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Parotis bezi tümörü nedeniyle ameliyat edilen olgularımızın retrospektif analizi

Yıl 2019, Cilt: 29 Sayı: 4, 163 - 168, 01.12.2019

Öz

Amaç: Parotis bezi tümörleri, tüm baş boyun tümörlerinin yaklaşık % 2-3' ünü oluşturmaktadır ve % 80-85' i benign natürdedir. Bu çalışmamızda, parotis kitlesi ile kliniğimize başvuran olguları retrospektif olarak inceleyerek; uygulanan cerrahi tedavileri, histopatolojik sonuçları, görülme oranlarını ve cerrahi sonrası komplikasyonları değerlendirmeyi amaçladık. Gereç ve Yöntem: Ocak 2013 ile Ocak 2019 tarihleri arasında, kliniğimize parotis kitlesi ile başvuran hastalar çalışmaya dahil edildi. Hastalar; cinsiyet, operasyon yöntemi, histopatolojik sonuçları ve post-operatif komplikasyonları açısından retrospektif olarak incelendi. Bulgular: 75 hastanın 52’ si erkek, 23’ si kadındı. Yaş ortalaması 49,7 min:23 max:94 σ:5.083 olarak tespit edildi. Cerrahi tedavi sonrası histopatoloji sonuçlarına göre olguların 62’ si benign % 82,5 , 13’ i habis % 17,5 idi. Selim tümör olarak en sık pleomorfik adenom 33 olgu saptandı. İkinci en sık selim tümör olarak ise Whartin tümörü olduğu görüldü 27 olgu . Cerrahi yöntem olarak 67 hastaya yüzeyel parotidektomi, 8 hastaya total parotidektomi uygulandı. İki olguda geçici fasiyal parezi, bir olguda tümör invazyonundan dolayı fasiyal sinirin rezeke edilmesine bağlı kalıcı fasiyal paralizi, bir hastada fasiyel sinirin bukkal dalından kaynaklanan sellüler schwannoma nedeniyle kalıcı parsiyel fasiyal paralizi, iki olguda ise post-operatif hematom izlendi. Sonuç: Parotis tümörlerinin tedavisi genel olarak cerrahidir. Histopatolojik tanı, tümörün evresi ve derecesi önemlidir. Gerektiğinde boyun diseksiyonu uygulanmalıdır.

