Feasibility of Transoral Approach to Accessory Parotid Tumors

Mani, Suresh; Mathew, John; Thomas, Regi; Michael, Rajiv C

doi:10.7759/cureus.4003

Cited by 7 publications

(7 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, it is unclear if a transoral incision allows for a proper oncological resection as it is common to require endoscopic assistance. 4 Given the benign pathology diagnosed on FNA, the senior author felt the benefit of a transoral approach was significant and counseled the patient appropriately.…”

Section: Discussionmentioning

confidence: 99%

Transoral Excision of a Large Accessory Parotid Gland Tumor

2021

View full text Add to dashboard Cite

Accessory parotid gland (APG) tumors account for 1% to 7% of all parotid gland neoplasms but are more likely to be malignant than main parotid gland tumors. Management of APG neoplasms entails surgical excision. Four primary approaches to resection have been described in the literature with varying facial nerve outcomes. We report a case of a 4-cm APG pleomorphic adenoma utilizing a transoral approach for excision without postoperative facial nerve injury. A transoral approach is known to mitigate patients’ cosmetic concerns; however, prior reports utilized endoscopic assistance on patients with smaller tumors. We conclude that large APG tumors can be excised through a transoral approach without undue risk to the distal facial nerves, though this transoral approach ultimately may not be appropriate for malignant neoplasms or difficult dissections.

show abstract

Section: Discussionmentioning

confidence: 99%

Transoral Excision of a Large Accessory Parotid Gland Tumor

2021

View full text Add to dashboard Cite

show abstract

“…Accessory parotid gland (APG) tumours are rare, accounting for less than 10% of parotid neoplasms 1 . Approximately half are benign 2–4 . Pleomorphic adenoma's (PA) are most common 3,4 .…”

Section: Introductionmentioning

confidence: 99%

“…A sizable flap will be raised, with subsequent superficial parotidectomy performed. This approach requires extensive facial nerve dissection 1–3,5 . This technique poses significant risks, including but not limited to damage to the facial nerve, numbness, poor cosmetic result due to scarring and Frey's Syndrome.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Transoral approach to accessory parotid tumours: case series and literature review

Tescher

Dixon

2023

ANZ Journal of Surgery

View full text Add to dashboard Cite

Accessory parotid tumours are rare, accounting for less than 10% of parotid neoplasms. Although similar tumours affect both the accessory parotid and parotid, accessory parotid tumours are associated with higher rates of malignancy. Surgery is first line management. Standard surgical management involves a similar approach to superficial parotidectomy, despite the anterior location of these lesions. This approach requires extensive subcutaneous access and facial nerve dissection and therefore, poses significant risk. It can also result in poor cosmetic result due to scarring and Frey's Syndrome. On the contrary, a transoral approach to reduces the risk of cosmetic deformity, reduces recovery time and does not increase risk to the facial nerve. We present a case series of patients with accessory parotid masses, which have been successfully excised transoral and without endoscopic assistance.

show abstract

“…From the turn of the century, a standard face lift approach or modi ed Blair incision [16] or standard parotidectomy incision with anterior extension [18] has been used. A transoral approach is known to mitigate patients' cosmetic concerns [22,23], however, prior reports utilized endoscopic assistance on patients with smaller tumours [24]. The endoscopic-assisted technique has proven useful to achieve tumour resection while avoiding serious complications due to surgical procedures [25,26].…”

Section: Introductionmentioning

confidence: 99%

Rationale for increasing oncological vigilance in relation to clinical findings in accessory parotid gland- observations based on 2192 cases of the Polish Salivary Network Database

Wierzbicka,

Bartkowiak,

Pietruszewska

et al. 2023

Preprint

View full text Add to dashboard Cite

The accessory parotid gland (APG, Vth level) differs in histological structure from main parotid tissue. This gives rise to the hypothesis, mirrored in clinical observations, that the representation of tumours is different than in the rest of the gland. Aim To analyse the epidemiological and histological differences of parotid tumours located in regions I-V, with particular emphasis on the distinctiveness of region V. To define the epidemiological factors that will indicate the risk of histological malignancy from clinically benign appearance. Material and Method Multicentre prospective study conducted between 2017-2021 by five Head and Neck Surgery University Departments, cooperating within the Polish Salivary Network Database 1929 patients (1048 women and 881 men) were included. The age, gender, patient occupation, place of inhabitation, tumour size, clinical features of malignancy, histology, facial nerve (FN) paresis were analysed for superficial lobe (I_II), deep lobe (III_IV) and with special regard to the tumours affecting region V. Results 28 tumours were located exclusively in region V (1.45% total) and 72 tumours in region V with extension to neighbouring regions (3,7% total), characterized by significantly younger age and less frequent in retirees. In I-IV regions approximately 90% of tumours were benign, pleomorphic adenoma (PA) and Whartin tumour (WT) predominance. In region V PA exceed 75% but TW were casuistic (2/28). Incidence of malignancies in region V was 40% but clinical signs of malignancy were evident only in tumours>4 cm or in the presence of FN paresis. In 19% of patients with a benign appearance, imaging revealed malignancy, however in 38% of patients, the result remained false negative both in terms of clinical and radiological features of malignancy. Logistic regression models in 28 patients with tumour located exclusively in region V vs 1901 other patients and the in 100 patients with V extension vs 1829 other patients showed no clinical symptoms of malignancy bind with final malignant tumor histology as a single variable or in combination with other variables. The logistic regression models obtained in this study shows strong linkage between tumor location and predictors (age, male gender and tumor diameter) and aimed to act as a good classifier. Conclusion Despite the very clear image of the mid-cheek tumour, easily accessible in palpation and ultrasound examination, it is necessary to improve the oncological vigilance and preoperative patient preparation.

show abstract

Feasibility of Transoral Approach to Accessory Parotid Tumors

Cited by 7 publications

References 11 publications

Transoral Excision of a Large Accessory Parotid Gland Tumor

Transoral Excision of a Large Accessory Parotid Gland Tumor

Transoral approach to accessory parotid tumours: case series and literature review

Rationale for increasing oncological vigilance in relation to clinical findings in accessory parotid gland- observations based on 2192 cases of the Polish Salivary Network Database

Contact Info

Product

Resources

About