Avaliação das complicações pós-operatórias em pacientes idosos submetidos à parotidectomia.

Júnior, Milton Sérgio Bohatch; Mendes, Ramon Alves; da-Silva, Amanda Fernandes Vidal; Lorenzini, Mariana Simonato; Dohler, Andre Wolf; Graciano, Agnaldo José

doi:10.1590/0100-6991e-20181896

Cited by 4 publications

(2 citation statements)

References 26 publications

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“…This confirmed by several studies [4]. the most common primary neoplasias were mucoepidermoid and adenoidecystic carcinomas [21,29]. In our series We found that mucoepidermoid carcinoma was the most common (27.9%), followed by carcinoma ex-pleomorphic adenoma (14.6%), adenoid cystic carcinoma (11.6%), acinic cell carcinoma (9.3%) and salivary duct carcinoma (7.4%).…”

Section: Cancer Therapy and Oncology International Journalsupporting

confidence: 89%

“…Recent studies have reported the accuracy rates of FNA for parotid masses ranging from 90%-95% [20]. Values of 62%-79% sensitivity and 98-100% specificity for diagnosis of malignant tumors were reported [21]. The accuracy of fine-needle aspiration ranges from 84%-97% in malignant tumors of the salivary gland [8] FNAC, with sensitivity 75%, 24, 25 has a relatively high risk of false results for malignant tumors [2] other reported, it is not possible to assess with 100% certainty the grade and histology of salivary gland tumour [1].…”

Section: Cancer Therapy and Oncology International Journalmentioning

confidence: 99%

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Management of Positive Cervical Lymph Nodes in Parotid Cancer

Zedan¹,

Aieat²,

Osama³

et al. 2021

CTOIJ

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Objective: Assessment the management of positive cervical lymph nodes in parotid cancer. Associated clinical symptoms, histological types, regional lymph node stage (n stage), occult metastasis, neck dissection by level, recurrence, neck irradiation. Methods. We carried out a retrospective analysis of 43 patient’s pathological positive lymph nodes metastatic from parodied cancer, who underwent neck dissection. treated in years 2010-2020, we analyzed the following parameters: age, sex, pT-Status, tumour size, skin invasion, facial nerve palsy, tumour fixation, extraparotid extension, localization, grade, histology, Distribution of T classification was: T3 (60%), and T4 (40%). Results: Mean patient age was 52 years, the most common location of cervical Nodes Met. was level II (72%), then III (49%) then I (42%), then IV (40%) and V (19%). The incidence was highest among patients with (27.9%) mucoepidermoid carcinoma was most common, followed by (14.6%) carcinoma ex-pleomorphic adenoma (9.3%) with acinic cell carcinoma (7%) with squamous cell carcinoma, (11.6%) with adenoid cystic carcinoma, (7.0%) with adenocarcinoma, (7.4%) salivary duct carcinoma, When classified by histological grade, 35% of patients with low/intermediate-grade versus 65.0% high-grade ., Pre-operative fine needle aspiration (83.7%) patients, Post-surgical irradiation was performed in all 43 patients (100%). The resection status (R) was Negative margins R0. (93%), lymphovascular space invasion (44.2%) and (25.6%) had perineural invasion. Skin invasion in (14%) patients, and (4.7%) had regional nodal recurrence (7%) patients with pN1, vs (93%) patients with pN2. Pathologically positive lymph node 4 (range: 1–8 Nodes) lymph nodes harvest 29(range, 23–41 lymph nodes)., Conclusion: modified Radical Neck Dissection with additional radiotherapy should be carried out in patients. Nodes positive parotied cancer especially High histological stage, advanced stage, perineural invasion, positive operative edge, a fixed mass with extra parotid extension facial-nerve paralysis and tumor pain in partied cancer.

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Section: Cancer Therapy and Oncology International Journalsupporting

confidence: 89%

Section: Cancer Therapy and Oncology International Journalmentioning

confidence: 99%

Management of Positive Cervical Lymph Nodes in Parotid Cancer

Zedan¹,

Aieat²,

Osama³

et al. 2021

CTOIJ

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The effect of fibrin sealant tissue glue in reducing post-operative collections following parotidectomy

Chudek

Wilkie

Hampton

et al. 2020

Eur Arch Otorhinolaryngol

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Reconstructive trends and complications following parotidectomy: incidence and predictors in 11,057 cases

Bovenzi

Ciolek

Crippen

et al. 2019

J of Otolaryngol - Head & Neck Surg

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BackgroundParotidectomy is a common treatment option for parotid neoplasms and the complications associated with this procedure can cause significant morbidity. Reconstruction following parotidectomy is utilized to address contour deformity and facial nerve paralysis. This study aims to demonstrate national trends in parotidectomy patients and identify factors associated with adverse postoperative outcomes. This study includes the largest patient database to date in determining epidemiologic trends, reconstructive trends, and prevalence of adverse events following parotidectomy.MethodsA retrospective review was performed for parotidectomies included in the ACS-NSQIP database between January 2012 and December 2017. CPT codes were used to identify the primary and secondary procedures performed. Univariate and multivariate analysis was utilized to determine associations between pre- and perioperative variables with patient outcomes. Preoperative demographics, surgical indications, and common medical comorbidities were collected. CPT codes were used to identify patients who underwent parotidectomy with or without reconstruction. These pre- and perioperative characteristics were compared with 30-day surgical complications, medical complications, reoperation, and readmission using uni- and multivariate analyses to determine predictors of adverse events.ResultsThere were 11,057 patients who underwent parotidectomy. Postoperative complications within 30 days were uncommon (1.7% medical, 3.8% surgical), with the majority of these being surgical site infection (2.7%). Free flap reconstruction, COPD, bleeding disorders, smoking, and presence of malignant tumor were the strongest independent predictors of surgical site infection. Readmission and reoperation were uncommon at an incidence of 2.1% each. The strongest factors predictive of readmission were malignant tumor and corticosteroid usage. The strongest factors predictive of reoperation were free flap reconstruction, malignant tumor, bleeding disorder, and disseminated cancer. Surgical volume/contour reconstruction was relatively uncommon (18%). Facial nerve sacrifice was uncommon (3.7%) and, of these cases, only 25.5% underwent facial nerve reinnervation and 24.0% underwent facial reanimation.ConclusionsThere are overall low rates of complications, readmissions, and reoperations following parotidectomy. However, certain factors are predictive of adverse postoperative events and this data may serve to guide management and counseling of patients undergoing parotidectomy. Concurrent reconstructive procedures are not commonly reported which may be due to underutilization or underreporting.

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Avaliação das complicações pós-operatórias em pacientes idosos submetidos à parotidectomia.

Abstract: parotid neoplasms present a differentiated profile in the elderly population, especially Warthin's tumor and squamous cell carcinoma. Hematoma and infection of the operative wound and facial nerve lesions were the most prevalent complications in the postoperative period.

Cited by 4 publications

References 26 publications

Management of Positive Cervical Lymph Nodes in Parotid Cancer

Management of Positive Cervical Lymph Nodes in Parotid Cancer

The effect of fibrin sealant tissue glue in reducing post-operative collections following parotidectomy

Reconstructive trends and complications following parotidectomy: incidence and predictors in 11,057 cases

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