• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.4
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• pp.237-241
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• 2022

Sclerosing polycystic adenosis (SPA) is a rare, asymptomatic disease that occurs mainly in the salivary glands. We report the case of a 51-year-old man who presented with trismus and pain upon mouth opening. Magnetic resonance imaging revealed a 2-cm mass located in the anterior portion of the left parotid gland. SPA was diagnosed based on histopathological examination of the surgical specimen. In pathologic findings, there was a well-circumscribed multicystic nodule in the parenchyma. Dense fibrosis and chronic non-specific inflammatory cells were observed in the stroma. In 13 previous reports on SPA, the most preferred treatment was superficial or total parotidectomy. This report suggests that simple excision of SPA preserves facial nerve function and facial volume.

• Archives of Craniofacial Surgery
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• v.10 no.2
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• pp.114-119
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• 2009

Purpose: Several therapeutic approaches have been introduced and tried to treat Frey syndrome following parotidectomy. However they were not proved as an effective treatment. A new therapeutic modality using botulinum toxin injections was presented previously by several study groups. But, the duration of the demonstrated positive effect was essentially unknown so far. The purpose of this clinical investigation is to demonstrate the effectiveness of Botulinum toxin type A(BTXA) in patients with Frey syndrome. Methods: For this study, 12 patients were treated, They were assessed with the Minor's iodine-starch test and interviewed before and after treatment. Botulinum toxin is injected with $1.0cm^2$ apart into the skin where symptoms of Frey's syndrome has manifestated. The patients were classified according to the concentration of botulinum toxin and dosage of botulinum toxin. Results: The outcome measures were the time of reappearance of gustatory sweating(subjective study), and the results of an Minor's iodine-starch test(objective study) of 3 weeks, 3 months, 6 months, 9 months, 12 months after treatment. This treatment was effective in all groups of patients. The concentrations and the amount of dosages did not affect the treatment. But high concentration produced faster effectiveness in subjective. Conclusion: Botulinum toxin type A(BTXA) for Frey syndrome is easy, convenient and effective withouts severe complication. And the patients has no difficulty and limitation in their life.

• Korean Journal of Head & Neck Oncology
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• v.10 no.1
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• pp.46-52
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• 1994

This review is based on the 52 cases of salivary gland tumors treated at the department of surgerym Hallym University Kangdong Sacred Heart hospital during the period from March 1987 to May 1992. There were 43 benign and 9 malignant tumors. Twenty eight(54%) of these cases were located in the parotid gland, 14(27%) in the submandibular gland, the rest of 10 cases(19%) in the minor salivary glands. Female outnumbered male by the ratio 1.6:1. Pleomorphic adenoma was the most common tumor followed by carcinoma and adenolymphoma(Warthin's tumor). The most common presenting symptom in both benign and malignant tumors was palpable mass. However, some patients with malignancy presented symptoms such as pain, facial palsy and dysphagia. Among 9 cases with malignancies 3 cases were found to have metastasis in the regional lymphnodes and two cases had distant metastasis. In majority of benign parotid tumors, superficial parotidectomy was carried out. In three cases of carcinoma of parotid gland with lymphnode metastasis, total parotidectomy with radical neck dissection was done. One case out of two cases of carcinoma of submandibular gland was treated with total excision of the gland with radical neck dissection. There were no postoperative mortalies. Two cases each of facial palsies and wound infections were observed as complication.

• Archives of Craniofacial Surgery
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• v.9 no.1
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• pp.23-26
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• 2008

Salivary duct carcinoma is a high-grade adenocarcinoma arising from the ductal epithelium and has very low prevalence. We report a case of salivary duct carcinoma in high risk group with satisfactory result. A 65-year-old male was referred to our clinic complaining of mass on Rt. cheek. Preoperative CT and MRI shows $2.0{\times}1.9cm$ sized multilobulated, cystic mass on the superficial lobe of Rt. parotid gland and multiple lymph node enlargement thorough the Rt. internal jugular chain. Total parotidectomy and modified radical neck dissection with adjuvant radiation therapy was performed. Pathologic result was salivary duct carcinoma and resection margin was free. Postoperative radiation therapy with 6400 cGy($200cGy{\times}12fx$) was performed. During the 24-months of follow up periods, recurrence or complications associated with operation and radiation therapy was not observed. Salivary duct carcinoma is rare disease with very poor prognosis. Lymph node metastasis is commonly accompanied at the time of diagnosis. Distant metastasis is the most common cause of death. Total parotidectomy, radical neck disssection and adjuvant radiation therapy can be the appropriate modality for the control of the salivary duct carcinoma especially in high risk group.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.1
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• pp.80-84
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• 2000

Tumors of the parotid gland are the most frequently encountered salivary gland tumors. Knowledge of the histology and anatomy of the salivary gland is important when considering the histiogenesis of salivary gland tumors, requiring close cooperation between the pathologist and the surgeon. Most tumors are benign epithelial formations. Pleomorphic adenomas predominate. Superficial lobectomy is adequate treatment. When the tumor involves a deep lobe, total parotidectomy is indicated. Treatment of malignant tumors depends on the histology, its TNM stage and other factors. Total parotidectomy with lymph adectomy and radiotherapy are needed in case of high grade malignancy. In children, vascular neoplasias are the most frequent, followed by malignant tumors. Their histological features and treatment are the same as for adults. We reviewed 64 cases of the parotid tumors at Department of surgery, Dong-A University Hospital from July. 1990 to Jan. 1999 for the purpose of apprehension of parotid gland tumor by the clinical study and review. Over all sex ratio was 1：1.13(M:F), mean age was 38.9 years, mean size was 3.53cm. According to histologic findings of 64 cases, pleomorphic adenoma was 55(85.9%), Warthin's tumor was 3(4.7%), mucoepidermoid carcinoma was 3(4.7%), squamous cell carcinoma was 2(3.1%), acinic cell carcinoma was 1(1,6%). Post op. facial nerve palsy 16(25%), Frey's syndrome 11(17.2%) cases were happened. Hence, the clinical manifestation of pain, tenderness, facial N. palsy suggest malignant tumors.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.38 no.1
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• pp.38-43
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• 2012

