek. The ratio of male to female was 1 : 1.13. The mean age was 44. The tumor of submandibular gland occurred in more younger age than that of other salivary gland. 2. In 15 patients of parotid pleomorphic adenoma, there was 1 case(6.7%, 1/15) of recurrence. That was transformed into the malignant pleomorphic adenoma after 4 years of first surgery. We performed superficial parotidectomy of 9 cases(56.2%, 9/16), total parotidectomy of 6 cases(37.5%, 6/16), and radical parotidectomy of 1 case(6.3%, 1/16). 3. We used the rotational Sternocleidomastoid muscular flap to cover the exposed facial nerve in 12 cases(75%) after parotidectomy(7 cases of superficial parotidectomy and 5 cases of total parotidectomy). We could see 3 cases(18.7%) of facial nerve palsy and 1 case(6.3%) of Frey's syndrome after parotidectomy. We examined Frey's syndrome in only 1 case which was not used SCM muscular flap after parotidectomy. 4. In 23 patients of palatal pleomorphic adenoma, there were 2 cases(8.7%) of recurrence. In recurrence cases, We performed re-excision after 4 and 5 years of first surgery, respectively. We preserved partial thin overlying palatal mucosa during tumor excision in 5 cases(20%), which were proved as benign mixed tumor in preoperative biopsy. That mucosa-preserved cases had thick palatal mucosa, did not show mucosa ulceration and revealed well encapsulated lesions in preoperative CT. 5. In palatal tumors, we could see the 13 cases(52%) of bony invasion in preoperative CT views and the 4 cases(16%) of oro-nasal fistula after tumor excision. In two cases of recurrence, one(20%, 1/5) was in palatal mucosa-preserved group and the other(5.5%, 1/18) was in palatal mucosa-excised group. 6. We excised tumors with submandibular glands in the all cases of submandibular pleomorphic adenoma. There was no specific complication or recurrence in these cases. 7. After excision of the cheek pleomorphic adenomas, we could not see any complication or recurrence.

• Korean Journal of Head & Neck Oncology
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• v.13 no.2
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• pp.221-227
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• 1997

The authors reviewed 106 cases of parotid gland tumor at Presbyterian Medical Center seen during the past 10 years between January, 1986 and December, 1995. The results were obtained as follows; 1) 86 cases(81.1%) were benign tumors and 20 cases(18.9%) were malignant tumors. 2) Overall male and female sex ratio was 1 : 1.4. 3) For benign tumors, the mean age was 47.9 and for malignant tumors, the mean age was 43.4. 4) Clinical manifestations in benign tumors were palpable mass in 86 cases(100%), pain in 6 cases(6.9%), facial nerve palsy in 2 cases(2.3%), lymphadenopathy in 1 case(1.2%); and in malignant tumors, palpable mass in 20 cases(100%), pain in 7 cases(35%), facial nerve palsy in 2 cases(10%) and lymphadenopathy in 3 cases(15%). Thus, the presence of pain, facial nerve palsy and lymphadenopathy suggest malignant tumors. 5) Operative procedures in benign tumors included superficial parotidectomy in 53 cases(61.6%), total parotidectomy in 10 cases(11.6%), local excision in 23 cases(26.7%); and in malignant tumors, superficial parotidectomy in 3 cases, total parotidectomy in 1 case, local excision in 1 case, superficial parotidectomy with supraomohyoid neck dissection in 6 cases, total parotidectomy with supraomohyoid neck dissection in 8 cases, total parotidectomy with radical neck dissection in 1 case. 6) Postoperative complications in benign tumors were transient facial nerve palsy in 14 cases, Frey's syndrome in 2 cases. In malignant tumors complications included transient facial nerve palsy in 3 cases and permanent facial nerve palsy in 1 case. 7) Pleomorphic adenoma was the most common benign parotid tumor and mucoepidermoid carcinoma was the most common malignant tumor. 8) In our review of 20 patients with malignant parotid tumors, all patients who received supraomohyoid neck dissection and postoperative radiation therapy remain alive from 1986 to 1995 years. Two deaths in this series were adenoid cystic carcinoma patients who failed to receive postoperative radiation therapy. These series of cases have been studied in order to determine whether supraomohyoid neck dissection and postoperative radiation therapy may have further therapeutic effect.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.40.1-40.7
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• 2015