Kaynakça

  • Spiro RH. Salivary neoplasms: overview of a 35 year expe- rience with 2807 patients. Head Neck Surg 1986; 8: 177-84.
  • Lunna MA. Pathology of tumors of the salivary glands. In: Thawley SE, Panje WR, Batsakis JG, Lindberg RD, editors. Comprehensive Management of Head and Neck Tumors. 2nd ed. Philadelphia: W.B. Sanders Company;1999:1106-46.
  • Guintinas-Lichius O, Klussmann JP, Wittekindt C, Stennert E. Parotidectomy for benign parotid disease at a university teaching hospital: Outcome of 963 operations. Laryngosco- pe 2006; 116: 534-40.
  • Eisele DW, Johns ME. Salivary gland neoplasms. In: Bailey BJ, Calhoun KH, Healy GB, Pillsbury III HC, Johnson JT, Tardy ME, Jackler RK, editors. Head and Neck Surgery-O- tolaryngology. 3rd ed. Lippincott Williams &Wilkins; 2001: 1279-97.
  • Lin CC, Tsai MH, Huang CC, et al. Parotid tumors: a 10- year experience. Am J Otolaryngol 2008;29: 94-100.
  • Junior AT, Almeida OP, Kowalski LP. Parotid neoplasms: analysis of 600 patients attended at a single institution. Braz J Otorhinolaryngol 2009; 75: 497-501.
  • Maddox PT, Paydarfar JA, Davies L. Parotiedtomy: a 17- year institutional experience at a rural academic medical center. Ann Otol Rhinol Laryngol 2012; 121: 100-3.
  • Schmidt RL, Hall BJ, Wilson AR, Layfield LJ. A systematic review and meta analysis of the diagnostic accuracy of fi- ne-needle aspiration cytology for parotid gland lesions. Am J Clin Pathol 2011; 136: 45-59.
  • Lin AC, Bhattacharyya N. The utility of fine needle aspira- tion in parotid malignancy. Otolaryngol Head Neck Surg 2007; 136: 793-8.
  • Batsakis JG, Sneige N, el-Naggar AK. Fine-needle aspirati- on of salivary glands: its utility and tissue effects. Ann Otol Rhinol Laryngol 1992; 101:185-8.
  • Tas A, Giran S, Yağız R, Yalçın Ö, Koten M, Adalı MK, Karasalihoğlu A. Parotis Bezi tümörü nedeniyle ameliyat edilen olguların cerrahi ve histopatolojik sonuçlarının de- ğerlendirilmesi. Trakya Univ Tıp Fak Derg 2009;26(2):43-8.
  • Inci E, Hocaoglu E, Kılıckesmez O, Aydın S, Cimilli T. Qu- antitative Diffusion-Weighted MR Imaging in the Diffe- rential Diagnosis of Parotid Gland Tumors: Is it a Useful Technique? Turkiye Klinikleri J Med Sci 2010; 30: 1339-45.
  • Brandwein MS, Huvos AG. Oncocytic tumors of majör sa- livary glands. A study of 68 cases with follow-up of 44 pa- tients. Am J Surg Pathol 1991; 15:514-28.
  • Carinci F, Farina A, Pelucchi S, Calearo C, Pastore A. Pa- rotid gland carcinoma: surgical strategy based on local risk factors. J Craniofac Surg. 2001;12:434-7.
  • Al Salamah SM, Khalid K, Khan IA, Gul R. Outcome of surgery for parotid tumours: 5-year experience of a general surgical unit in a teaching hospital. ANZ J Surg 2005; 75: 948-52.
  • O'Brien CJ. Current management of benign parotid tu- mors--the role of limited superficial parotidectomy. Head Neck 2003; 25: 946-52.
  • Bron LP, O'Brien CJ. Facial nerve function after parotidec- tomy. Arch Otolaryngol Head Neck Surg 1997; 123: 1091-6.
Yıl 2019, Cilt: 29 Sayı: 4, 163 - 168, 01.12.2019

Öz

Objective: Parotid gland tumors constitute about 2-3 % of all head and neck tumors and 80-85 % of them are benign compressions. In this study, we aimed to review the cases which were admitted to our clinic with parotid mass, retrospectively. We evaluated histopathological results of surgical treatment and incidence of postoperative complications.Material and Methods: Patients who were admitted to our clinic with parotid masses between January 2013 and January 2019 were included in the study. Patients were reviewed retrospectively in terms of age, sex, method of operation, histopathological results and postoperative complications.Results: 75 patients were composed of 52 males and 23 females. The average age was found as 49.7 min:23 max:94 σ:5.083 . According to their histopathology results, 62 of the patients was benign 82.5 % , and 13 of them was malignant 17.5 % . The most common benign tumor was pleomorphic adenoma 33 cases . The second most common solid tumor was Whartin tumor 27 cases . As a surgical technique, 67 patients underwent superficial parotidectomy, and only 8 patients underwent total parotidectomy. Transient facial paresis was seen in 2 cases, permanent facial paresis was seen in one patient due to resection of the nerve which was invaded by the tumor and permanent partial facial paralysis due to cellular schwannoma arising from the buccal branch of the facial nerve in one patient. Postoperative hematoma was observed just in one case.Conclusion: Generally, treatment for parotid tumor is surgery. Histopathological diagnosis, stage and grade of the tumors are important. Neck dissection should be performed if necessary

