Θεραπευτική Αντιμετώπιση των Όγκων της Παρωτίδας
Langdon Ό. John*
Τμήμα Στοματικής & Γναθοπροσωπικής Χειρουργικής, Guy's, King's & St Thomas' Dental Institute, King's College Hospital, Λονδίνο, Αγγλία
(Διευθυντής: Καθ. John D. Langdon)
* Καθηγητής και Διευθυντής, MDS, FDSRCS, FRCS, FmedSci.
Αρχεία Ελληνικής Στοματικής και Γναθοπροσωπικής Χειρουργικής 2(4): 237 - 249, 2001.
ΠΕΡΙΛΗΨΗ
Στην εργασία αυτή γίνεται ανασκόπηση των δεδομένων της χειρουργικής παθολογίας των όγκων των σιαλο-
γόνων αδένων με ιδιαίτερη έμφαση στην παρωτίδα. Αναφέρονται ενδιαφέροντα στατιστικά στοιχεία σχετικά με
την επίπτωση, την πρόγνωση, τα ποσοστά ανταπόκρισης στη θεραπεία καθώς και τα ποσοστά των επιπλοκών της
χειρουργικής αντιμετώπισης των όγκων της παρωτίδας. Περιγράφεται η τεχνική της παρωτιδεκτομής και των
παραλλαγών της, ενώ γίνεται ιδιαίτερη μνεία των αντομικών στοιχείων που βοηθούν στην ανεύρεση και παρασκευή
του προσωπικού νεύρου.
Λέξεις κλειδιά: Παρωτίδα, Όγκοι, Χειρουργική Αντιμετώπιση
REFERENCES
Armisted PR, Smiddy FG, Frank HG: Simple enucleation and
radiotherapy, in the treatment of the pleomorphic adenoma
of the parotid gland. Br J Surg 66: 716-717, 1979
Bearhrs OH, Adsom MA: The surgical anatomy and technique of
parotidectomy. Am J Surg 95: 885-896, 1958
Benedict EG, Meigs JV: Tumours of the parotid gland. A study of
225 cases with complete end results in 80 cases. Surgery,
Gynaecology & Obstetrics 51: 626-647, 1930
Blanck C, Eneroth CM, Jacobsson F, Jacobsson PA: Adenoid
cystic carcinoma of the parotid gland. Acta Radiol Ther Phys
Biol 6:177-196, 1967
Brusati R, Bozzetti A, Chiapasco M: Facial nerve and parotid
surgery. J Cranio - Maxillofac Surg 15: 278-280, 1987
Cawson RA, Gleeson MJ, Eveson JW: Pathology and surgery of
the salivary glands. Oxford. ISIS Medical Media 1997, pp
182-4
Cawson RA, Langdon JD, Eveson JW: Surgical pathology of the
mouth and jaws. Investigational Methods., Oxford, Wright
1996, pp 8-10
Chinn S, Gunn A: Conservative parotidectomy by the peripheral
approach. Br J Surg 68: 405 - 407, 1981
Donovan DT, Conely J J: Capsular significance in parotid tumour
surgery: Reality and Myths of Lateral Lobectomy.
Laryngoscope 94: 324-329, 1984
Eddey HH: Parotid tumours. A review of 138 cases. Austr &
New Zeal J Surg 40: 1 -14, 1970
Eveson JW, Cawson RA: Warthin's tumour of salivary glands. A
clinicopathological investigation of 278 cases. Oral Surg,
Oral Med, Oral Path 61: 256-262, 1986
Foote FW, Frazell EL: Tumours of the major salivary glands.
Atlas of tumour pathology: Armed forces institute of
pathology. Section IV Fascicle 11, Washington, 1954
Frable WJ: Fine-Needle aspiration biopsy, Philadelphia, WB
Suanders 1983
Gleave EN, Whittaker JS, Nicholson A: Salivary tumours -
experience over 30 years. Clinical Otolaryngology 4: 247-
257, 1979
Hancock BD: Pleomorphic adenomas of the parotid, removal
without rupture. Annals of the Royal College of Surgeons of
England 69: 293-295, 1987
Haw CS: Pleomorphic adenoma of the parotid gland. Journal of
the Royal College of Surgeons of Edinburgh 20: 25-29, 1975^
Hawe MJG, Bell DM: Superficial parotidectomy for pleomorphic
parotid adenomas. Clinical Oncology 8: 207-211, 1982
Lam KH, Wei WI, Ho HC, Ho CM: Whole organ sectioning of
mixed parotid tumours. Am J Surg 160: 377-381, 1982
Langdon JD: Parotid surgery in operative maxillofacial surgery.