Introduction: The location of parotid gland tumors in the superficial or deep lobes can affect the time and difficulty of operations. Therefore, accurate preoperative evaluation of the tumor location is important for surgical outcomes. Materials and Methods: A total of 16 patients with parotid gland tumors and who underwent a parotidectomy between April 2003 and March 2011 were retrospectively reviewed in terms of demographic background, tumor location, surgical treatment, and treatment outcomes. Tumor location was estimated by four landmarks on contrast enhanced computerized tomography scans, which were Conn's arc, the facial nerve (FN) line, the Utrecht line, and the retromandibular vein. Tumor location was confirmed by relative position depending on the facial nerve during surgery. It was assumed positive since the tumor lies in the superficial lobe of the parotid gland, the sensitivity, specificity, positive predictive value, negative predictive value, and efficiency of each landmark were evaluated. Results: Our result revealed that the facial nerve line had a sensitivity of 83.3%, specificity of 100%, positive predictive value of 100%, negative predictive value of 71.4%, and efficiency of 87.5%. Some would be more efficient preoperative evaluation methods of the relationship of parotid gland tumors to the facial nerve than others. Conclusion: In our study, the FN line was found to be the most reliable analysis method.

• Archives of Craniofacial Surgery
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• v.11 no.2
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• pp.99-102
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• 2010

Purpose: Primary malignant lymphomas of the salivary glands are uncommon, representing only 1.7% to 3.1% of all salivary neoplasms and 0.6% to 5% of all tumors and tumor-like lesions of the parotid gland. Lymphomas of the parotid glands are usually manifestations of a systemic disease process but primary lymphomas of the parotid glands are rare. Most of these lesions are classified as extranodal non-Hodgkin's lymphoma. We report the clinicopathological features of primary malignant lymphoma of the parotid gland based on an analysis of our cases. Methods: The subject was a 48-year-old male patient with a malignant lymphoma originating in the parotid gland, which had been slowly increasing in size over previous 6 months. The diagnosis was established by MRI and a superficial lobectomy. After diagnosis, the patient was referred to an oncologist for staging and medical treatment. Results: The stage was IIIA. The patient was treated with chemotherapy following surgery with rituximab and CHOP (Cyclophosphamide, Adriamycin, Vincristine, Prednisolone). The tumor was controlled successfully by chemotherapy. The patient was followed up for 1 year with no relapse. Conclusion: A case of primary non-Hodgkin's lymphoma of the parotid gland was treated with a superficial parotidectomy and chemotherapy. The disease was well controlled after a 1 year follow-up.

• Archives of Craniofacial Surgery
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• v.14 no.2
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• pp.129-132
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• 2013

Cutaneous squamous cell carcinoma is the second-most common skin cancer and represents 20% of all skin cancers. Cutaneous squamous cell carcinoma often spreads to the parotid gland through lymph nodes, but, direct invasion of an adjacent organ may also occur. We present the case of 78-year-old man with ulcerated mass on the right infra-auricular area. The histopathologic finding was squamous cell carcinoma. There was no evidence of distant metastasis, but the mass was found to invade the superficial lobe of the right parotid gland. The mass was widely excised and superficial parotidectomy was performed while preserving the facial nerve. The defect was covered by primary closure. Postoperative radiotherapy was performed. At 20 months after surgery, our patient had no facial palsy, local recurrence, or metastasis. Cutaneous squamous cell carcinoma involving the parotid gland is an aggressive, rapidly advancing lesion, which if not recognized and treated early will result in high morbidity and mortality. Squamous cell carcinoma of the parotid gland has shown that patients who receive adjuvant radiotherapy have a lower recurrence rate and a higher survival rate than patients treated with surgery alone. The role of elective neck dissection remains controversial.

• Korean Journal of Head & Neck Oncology
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• v.31 no.1
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• pp.9-13
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• 2015

Fine needle aspiration cytology as a diagnostic workup of parotid gland tumor is a simple and useful method. Although fine needle aspiration cytology could not predict accurate diagnosis in all cases, it is usually helpful in differentiating malignancy and benign lesions. A 35-year-old female was found to have a parotid mass for 1 year. Preoperative evaluation including computed tomography and magnetic resonance imaging were non-diagnostic, but, fine needle aspiration cytology on parotid mass showed the suspicion of a low-grade mucoepidermoid carcinoma. Superficial parotidectomy and selective neck node dissection were done based on cytology. However, final pathological examination confirmed benign pleomorphic adenoma. Here, the diagnostic accuracy and cautions in interpretation of result of fine needle aspiration cytology is discussed with respect to the case.

• Korean Journal of Head & Neck Oncology
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• v.32 no.1
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• pp.29-32
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• 2016

Venous malformation with phleboliths is uncommon cause of unilateral parotid swelling. The clinical and radiographic appearance of venous malformation with phleboliths may masquerade as sialolithiasis. A 49-year-old female complained about unilateral parotid swelling for 6 years. Preoperative evaluation including computed tomography and sonography showed the suspicion of venous malformation with phleboliths. Superficial parotidectomy was performed. Pathological examination confirmed that the mass was venous malformation with phleboliths combined with sialolith in the parotid gland. We present the case of unilateral parotid swelling caused by a venous malformation combined with sialolithiasis.