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He JL, Zhou XE, Cao C, Tang HY, Jia BL, Dong YT, Sun Y, Zhu GQ. Endoscope-assisted transoral procedure of accessory parotid gland tumor resection. Laryngoscope 2025; 135:1423-1426. [PMID: 39504350 DOI: 10.1002/lary.31887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Revised: 09/19/2024] [Accepted: 10/14/2024] [Indexed: 11/08/2024]
Abstract
In the present study, we presented the detailed procedure and experience of endoscope-assisted transoral procedure of accessory parotid gland (APG) tumor resection. The surgical steps and tips were described and summarized clearly in our video. Laryngoscope, 135:1423-1426, 2025.
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Affiliation(s)
- Jia-Lu He
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xue-Er Zhou
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Chang Cao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - He-Yi Tang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Bao-Lin Jia
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yong-Tao Dong
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yan Sun
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Gui-Quan Zhu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Aoki K, Tosa M, Akiyama G, Ogawa R. Subcutaneous Pleomorphic Adenoma in an Accessory Parotid Gland in the Cheek. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e6211. [PMID: 39364280 PMCID: PMC11446589 DOI: 10.1097/gox.0000000000006211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Accepted: 08/14/2024] [Indexed: 10/05/2024]
Abstract
The accessory parotid gland (APG) is a distinct salivary tissue in the cheek that is located on the masseter muscle and is separate from the main parotid gland. APG tumors (APGTs) are rare. Due to aesthetic reasons and the risk of both malignancy and recurrence, APGTs are best treated with surgical resection. The resection should be conducted carefully due to potential complications such as Stensen duct and facial nerve injuries. Notably, plastic surgeons rarely see APGT cases because they are classified as parotid gland tumors and are thus mostly treated by otorhinolaryngologists. Nonetheless, because they are subcutaneous tumors in the cheek, patients with APGTs do occasionally visit the plastic surgery outpatient clinic. We report a case of APGT in a 59-year-old woman. She presented in our hospital with a rigid mass in the right cheek that was difficult to diagnose on the basis of clinical findings. After magnetic resonance imaging, APGT was considered along with several other possibilities. However, it was only diagnosed after histopathology on the resected tissues. Thus, plastic surgeons treating subcutaneous tumors of the cheek should consider APGT in their differential diagnosis and seek an accurate preoperative diagnosis, because this will help avoid postoperative complications.
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Affiliation(s)
- Kenko Aoki
- From the Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School Hospital, Tokyo, Japan
| | - Mamiko Tosa
- From the Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School Hospital, Tokyo, Japan
| | - Gou Akiyama
- From the Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School Hospital, Tokyo, Japan
| | - Rei Ogawa
- From the Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School Hospital, Tokyo, Japan
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Wierzbicka M, Bartkowiak E, Pietruszewska W, Stodulski D, Markowski J, Burduk P, Olejniczak I, Piernicka-Dybich A, Wierzchowska M, Amernik K, Chańko A, Majszyk D, Bruzgielewicz A, Gazinska P, Mikaszewski B. 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. Cancers (Basel) 2024; 16:463. [PMID: 38275903 PMCID: PMC10814580 DOI: 10.3390/cancers16020463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/11/2024] [Accepted: 01/16/2024] [Indexed: 01/27/2024] Open
Abstract
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. The aim of the study was 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, multicentre prospective studies 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, and facial nerve (FN) paresis were analysed for superficial (I_II) and deep (III_IV) lobes and with special regard to the tumours affecting region V. Twenty eight tumours were located exclusively in region V (1.45% total) and seventy-two tumours were found in region V exhibiting extensions to neighbouring regions (3.7% total), characterised as significantly younger and less frequent in retirees. In I-IV regions, approximately 90% of tumours were benign, with pleomorphic adenoma (PA) and Whartin tumour (WT) predominance. In region V, PA exceeded 75% but WT were casuistic (2/28). Incidences 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, 38% of patients showed false negative results both in terms of clinical and radiological features of malignancy. Logistic regression models in 28 patients with tumours located exclusively in region V vs. 1901 other patients and in 100 patients with V extension vs. 1829 other patients showed no clinical symptoms of malignancy binding with final malignant tumour histology as a single variable or in combination with other variables. The logistic regression models obtained in this study show strong linkage between tumour location and predictors (age, male gender, and tumour diameter) and also aimed to function as a good classifier. Our conclusion is that, despite the very clear image of the mid-cheek tumour which is easily accessible in palpation and ultrasound examination, it is necessary to improve oncological vigilance and preoperative patient preparation.