Eds Langdon JD, Patel MF. London Chapman & Hall
1998B, pp 381-90
Langdon JD: Complications for parotid gland surgery. J
Maxillofac Surg 12: 225-229, 1984
Langdon JD: Tumours of the salivary glands. J Oral Maxillofac
Surg 43: 688-692, 1985
Langdon JD: Salivary gland disorders In pediatric surgery and
urology: Long term outcomes. Eds Stringer MD, Oldham KT,
Mouriquand PDE, Howard ER. London, WB Saunders
1998A, pp 92-103
Lanier VC, McSwain B, Rosenfeld L: Mixed tumours of salivary
glands: A 44 year Study. Southern Medical Journal 65:
1485-1488, 1972
Lefor AT, Ord RA: Multiple synchronous bilateral Warthin's
tumours of the parotid gland with pleomorphic adenoma.
Oral Med, Oral Path 76: 319-324, 1993
Leverstein H, Van Der Wal JE, Tiwari RM, Van Der Wal, L
Snow GB: Surgical management of 246 previously untreated
pleomorphic adenomas of the parotid gland. Br J Surg 85:
399-403, 1997
Maimaris CV, Vail MJ: Treatment of parotid gland tumours by
conservative parotidectomy. Br J Surg 73: 897, 1986
Martin H: The operative removal of tumours of the parotid
salivary gland. Surg. 31: 670-682, 1952
Martis C: Parotid benign tumours: comments on surgical
treatment of 263 cases. Int J Oral Surg 12: 211-220, 1983
Mc Evedy BV, Ross WM: The treatment of mixed parotid
tumours by enucleation and radiotherapy. Br J Surg 63:
341-342, 1976
McEvedy PG: Diseases of the salivary glands. Clinical Journal
63: 334-338, 1934
McFarland J: The mysterious mixed tumour of the salivary
glands. Surgery, Gynaecology & Obstetrics 76: 23-34, 1943
McFarland J: Three hundred tumours of the salivary glands of
which 69 recurred. Surgery, Gynaecology & Obstetrics 63:
457-468, 1936
McGurk M, Renehan A, Gleave EN, Hancock BD: Clinical
significance of the tumour capsule in the treatment of parotid
pleomorphic adenomas. Br J Surg 83: 1747-1749, 1996.
Moody AB, Avery CME, Taylor J, Langdon JD: A comparison of
one hundred and fifty consecutive parotidectomies for
tumours and inflammatory disease. Int J Oral Maxillofac Surg
28:211-215,1999
Natvig K, Soberg R: Relationship intraoperative rupture of pleomorphic adenomas to recurrence: an 11-25 year follow
up study. Head & Neck 16: 213-217, 1994
Patridge M, Langdon JD, Rankin S, Borthwick-Clarke A:
Diagnostic techniques for parotid disease. Br J Oral and
Maxillofac Surg 24: 311-332, 1986
Patey DH, Thackray AC: The treatment of parotid tumours in the
light of a pathological study of parotidectomy material. Br J
Surg 55: 477-487, 1958
Patey DH: The treatment of mixed tumours of the parotid gland.
Br J Surg. 28: 29-38, 1940
Prichard AJN, Barton RPE, Narula AA: Complications of
superficial parotidectomy versus extracapsular lumpectomy
in the treatment of benign parotid lesions. Journal of the
Royal College of Surgeons of Edinburgh 37: 155-158, 1992
Rawson AJ, Howard JM, Royster HP, Horn RC: Tumours of the
salivary glands. A clinicopathological study of 160 cases.