Surgical procedures for parotidectomy had been developed to gain adequate approach, prevent morbidity of nerve, and give esthetic satisfaction. We performed two cases of parotidectomy through facelift incision. One case was reconstructed with superficial musculoaponeurotic system (SMAS) flap and sternocleidomastoid (SCM) muscle rotated flap at the parotid bed. In second case, same procedures were performed, but collagen membrane was additionally implanted for prevention of Frey's syndrome. After surgery, two cases showed esthetic results without neck scar and hollow defect on parotid bed area.

• Korean Journal of Head & Neck Oncology
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• v.2 no.1
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• pp.33-39
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• 1986

This is a clinical analysis of 24 cases of parotid gland tumor who were treated in the department of Surgery, Chonnam National University Medical School during the past 10years from January, 1976 to December, 1985. According to this analysis of total 24 cases, we concluded as follows; 1) 21 cases were benign tumors and 3 cases were malignant tumors. As the histopathological findings, benign tumor included 88%and malignant tumor 12%. Majority of benign tumor contained mixed tumor(86.7%), and the malignant tumor contained mucoepidermoid carcinoma (66.7%). 2) The peak age incidence was 40th in benign tumor and 50th in malignant tumor. 3) The chief complaints of patient was a painless mass and the duration of illness was average 5.2 years. 4) The mean size of mass was 4.5cm in diameter. 5) The surgical procedures were performed with excision 6 cases, superficial lobectomy 8 cases, wide excision with partial parotidectomy 4 cases, total parotidectomy 3 cases in benign tumors. In malignant tumors, total parotidectomy 2 cases and wide excision with partial parotidectomy 1 case were performed. 6) Major postoperative complications such as facial nerve palsy 7 cases (temporary ; 5 cases, permanent; 2 cases), Frey syndrome 1 case, seroma 1 case, hematoma 1 case, and wound infection 1 case were developed. The recurrence contained pleomorphic adenoma 1 case and mucoepidermoid carcinoma 1 case.

• Journal of Acupuncture Research
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• v.41 no.2
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• pp.121-128
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• 2024

This study presents a case of facial nerve injury that occurred after parotidectomy for a benign tumor of the parotid gland that improved with integrated Korean medicine (IKM). On June 24, 2023, the patient presented with facial nerve injury based on a facial nerve conduction study after parotidectomy, with a score of five on Yanagihara's unweighted grading system (Y-system) and a grade of five on the House-Brackmann facial grading scale (H-B scale). During the 15 days of admission, IKM treatments, including acupuncture, pharmacopuncture, moxibustion, herbal steam therapy, physiotherapy, herbal medicine, and thread embedding acupuncture treatment, were performed. After treatment, the strength of the orbicularis oculi, orbicularis oris, and masticatory muscles improved, with a Y-system score of 17 and an H-B scale of III. In conclusion, the findings of this study confirm the applicability and effectiveness of IKM in the treatment of facial paralysis following parotidectomy.

• Korean Journal of Head & Neck Oncology
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• v.32 no.1
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• pp.1-5
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• 2016