Kaynakça

  • Spiro RH. Salivary neoplasms: overview of a 35 year expe- rience with 2807 patients. Head Neck Surg 1986; 8: 177-84.
  • Lunna MA. Pathology of tumors of the salivary glands. In: Thawley SE, Panje WR, Batsakis JG, Lindberg RD, editors. Comprehensive Management of Head and Neck Tumors. 2nd ed. Philadelphia: W.B. Sanders Company;1999:1106-46.
  • Guintinas-Lichius O, Klussmann JP, Wittekindt C, Stennert E. Parotidectomy for benign parotid disease at a university teaching hospital: Outcome of 963 operations. Laryngosco- pe 2006; 116: 534-40.
  • Eisele DW, Johns ME. Salivary gland neoplasms. In: Bailey BJ, Calhoun KH, Healy GB, Pillsbury III HC, Johnson JT, Tardy ME, Jackler RK, editors. Head and Neck Surgery-O- tolaryngology. 3rd ed. Lippincott Williams &Wilkins; 2001: 1279-97.
  • Lin CC, Tsai MH, Huang CC, et al. Parotid tumors: a 10- year experience. Am J Otolaryngol 2008;29: 94-100.
  • Junior AT, Almeida OP, Kowalski LP. Parotid neoplasms: analysis of 600 patients attended at a single institution. Braz J Otorhinolaryngol 2009; 75: 497-501.
  • Maddox PT, Paydarfar JA, Davies L. Parotiedtomy: a 17- year institutional experience at a rural academic medical center. Ann Otol Rhinol Laryngol 2012; 121: 100-3.
  • Schmidt RL, Hall BJ, Wilson AR, Layfield LJ. A systematic review and meta analysis of the diagnostic accuracy of fi- ne-needle aspiration cytology for parotid gland lesions. Am J Clin Pathol 2011; 136: 45-59.
  • Lin AC, Bhattacharyya N. The utility of fine needle aspira- tion in parotid malignancy. Otolaryngol Head Neck Surg 2007; 136: 793-8.
  • Batsakis JG, Sneige N, el-Naggar AK. Fine-needle aspirati- on of salivary glands: its utility and tissue effects. Ann Otol Rhinol Laryngol 1992; 101:185-8.
  • Tas A, Giran S, Yağız R, Yalçın Ö, Koten M, Adalı MK, Karasalihoğlu A. Parotis Bezi tümörü nedeniyle ameliyat edilen olguların cerrahi ve histopatolojik sonuçlarının de- ğerlendirilmesi. Trakya Univ Tıp Fak Derg 2009;26(2):43-8.
  • Inci E, Hocaoglu E, Kılıckesmez O, Aydın S, Cimilli T. Qu- antitative Diffusion-Weighted MR Imaging in the Diffe- rential Diagnosis of Parotid Gland Tumors: Is it a Useful Technique? Turkiye Klinikleri J Med Sci 2010; 30: 1339-45.
  • Brandwein MS, Huvos AG. Oncocytic tumors of majör sa- livary glands. A study of 68 cases with follow-up of 44 pa- tients. Am J Surg Pathol 1991; 15:514-28.
  • Carinci F, Farina A, Pelucchi S, Calearo C, Pastore A. Pa- rotid gland carcinoma: surgical strategy based on local risk factors. J Craniofac Surg. 2001;12:434-7.
  • Al Salamah SM, Khalid K, Khan IA, Gul R. Outcome of surgery for parotid tumours: 5-year experience of a general surgical unit in a teaching hospital. ANZ J Surg 2005; 75: 948-52.
  • O'Brien CJ. Current management of benign parotid tu- mors--the role of limited superficial parotidectomy. Head Neck 2003; 25: 946-52.
  • Bron LP, O'Brien CJ. Facial nerve function after parotidec- tomy. Arch Otolaryngol Head Neck Surg 1997; 123: 1091-6.
Toplam 17 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Original Article
Yazarlar

İsa Özbay Bu kişi benim

Muhammet Fatih Topuz Bu kişi benim

Cüneyt Kucur Bu kişi benim

Fatih Oğhan Bu kişi benim

Aykut Ceyhan Bu kişi benim

Hüseyin Metineren Bu kişi benim

Yayımlanma Tarihi 1 Aralık 2019
Yayımlandığı Sayı Yıl 2019 Cilt: 29 Sayı: 4

Kaynak Göster

Vancouver Özbay İ, Topuz MF, Kucur C, Oğhan F, Ceyhan A, Metineren H. Parotis bezi tümörü nedeniyle ameliyat edilen olgularımızın retrospektif analizi. Genel Tıp Derg. 2019;29(4):163-8.