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Affiliation(s)
- Małgorzata Wierzbicka
- Department of Otolaryngology, Regional Specialist Hospital Wroclaw, Research & Development Centre, 51-124 Wroclaw, Poland;
- Faculty of Medicine, Wroclaw University of Science and Technology, 50-370 Wroclaw, Poland
- Institute of Human Genetics, Polish Academy of Sciences, 01-447 Poznan, Poland
| | - Ewelina Bartkowiak
- Department of Otolaryngology and Laryngological Oncology, Poznan University of Medical Sciences, 61-701 Poznan, Poland;
| | - Wioleta Pietruszewska
- Department of Otolaryngology, Head Neck Oncology, Medical University of Lodz, 90-419 Lodz, Poland;
| | - Dominik Stodulski
- Department of Otolaryngology, Faculty of Medicine, Medical University of Gdansk, 80-210 Gdansk, Poland; (D.S.); (B.M.)
| | - Jarosław Markowski
- Department of Laryngology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-055 Katowice, Poland; (J.M.); (A.P.-D.)
| | - Paweł Burduk
- Department of Otolaryngology, Phoniatrics and Audiology, Collegium Medicum, Nicolaus Copernicus University, 87-100 Bydgoszcz, Poland; (P.B.); (M.W.)
| | - Izabela Olejniczak
- Department of Otolaryngology, Head Neck Oncology, Medical University of Lodz, 90-419 Lodz, Poland;
| | - Aleksandra Piernicka-Dybich
- Department of Laryngology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-055 Katowice, Poland; (J.M.); (A.P.-D.)
| | - Małgorzata Wierzchowska
- Department of Otolaryngology, Phoniatrics and Audiology, Collegium Medicum, Nicolaus Copernicus University, 87-100 Bydgoszcz, Poland; (P.B.); (M.W.)
| | - Katarzyna Amernik
- Department of Otolaryngology, Pomeranian University of Medicine, 70-204 Szczecin, Poland; (K.A.); (A.C.)
| | - Alicja Chańko
- Department of Otolaryngology, Pomeranian University of Medicine, 70-204 Szczecin, Poland; (K.A.); (A.C.)
| | - Daniel Majszyk
- Department of Otorhinolaryngology Head and Neck Surgery, Medical University of Warsaw, 02-091 Warsaw, Poland; (D.M.); (A.B.)
| | - Antoni Bruzgielewicz
- Department of Otorhinolaryngology Head and Neck Surgery, Medical University of Warsaw, 02-091 Warsaw, Poland; (D.M.); (A.B.)
| | - Patrycja Gazinska
- Biobank Research Group, Lukasiewicz Research Network—PORT Polish Center for Technology Development, Stabłowicka St., 147, 54-066 Wroclaw, Poland;
| | - Bogusław Mikaszewski
- Department of Otolaryngology, Faculty of Medicine, Medical University of Gdansk, 80-210 Gdansk, Poland; (D.S.); (B.M.)
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Lohmeier SJ, Heidel RE, Hechler BL. Does three-dimensional intraglandular location predict malignancy in parotid tumors? Int J Oral Maxillofac Surg 2023; 52:296-303. [PMID: 35791993 DOI: 10.1016/j.ijom.2022.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 06/19/2022] [Accepted: 06/22/2022] [Indexed: 10/17/2022]
Abstract
Tumors arising within the parotid encompass a heterogeneous mix of benign and malignant neoplasms and other tissue growths. The purpose of this study was to determine the association between the location of intraparotid masses and the risk of malignancy. A retrospective cohort study was performed of patients diagnosed with parotid tumors following open tumor excision. The primary predictor variable was the location of the epicenter of the tumor in three-dimensional space, as determined from preoperative imaging. Other variables were patient demographics and clinical parameters. The primary outcome variable was the final histopathologic diagnosis of a benign or malignant process. A χ2 analysis was performed to test for any significant associations between demographic, clinical, and radiographic factors in relation to the outcome, and backwards stepwise logistic regression analysis was used to control for variables. Both increasing age (P = 0.002) and the presence of local pain (P = 0.020) were associated with malignancy. Tumors located anterior to the posterior border of the retromandibular vein had 2.18 times higher odds of malignancy (95% confidence interval 1.13-4.21; P = 0.020). Multivariate regression analysis suggested that patient age, the presence of pain, and tumor location anterosuperiorly and superoinferiorly could all assist in determining the odds of malignancy.
