Parotid Gland Tumors: 2-Year Prospective Clinicopathological Study

Abstract

Context: Parotid gland tumors account for 80% of all salivary gland neoplasms. Most parotid masses are operated on before obtaining the final histological diagnosis, which complicates the management of the facial nerve damage during parotid surgery.

Aims: The aim of this study is to analyze the age- and gender-wise incidence of parotid gland tumors, the incidence of various types of tumors, to assess their clinical modes of presentation, the efficacy of treatment, and to evaluate the complications ensuing therein, because of intervention.

Settings and design: The present study was conducted in the Department of Oral and Maxillofacial Surgery, A. B. Shetty Memorial Institute of Dental Sciences and Justice K. S. Hegde Charitable Hospital, Nitte University, Mangalore.

Subjects and methods: A clinicopathological study of parotid gland tumors was undertaken in a tertiary care hospital. Patients with parotid swelling were clinically evaluated, followed by fine-needle aspiration cytology (FNAC). Surgery was planned and performed based on the tumor location and FNAC report. Patients were followed up for postoperative complications.

Results: The study comprised 59 patients with parotid gland tumors. The age range of the patient affected was between 18 and 75 years. Benign tumors are more common than malignant tumor in the ratio of 3.5:1. Slow progressively parotid swelling was the common presenting complaint. Superficial parotidectomy was the most common surgery (69.49%) performed. The most common postoperative complication encountered was transient facial palsy (22.03%). Benign tumors were more common (77.97%). The most common benign tumor was pleomorphic adenoma, and malignant tumor was mucoepidermoid carcinoma.

Conclusions: The incidence of parotid salivary gland tumors is increasing in recent years. Parotidectomy is safe procedure for treating parotid tumors. Transient facial palsy is the most common postoperative complication, which is reduced in superficial parotidectomy.

Keywords: Facial nerve palsy; histopathology; parotid gland tumors; parotidectomy.

Figure 1

Frequency of age distribution of benign and malignant parotid gland tumors

Figure 2

A female patient with left benign parotid tumor (inset: Cut section of Pleomorphic adenoma showing tumor with glistening white mucoid areas)

Figure 3

A female patient with malignant right parotid tumor showing skin fixity and ulceration (inset: Cut section of malignant tumor showing irregular grey white tumor with areas of necrosis and hemorrhage)

Figure 4

Modified blair incision for parotidectomy

Figure 5

Upper trunk of facial nerve during parotidectomy

Figure 6

Lower trunk of facial nerve during parotidectomy

Figure 7

Tragal cartilage during parotidectomy

Figure 8

Patient demonstrating postoperative complication of facial nerve palsy

Figure 9

Microphotograph of (a) pleomorphic adenoma showing streaming’ pattern of myoepithelial cells in chondromyxoid stroma and (b) high-grade mucoepidermoid carcinoma predominantly solid tumor cell clusters displaying squamoid features with keratinization and focal mucin-producing cells (H and E, ×40)