Warthin's tumor surgery: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{CMG}}; {{AE}} {{Ammu}} | {{CMG}}; {{AE}} {{Ammu}} {{N.F}} | ||
{{Warthin's tumor}} | {{Warthin's tumor}} | ||
==Overview== | ==Overview== | ||
[[Surgery]] is the mainstay of treatment for Warthin's tumor. | [[Surgery]] is the mainstay of treatment for Warthin's tumor. Recurrence and [[malignant]] transformation is very [[rare]]. Post surgery [[Complication (medicine)|complications]] include [[facial paralysis]], [[Fistula|salivary fistula]] and [[numbness]] in the distribution of great auricular nerve. | ||
==Surgery== | ==Surgery== | ||
* Surgery is the mainstay of treatment for Warthin's tumor. Recurrence is rare, occurring in 6 - 12% of cases. Warthin's tumor is highly unlikely to become [[malignant]]. | * Surgery is the mainstay of treatment for Warthin's tumor. Recurrence is rare, occurring in 6 - 12% of cases. Warthin's tumor is highly unlikely to become [[malignant]]. | ||
* [[Surgery]] should be followed by careful observation to watch for changes in the tumor over time.<ref name="pmid12593546">{{cite journal| author=Gooden E, Witterick IJ, Hacker D, Rosen IB, Freeman JL| title=Parotid gland tumours in 255 consecutive patients: Mount Sinai Hospital's quality assurance review. | journal=J Otolaryngol | year= 2002 | volume= 31 | issue= 6 | pages= 351-4 | pmid=12593546 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12593546 }} </ref> Frey syndrome has been successfully treated with injections of botulinum toxin A.<ref>Salivary gland tumor. Cancer.gov (2016). http://www.cancer.gov/types/head-and-neck/hp/salivary-gland-treatment-pdq Accessed on January 4, 2016</ref> | * [[Surgery]] should be followed by careful observation to watch for changes in the [[tumor]] over time.<ref name="pmid12593546">{{cite journal| author=Gooden E, Witterick IJ, Hacker D, Rosen IB, Freeman JL| title=Parotid gland tumours in 255 consecutive patients: Mount Sinai Hospital's quality assurance review. | journal=J Otolaryngol | year= 2002 | volume= 31 | issue= 6 | pages= 351-4 | pmid=12593546 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12593546 }} </ref> Frey syndrome has been successfully treated with [[Injection (medicine)|injections]] of [[Botulinum toxin|botulinum toxin A]].<ref>Salivary gland tumor. Cancer.gov (2016). http://www.cancer.gov/types/head-and-neck/hp/salivary-gland-treatment-pdq Accessed on January 4, 2016</ref> | ||
'''Complications of surgery:''' | '''Complications of surgery:''' | ||
* Frey syndrome:<ref name="de Breevan der Waal2007">{{cite journal|last1=de Bree|first1=Remco|last2=van der Waal|first2=Isaäc|last3=Leemans|first3=C. René|title=Management of frey syndrome|journal=Head & Neck|volume=29|issue=8|year=2007|pages=773–778|issn=10433074|doi=10.1002/hed.20568}}</ref> | * Frey syndrome:<ref name="de Breevan der Waal2007">{{cite journal|last1=de Bree|first1=Remco|last2=van der Waal|first2=Isaäc|last3=Leemans|first3=C. René|title=Management of frey syndrome|journal=Head & Neck|volume=29|issue=8|year=2007|pages=773–778|issn=10433074|doi=10.1002/hed.20568}}</ref> | ||
** Frey syndrome is also known | ** Frey syndrome is also known as [[gustatory]] [[sweating]] or auriculotemporal syndrome. | ||
** Include [[flushing]] and sweating over the [[parotid]] region during [[mastication]]. | ** Include [[flushing]] and [[sweating]] over the [[parotid]] region during [[mastication]]. | ||
** May occur from 2 weeks to 2 years | ** May occur from 2 weeks to 2 years | ||
** Result from [[regeneration]] of cut [[parasympathetic]] | ** Result from [[regeneration]] of cut [[parasympathetic]] fibers between [[otic ganglion]] and salivary tissue. | ||
** [[Botulinum toxin|Botulinum toxin A]] by | ** [[Botulinum toxin|Botulinum toxin A]] by intra cutaneous injections provides successful treatment. | ||
* Bleeding and [[hematoma]] | * Bleeding and [[hematoma]] | ||
* [[Numbness]] in the distribution of great Auricular nerve including ear, face and neck | * [[Numbness]] in the distribution of great [[Auricular branch|Auricular nerve]] including ear, face and neck | ||
* Sialocele and salivary [[fistula]] occurs in 5% post operative patients. | * Sialocele and [[Salivary gland|salivary]] [[fistula]] occurs in 5% post operative patients. | ||
* Deep lobe and [[pharyngeal]] space [[dissection]] may result in [[cramping]] and [[spasm]] in [[parotid]] region during [[swallowing]]. | * Deep lobe and [[pharyngeal]] space [[dissection]] may result in [[cramping]] and [[spasm]] in [[parotid]] region during [[swallowing]]. | ||
* Incidence of [[facial paralysis]] is 27-43% | * Incidence of [[facial paralysis]] is 27-43% | ||
Latest revision as of 20:47, 11 December 2018
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2] Nazia Fuad M.D.
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Overview
Surgery is the mainstay of treatment for Warthin's tumor. Recurrence and malignant transformation is very rare. Post surgery complications include facial paralysis, salivary fistula and numbness in the distribution of great auricular nerve.
Surgery
- Surgery is the mainstay of treatment for Warthin's tumor. Recurrence is rare, occurring in 6 - 12% of cases. Warthin's tumor is highly unlikely to become malignant.
- Surgery should be followed by careful observation to watch for changes in the tumor over time.[1] Frey syndrome has been successfully treated with injections of botulinum toxin A.[2]
Complications of surgery:
- Frey syndrome:[3]
- Frey syndrome is also known as gustatory sweating or auriculotemporal syndrome.
- Include flushing and sweating over the parotid region during mastication.
- May occur from 2 weeks to 2 years
- Result from regeneration of cut parasympathetic fibers between otic ganglion and salivary tissue.
- Botulinum toxin A by intra cutaneous injections provides successful treatment.
- Bleeding and hematoma
- Numbness in the distribution of great Auricular nerve including ear, face and neck
- Sialocele and salivary fistula occurs in 5% post operative patients.
- Deep lobe and pharyngeal space dissection may result in cramping and spasm in parotid region during swallowing.
- Incidence of facial paralysis is 27-43%
References
- ↑ Gooden E, Witterick IJ, Hacker D, Rosen IB, Freeman JL (2002). "Parotid gland tumours in 255 consecutive patients: Mount Sinai Hospital's quality assurance review". J Otolaryngol. 31 (6): 351–4. PMID 12593546.
- ↑ Salivary gland tumor. Cancer.gov (2016). http://www.cancer.gov/types/head-and-neck/hp/salivary-gland-treatment-pdq Accessed on January 4, 2016
- ↑ de Bree, Remco; van der Waal, Isaäc; Leemans, C. René (2007). "Management of frey syndrome". Head & Neck. 29 (8): 773–778. doi:10.1002/hed.20568. ISSN 1043-3074.