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Affiliation(s)
- S J Lohmeier
- Department of Oral and Maxillofacial Surgery, San Antonio Military Health System, San Antonio, TX, USA
| | - R E Heidel
- Department of Surgery, University of Tennessee Medical Center, Knoxville, TN, USA
| | - B L Hechler
- Department of Surgery, Division of Plastic, Maxillofacial, and Oral Surgery, Department of Head and Neck Surgery and Communication Sciences, Duke University Medical Center, Durham, NC, USA.
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Stankevicius D, Petroska D, Zaleckas L, Kutanovaite O. Hybrid intercalated duct lesion of the parotid: A case report. World J Clin Cases 2022; 10:12358-12364. [PMID: 36483828 PMCID: PMC9724509 DOI: 10.12998/wjcc.v10.i33.12358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/10/2022] [Accepted: 10/13/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Intercalated duct lesions (IDLs) are considered relatively benign and rare tumors of salivary glands, that were only described recently. Their histopathological appearance may range from ductal hyperplasia to encapsulated adenoma with hybrid patterns of both variants. It is thought that IDLs may be the precursor for malignant proliferations, therefore their correct diagnosis remains crucial for proper lesion management. It is the first reported IDL case arising from the accessory parotid gland (APG), which stands for less frequent but higher malignancy rate tumor developmental area.
CASE SUMMARY A 24-years-old male with no accompanying diseases was referred to the hospital with a painless nodule on the right cheek. On physical examination, the stiff, immobile, and painless mass was palpable in the anterior portion of the right parotideomasseteric region, just superior to the parotid duct. Ultrasound examination demonstrated 1.5 cm × 1.0 cm hypoechogenic mass on the anterior part of the right parotid gland. Ultrasound-guided fine needle aspiration cytology, followed by liquid-based fine needle aspiration biopsy were performed. However, the results were uninformative. A contrast-enhanced magnetic resonance imaging (MRI) of the parotid was obtained, demonstrating a 1.5 cm × 1.0 cm × 0.5 cm tumor with high intensity capsule together with low intensity core in the very anterior part of right superficial lobe, situated in the APG. An MRI features were uncharacteristic to common parotid tumors, therefore surgical resection followed up. After histopathological examination, the final diagnosis of hybrid IDL was confirmed.
CONCLUSION Fine needle aspiration biopsy might not always be diagnostic, and given the malignant potential, the surgical resection of such lesion remains the treatment of choice.
