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Category: Volume 08 Issue 07 July 2020
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Title: Parotid Cancers - A 5 Yr Experience at a Tertiary Care Centre

Authors: Dr Pandudasappa, Dr Bhagavan. B.C, Dr Deepak Lal .S. D

 DOI: https://dx.doi.org/10.18535/jmscr/v8i7.95

Abstract

Background: From 1823 when the first documented parotidectomy was done, parotid tumors which form a majority of the salivary tumors with 70% being benign and have been studied ever since.

Aims and Objectives: To analyse parotid tumours at a tertiary care hospital and their diagnostic modalities, treatment and associated complications.

Methods: This prospective study was conducted on 68 patients who underwent parotidectomy from December 2014-Dcember 2019 for parotid tumours. Thorough clinical examination and facial nerve assessment done and subjected to radiological and pathological investigations.52 patients underwent superficial parotidectomy (46 patients for pleomorphic adenoma,6 patients for warthin tumour) and 14 patients underwent Total conservative parotidectomy (11 patients for parotid malignancy and 1 patients for pleomorphic adenoma recurrence and 1 patients pleomorphic adenoma involving deep lobe of parotid) and 1 underwent wide excision with neck dissection due to involvement of the hard palate post recurrence . Neck dissection also carried out in CT proven lymph node metastasis

Results: In our study, Usg with FNAC was found to have 90% sensitivity, 98.3% specificity, 90% positive predictive value, a 90% negative predictive value and a 90% accuracy. Higher investigations such as CT scan was only advised for palpable neck nodes or in case of suspected metastasis 10 patients developed complication. Several complications have been reported in parotid surgery. Temporary facial nerve paresis was the most common postoperative complication.  Most patient regained normal facial nerve function within 2 months from the onset.

Conclusion: The incidence of parotid tumors is seeing a shift towards the younger age group with clinical, radiological and pathological diagnosis being the best mode of approach. Parotidectomy is the currently the best treatment available with complications increasing in proportion to the extensiveness of the procedure with facial paresis being the most common.

Keywords: Parotid; parotidectomy; parotid tumor; facial nerve palsy.

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Corresponding Author

Dr Deepak Lal .S. D

Junior Resident/ Post-graduate, Department of General Surgery, Kempegowda Institute of Medical Sciences, Bengaluru, Karnataka, India