Objectives: Frey's syndrome is an infrequent complication after parotidectomy and its incidence varies from 23.5% to 50.8% in the literature. The objective of this study was to evaluate the actual incidence and clinical characteristics of Frey's syndrome. Methods: We analyzed 31 patients who underwent parotidectomy and serial Minor's starch-iodine test. The mean follow-up period was $66{\pm}26.1$ months (range, 24-118 months). The Frey's syndrome was analyzed using a questionnaire for the assessment of the subjective symptom and Minor's starch-iodine test for the objective measurement at 1, 3, 6, and 12 months after the surgery and then every 6 or 12 months. Minor's starch-iodine test was graded from 0 to 3 according to the area of discolorization. Results: Frey's syndrome occurred in 11 patients (35.5%) on the Minor's starch-iodine test. The mean onset of Frey's syndrome on the starch-iodine test was $13.6{\pm}10.4$ months after parotidectomy. Sixteen patients (51.6%) complained about gustatory sweating and flushing. The onset of the subjective symptom was $11.27{\pm}6.96$ months after the surgery. There was a significant correlation between the grade of the starch-iodine test and the severity of subjective symptoms (P <0.001). Various factors including size and location of tumor, incision method, and extent of parotidectomy did not correlate with the Frey's syndrome. Conclusion: The incidence of Frey's syndrome was 35.5% on the Starch-Iodine test, and the onset was about postoperative 13.6 months.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.6
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• pp.547-550
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• 2001

Acinic cell carcinoma is a rare salivary gland carcinoma, usually being found in the parotid gland and is uncommon in the other major and minor salivary glands. The tumor cells consist of either serous or mucous acinar cells with few ductal or myoepithelial cell elements. The tumor is a low-grade malignancy with slow growth potential. Surgical therapy depends on tumor size and the extent of infiltration into neighboring tissues. Superficial parotidectomy or total parotidectomy is the initial method of therapy in case of acinic cell carcinoma on parotid gland. When regional neck lymph nodes are involved, the operation is combined with a neck dissection, or with radiation therapy. In the short follow up period, acinic cell carcinoma has good prognosis with 5 year survival rate after surgery is over 80%. In the long-term follow-up, however, there is a tendency to increase in recurrence or metastasis. We experienced a case of acinic cell carcinoma of parotid gland in a 57-year-old female, so we report it with literatures review.

• Archives of Craniofacial Surgery
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• v.9 no.2
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• pp.97-100
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• 2008

Warthin's tumor is a benign neoplasm that most frequently occurs in the parotid gland. Warthin's tumor shows a tendency of bilateral occurrence, but most of bilateral tumors occur at different time. It usually affects older man and grows slowly. Surgical excision is appropriate treatment for patients with Warthin's tumor and rarely recurs after removal. We report a rare case of bilateral Warthin's tumor which detected at the same time. A 54-year-old man had painless, slowly growing masses on the both mandibular angles. The masses were detected ten years ago. CT scan, ultrasonographic evaluation and fine needle biopsy was performed for preoperative diagnostic study. Superficial parotidectomy was done one after the other at ten-day intervals. After excision, histological examination revealed a mixture of ductal epithelium and a lymphoid stroma. The overlying surface of lymphoid tissue was covered with epithelial cells that was abundant of eosinophilic cytoplasm. Both masses were diagnosed as Warthin's tumor. Postoperatively, the patient did well and had no evidence of recurrence of tumor for 2 years follow-up period. Authors experienced a rare case of bilateral Warthin's tumor which detected at the same time. We recommend stepwise superficial parotidectomy at one or two-week intervals as treatment of bilateral Warthin's tumor.

• Archives of Craniofacial Surgery
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• v.18 no.2
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• pp.132-136
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• 2017

Frey's syndrome and infra-auricular depressed deformities are the ones of the most common complications that can occur after total parotidectomy. We report 1 case of pleomorphic adenoma occurred in the deep lobe that obtained good results from using acellular dermal matrix (ADM) after total parotidectomy. A 24-year-old man visited the hospital with oval shape mass in right mandibular angle which of 4 cm in size was found in the deep lobe of right parotid gland from Magnetic resonance imaging scanning and a pleomorphic adenoma was suspected. A total parotidectomy was performed while preserving the facial nerve. The material known as ADM were placed in the depressed part from where the mass was removed, and the site was sutured. The surgery site was healed well without any complications such as Frey's syndrome or infra-auricular depressed deformities. The pathological result was confirmed as pleomorphic adenoma. In addition to these advantages, it does not have little potential of deformation by the gravity after the surgery, and there is no restraint on circulation, which makes fabrication free and each deformation into various shapes can be described as another advantage of the reconstruction using the ADM.