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Affiliation(s)
- Dominykas Stankevicius
- Centre of Oral and Maxillofacial Surgery, Institute of Dentistry, Faculty of Medicine, Vilnius University, Vilnius LT-08217, Lithuania
| | - Donatas Petroska
- Department of Pathology, Forensic Medicine and Pharmacology, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius LT-03101, Lithuania
| | - Linas Zaleckas
- Centre of Oral and Maxillofacial Surgery, Institute of Dentistry, Faculty of Medicine, Vilnius University, Vilnius LT-08217, Lithuania
| | - Otilija Kutanovaite
- Department of Head and Neck Surgery and Oncology, National Cancer Institute, Vilnius LT-08660, Lithuania
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Biau J, Nutting C, Langendijk J, Frédéric-Moreau T, Thariat J, Piram L, Bellini R, Saroul N, Pham Dang N, O'Sullivan B, Giralt J, Blanchard P, Bourhis J, Lapeyre M. Radiographic-anatomy, natural history and extension pathways of parotid and submandibular gland cancers. Radiother Oncol 2022; 170:48-54. [DOI: 10.1016/j.radonc.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 01/27/2022] [Accepted: 03/06/2022] [Indexed: 11/16/2022]
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Romano A, Lo Faro C, Iaconetta G, Committeri U, Audino G, Salzano G, Maglitto F, Califano L, Dell'aversana Orabona G. Adenoid cystic carcinoma of accessory parotid gland: A case report and review of the literature. ORAL AND MAXILLOFACIAL SURGERY CASES 2020. [DOI: 10.1016/j.omsc.2020.100188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Pasick LJ, Tong JY, Benito DA, Thakkar P, Goodman JF, Joshi AS. Surgical management and outcomes of accessory parotid gland neoplasms: A systematic review. Am J Otolaryngol 2020; 41:102610. [PMID: 32580067 DOI: 10.1016/j.amjoto.2020.102610] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/07/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate surgical approaches and outcomes associated with accessory parotid gland neoplasms. DATA SOURCES MEDLINE, SCOPUS, and the Cochrane Central Register of Controlled Trials. REVIEW METHODS A systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was performed. Studies were included if they reported surgical management and outcomes of patients with accessory parotid gland neoplasms. RESULTS After screening 3532 records, 15 studies were included with a total of 187 patients. Benign tumors consisted of 61.5% of cases. External open, transoral, and preauricular endoscopic approaches were used for 82.3%, 11.3%, and 6.5% of cases, respectively. Accessory lobe resection alone, concurrent with partial parotidectomy, and concurrent with total parotidectomy were used in 54.8%, 43.0%, and 2.2% of cases, respectively. Complication rates were similar between histology groups (7.8% benign vs. 8.3% malignant, p = 0.82). Accessory lobe resection with concurrent partial parotidectomy had the lowest overall complication rate (6.3%). Resections limited to the accessory lobe were found to have an overall complication rate of 8.7%. CONCLUSION The results offer an overview of the surgical management and complications for accessory parotid gland tumors. Overall surgical complication rates found in these case series may be lower for management of accessory gland tumors than rates available in the literature for tumors within the main parotid gland.
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Affiliation(s)
- Luke J Pasick
- Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine, United States of America.
| | - Jane Y Tong
- Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, United States of America
| | - Daniel A Benito
- Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, United States of America
| | - Punam Thakkar
- Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, United States of America
| | - Joseph F Goodman
- Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, United States of America
| | - Arjun S Joshi
- Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, United States of America
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Huvenne W, De Vriese C, Bogaert J, Vermeersch H. Review of publications on the possible advantages of a direct cheek incision for accessory parotid gland masses. Br J Oral Maxillofac Surg 2020; 58:e248-e253. [PMID: 32847722 DOI: 10.1016/j.bjoms.2020.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Accepted: 08/03/2020] [Indexed: 11/30/2022]
Abstract
Lesions of the accessory parotid gland (APG) are rare and surgical management is generally under-discussed. The surgical approach should provide complete resection, while minimising complications and aesthetic complaints. The current study reviews recent publications on the surgical management of APG masses, and discusses the advantages, and limitations of, and our experience with, direct cheek incision. Papers on the surgical management of APG masses published in the last 10 years were systematically searched. Information was obtained regarding the surgical approach, type of excision, and postoperative complications. In the included studies, 253 APG masses were selected for analysis, whereof six were treated with the direct cheek incision. Although no local recurrence or postoperative complications were observed after this, the approach was usually not recommended due to a higher reported risk of recurrence and complications in older papers. More recent studies, however, indicate that the direct cheek incision should be considered as a valuable alternative to standard approaches in selected patients.
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Affiliation(s)
- W Huvenne
- Department of Head and Neck Surgery, University Hospital Ghent, Ghent, Belgium
| | - C De Vriese
- Faculty of Medicine, University of Ghent, Ghent, Belgium.
| | - J Bogaert
- Faculty of Medicine, University of Ghent, Ghent, Belgium
| | - H Vermeersch
- Department of Head and Neck Surgery, University Hospital Ghent, Ghent, Belgium; Department of Plastic and Reconstructive Surgery, University Hospital Ghent, Ghent, Belgium
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