The Change And Outcome Of Postoperative Residual Parotid Gland In Patients With Parotid Benign Tumor

Objective: To observe the change and outcome of postoperative residualparotid gland organization after modified superficial parotidectomy (Removesuperficial parotid gland and tumor, preserve facial nerve without ligation ofduct.) and conventional superficial parotidectomy (Remove superficial parotidgland and tumor, preserve facial nerve with ligation of duct) in patients withparotid benign tumor by following up and Imageology, in order to comparethe effect of different surgical methods and provide the theoretical evidencefor new surgical method.Methods:30patients with preliminary diagnosis of parotid benign tumorwere selected as the experiment group from January to June in2012.13women and17men were include in this group(male: female ratio is1.3:1),age ranged from12to74and average age is45.53. Routing parotid CT wasperformed to identify the size, border, and adjacent structure of tumor beforesurgery.30patients with parotid benign tumor were performed with themodified superficial parotidectomy (Remove superficial parotid gland andtumor, preserve facial nerve without ligation of duct) after the preoperativepreparation.30another patients performed with conventional superficialparotidectomy (Remove superficial parotid gland and tumor, preserve facialnerve with ligation of duct) were selected as the control group. We followedup two groups in3,6and12months after surgery respectively. Observationsinclude saliva secretion， temporary facial paralysis, salivary fistula, tastesweating syndrome (Frey’s syndrome), wound infection, the area concavedeformity and recurrence of tumor in3and6months after surgery. And40%iodized oil radiography and bilateral parotid CT scan were performed toobserve the change of residual parotid tissue and duct system in12monthsafter surgery. Result:1Follow-up results for patients with different surgical methods in3to6months after sugery.1.1Pathological pattern of The30patients performed with modifiedsuperficial parotidectomy include:20cases pleomorphic adenoma,7casesWarthin’s tumor,1case parotid sarcoidosis1case schwannoma and1caseadenoid cystic carcinoma. The minimum diameter of tumor was1㎝x0.8㎝x0.8㎝, and the maximum diameter was3.3㎝x3.7㎝x5.3㎝.1.2Through the data in the table we can see there were no significantdifferences in tumor recurrence,wound infection and temporary facialparalysis between modified and conventional superficial parotidectomy.However, the modified mothed is better than conventional method in tastesweating syndrome (Frey’s syndrome), the area concave deformity, salivaryfistula and dry mouth. Moreover, saliva secretion was observed in all thepatients performed with modified superficial parotidectomy.2the results of bilateral parotid iodine oil radiography and CT scan forpatients performed with modified superficial parotidectomy in12months aftersugery.We checked the patients before40%iodine oil radiography wereperformed and found that the saliva flowed out in operative parotid duct.Then angiography needle enter into the parotid catheter smoothly, the contrastagent which we injected were on average2ml. After parotid CT scan,radiography immediately showed that there is the residual parotid between theskin and flake iodine oil pool, iodine oil pool and residual parotid tissue areinterlinked and visible, the image of Stensen’s duct are normal, there are notnarrow, expansion and sausage-like changes can be seen branch duct andintercalated duct were not enhanced.Conclusion:1The residual parotid gland tissue still has a good secretion function aftermodified superficial parotidectomy (Remove superficial parotid gland andtumor, preserve facial nerve without ligation of duct.) 2The complications such as sweat taste syndrome (Frey’s syndrome), drymouth and area concave deformity will be reduced after modified superficialparotidectomy.3Residual parotid tissue plays a normal secretion function, but its secret waywas changed.