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. 2005 Jun;25(3):169-73.

Extended parotidectomy

M De Vincentiis  1 , G Magliulo, P Soldo, V Manciocco, G Pagliuca, R Del Gaizo, A Gallo
Affiliations

Extended parotidectomy

M De Vincentiis et al. Acta Otorhinolaryngol Ital. 2005 Jun.

Abstract
in English, Italian

Malignant tumours of the parotid gland represent a group of relatively rare lesions. The medical records of 363 patients with parotid swelling treated between 1974 and 2003 at the "G. Ferreri" Department of Otorhinolaryngology, "La Sapienza" University in Rome were retrospectively analysed. Clinical presentation, pre-operative investigations, surgical procedure, histopathology report, post-operative complications, and the oncological results of 19 patients who underwent extended radical parotidectomy for malignant neoplasm of the parotid gland are discussed. Extended radical parotidectomy, reserved for neoplasms in an advanced stage, involves the removal of the entire parotid gland, with sacrifice of the facial nerve and the resection en bloc of the adjacent structures affected by neoplastic infiltration, such as the temporal bone, the mandibular bone, the skin, blood vessels and nerves. In addition to this surgical treatment, a cycle of adjuvant radiotherapy is also necessary. The overall rate of survival at 10 years depends mainly on the histological characteristics of the tumour, and, in this series, is reported to be approximately 58%. These data indicate that total extended radical parotidectomy combined with post-operative radiotherapy, represents the best therapeutic approach with regard both to quality of life and life expectancy, in patients with an advanced stage of malignant neoplasm of the parotid gland.

I tumori maligni della ghiandola parotide rappresentano un gruppo di lesioni eterogenee e relativamente rare. Partendo da una casistica di 363 pazienti con tumefazione parotidea trattati presso il Dipartimento di Otorinolaringoiatria, Audiologia e Foniatria “G. Ferreri” dell’Università di Roma “La Sapienza” tra il 1974 ed il 2003, abbiamo retrospettivamente analizzato i risultati oncologici di 19 pazienti sottoposti ad intervento di parotidectomia radicale allargata per una neoplasia maligna della ghiandola parotide. La parotidectomia radicale allargata, riservata a neoplasie in stadio avanzato, associa all’asportazione di tutto il parenchima ghiandolare parotideo compreso il nervo facciale, la resezione in blocco delle strutture contigue alla ghiandola interessate da infiltrazione neoplastica come l’osso temporale, l’osso mandibolare, la cute, i vasi ed i nervi. È necessario associare alla terapia chirurgica un ciclo di radioterapia adiuvante. La sopravvivenza globale a dieci anni è condizionata principalmente dalle caratteristiche istologiche del tumore ed è del 58%. Questo dato indica che la parotidectomia totale allargata associata a radioterapia post-operatoria, rappresenta l’approccio terapeutico migliore per qualità ed aspettativa di vita nei pazienti con stadio avanzato di neoplasia maligna della ghiandola parotide.

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