• Archives of Craniofacial Surgery
• /
• v.17 no.2
• /
• pp.90-92
• /
• 2016

Pleomorphic adenoma is the most common type of salivary gland tumor and the most common tumor of the parotid gland. Because of its propensity for invasion, pleomorphic adenoma of the parotid requires superficial parotidectomy or total parotidectomy to minimize the risk of tumor recurrence. We report a case of pleomorphic adenoma of the parotid gland with repeated recurrences. A 23-year-old male patient presented with a protruding neck mass. Six years prior to this presentation, the patient had undergone superficial parotidectomy for the removal of pleomorphic adenoma of the right parotid gland at our institution. The patient experienced recurrence at 17 months after the initial resection, which required a total parotidectomy with partial resection of the facial nerve. Pathologic examination revealed histologic findings consistent with pleomorphic adenoma across the surgical specimen from all three of the operations. The patient suffered from facial nerve paralysis, with facial expressions partially recovered over a year.

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

• Korean Journal of Head & Neck Oncology
• /
• v.16 no.1
• /
• pp.37-41
• /
• 2000

Background and Objectives: The most commonly used incision for parotidectomy is modified Blair incision, but it has unsatisfactory cosmetic result due to long exposed scar in the neck. Therefore, we introduce an alternative approach with more acceptable scar named modified facelift incision. We report it's techniques, indications and disadvantages with our experiences. Materials and Methods: During the 1999, 15 patients were underwent parotidectomies using modified facelift incision. We studied the postoperative complications and the cosmetic results respectively. Results: There were 11 benign tumors, 3 malignant tumors, and 1 chronic inflammation. Total parotidectomy was performed in 2 malignant tumors and chronic parotitis patients. The others has superficial parotidectomy. In terms of operation field, there was no difference between classical incision and facelift incision. Partial facial nerve palsy was noted in 2 cases, who required sacrifice of branches of facial nerve because of malignant tumor invasion. There were no specific complications associated with this type of approach. Postoperative cosmetic results were satisfactory in all cases. Conclusion: Modified facelift incision provides better cosmetic result than conventional incision without narrowing of operation field. We believe that it is a safe alternative approach to all parotidectomy cases especially to women and patient with keloid skin. The only limitation of this incision is poor adaptability for combining neck dissection.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.35 no.5
• /
• pp.384-387
• /
• 2009

Tumors of the deep lobe of parotid gland are rare. These benign tumors have usually been treated by total parotidectomy, which has functional and esthetic side effects. Recently, there has been a trend for operations of parotid gland benign tumors to be less radical and selective deep lobe parotidectomy has been introduced. This technique preserves the superficial lobe and facial nerve when tumor is located in the deep lobe. Selective deep lobe parotidectomy preserves parotid salivary function, minimizes the incidence of facial nerve damage and gustatory sweating (Frey's syndrome) and improves cosmetic outcome. We report a case of pleomorphic adenoma of the deep lobe that was successfully treated by selective deep lobe parotidectomy with satisfactory result.

• Korean Journal of Head & Neck Oncology
• /
• v.23 no.2
• /
• pp.142-146
• /
• 2007

Objectives and Backgrounds : After parotidectomy, some of patients complain gustatory sweating, facial flushing and discomfort in the same area. A series of these symptoms are supposed to be caused by the aberrant regeneration of the secretory parasympathetic fibers to sweat glands and blood vessels of the skin following parotidectomy. In this study, we want to compare the efficacy of thermography to the Minor's starch-iodine test for determining the presence of Frey's syndrome. Materials and Methods : 48 patients who underwent total or superficial parotidectomy from March 2002 to December 2004 were selected for this study. A subjective clinical questionnaire and the objective Minor's starchiodine test were performed to evaluate the incidence of this syndrome. Total 21 patients were confirmed as positive Frey's syndrome and infrared thermography was performed for them. Result : Frey's syndrome occurred in 21 patients(43.8%). The average temperature of parotidectomy site and normal opposite area were $27.65^{\circ}C\;and\;26.41^{\circ}C$ respectively. Thermography showed temperature difference in 20 patient(95.2%) and the difference of temperature was statistically significant above $1.0^{\circ}C$(p<0.001). The severity of symptoms were related with the difference of temperature(p<0.05). Conclusion : Thermography is useful, non-invasive, simple and quantifying method to diagnose Frey's syndrome. Additionally, this geographic diagnosis is available to show the accurate area for botulinum toxin injection.

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

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

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

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.32 no.6
• /
• pp.588-591
• /
• 2010

Parotid deep lobe tumors usually has been treated by total parotidectomy. But there is functional and aesthetic side effects such as post parotidectomy depressions, variable aesthetic deformities, facial nerve injury and Frey's syndrome. Conservative limited deep parotidectomy may result in fewer side effect. Preservation of the superficial lobe for deep lobe tumors could decrease the incidence of complications without any problems in the treatment effect. Additionally, the parotid function preservation and cosmetic appearance after operation also satisfy both the patients and surgeons. We report a case of pleomorphic adenoma of the deep lobe which has been successfully treated by conservative deep parotidectomy.

• Korean Journal of Head & Neck Oncology
• /
• v.28 no.2
• /
• pp.122-124
• /
• 2012

Introduction : No drain technique during parotidectomy had been introduced to reduce postoperative morbidity and to minimize hospital stay in a few previous publications. Since the authors have applied this technique in select patients for several years, we wanted to evaluate the feasibility and usefulness of no drain parotidectomy. Material & Methods : We retrospectively reviewed the medical records of 96 patients who underwent superficial or total parotidectomy by one surgeon from May 2005 to July 2012. The decision on drain insertion was made by the operator at the end of the surgery. The patients were categorized as drain insertion group and no drain group. Results : The patients who have smaller tumors and benign lesions were more frequently chosen into no drain group. Hospital stay was shorter in no drain group than in drain insertion group. Although no drain group showed increased number of acute complications such as seroma and hematoma, the complications were mild and could be controlled easily at the outpatient clinic. Conclusion : No drain technique during parotidectomy could be done relatively safely in select patients and it could reduce hospital stay.