Cancer 3: 445-458, 1950
Seifert G, Miehlke A, Haubrich J, Chilla R: Diseases of the
salivary glands, Stuttgart, Georg Thieme 1986
Seifert G: Histological typing of salivary gland tumours. 2nd Ed
Berlin: World Health Organisation. Springer Verlag 1991
Stea G: Conservative surgical treatment of mixed tumours of the
parotid gland. J Maxillofac Surg 3: 135-137, 1975
Stein I, Geschickter CF: Tumours of the parotid gland. Arch Surg
28: 482-526, 1934
Stevens KL, Hobsley M: The treatment of pleomorphic
adenomas by formal parotidectomy. Br J Surg 69: 1-3, 1982
Tighe JVP, Langdon JD, Stenhouse P: Experience with a
modified rhytidectomy approach for parotidectomy. Br J
Oral Maxillofac Surg 39: 233, 2001
Touquet R, MacKenzie IJ, Carruth JAS: Management of the
parotid pleomorphic adenoma, the problem of exposing
tumour tissue at operation. The logical pursuit of treatment
policies. Br J Oral Maxillofac Surg 28: 404-408, 1990
Wennmo C, Spandow O, Eingard P, Krouthen B: Pleomorphic
adenomas of the parotid gland: Superficial parotidectomy or
limited excision? J Laryngol Otol 102: 603-605, 1988
Wood FC: Mixed tumours of the salivary glands. Ann Surg 39:
57, 1904
Woods JE, Chang GC, Beahrs OH: Experiences with 1360
primary parotid tumours. Am J Surg 130: 460-462, 1975
Yamashita T, Tomoda K, Kumazawa T: The usefulness of partial
parotidectomy for benign parotid gland tumours. Acta
Otolaryngol 500: 113-116, 1993
Τμήμα Στοματικής & Γναθοπροσωπικής Χειρουργικής, Guy's, King's & St Thomas' Dental Institute, King's College Hospital, Λονδίνο, Αγγλία
(Διευθυντής: Καθ. John D. Langdon)
* Καθηγητής και Διευθυντής, MDS, FDSRCS, FRCS, FmedSci.
Αρχεία Ελληνικής Στοματικής και Γναθοπροσωπικής Χειρουργικής 2(4): 237 - 249, 2001.
ΠΕΡΙΛΗΨΗ
Στην εργασία αυτή γίνεται ανασκόπηση των δεδομένων της χειρουργικής παθολογίας των όγκων των σιαλο-
γόνων αδένων με ιδιαίτερη έμφαση στην παρωτίδα. Αναφέρονται ενδιαφέροντα στατιστικά στοιχεία σχετικά με
την επίπτωση, την πρόγνωση, τα ποσοστά ανταπόκρισης στη θεραπεία καθώς και τα ποσοστά των επιπλοκών της
χειρουργικής αντιμετώπισης των όγκων της παρωτίδας. Περιγράφεται η τεχνική της παρωτιδεκτομής και των
παραλλαγών της, ενώ γίνεται ιδιαίτερη μνεία των αντομικών στοιχείων που βοηθούν στην ανεύρεση και παρασκευή
του προσωπικού νεύρου.
Λέξεις κλειδιά: Παρωτίδα, Όγκοι, Χειρουργική Αντιμετώπιση
REFERENCES
Armisted PR, Smiddy FG, Frank HG: Simple enucleation and
radiotherapy, in the treatment of the pleomorphic adenoma
of the parotid gland. Br J Surg 66: 716-717, 1979
Bearhrs OH, Adsom MA: The surgical anatomy and technique of
parotidectomy. Am J Surg 95: 885-896, 1958
Benedict EG, Meigs JV: Tumours of the parotid gland. A study of
225 cases with complete end results in 80 cases. Surgery,
Gynaecology & Obstetrics 51: 626-647, 1930
Blanck C, Eneroth CM, Jacobsson F, Jacobsson PA: Adenoid
cystic carcinoma of the parotid gland. Acta Radiol Ther Phys
Biol 6:177-196, 1967
Brusati R, Bozzetti A, Chiapasco M: Facial nerve and parotid
surgery. J Cranio - Maxillofac Surg 15: 278-280, 1987
Cawson RA, Gleeson MJ, Eveson JW: Pathology and surgery of
the salivary glands. Oxford. ISIS Medical Media 1997, pp
182-4
Cawson RA, Langdon JD, Eveson JW: Surgical pathology of the
mouth and jaws. Investigational Methods., Oxford, Wright
1996, pp 8-10
Chinn S, Gunn A: Conservative parotidectomy by the peripheral
approach. Br J Surg 68: 405 - 407, 1981
Donovan DT, Conely J J: Capsular significance in parotid tumour
surgery: Reality and Myths of Lateral Lobectomy.
Laryngoscope 94: 324-329, 1984
Eddey HH: Parotid tumours. A review of 138 cases. Austr &
New Zeal J Surg 40: 1 -14, 1970
Eveson JW, Cawson RA: Warthin's tumour of salivary glands. A
clinicopathological investigation of 278 cases. Oral Surg,
Oral Med, Oral Path 61: 256-262, 1986
Foote FW, Frazell EL: Tumours of the major salivary glands.
Atlas of tumour pathology: Armed forces institute of
pathology. Section IV Fascicle 11, Washington, 1954
Frable WJ: Fine-Needle aspiration biopsy, Philadelphia, WB
Suanders 1983
Gleave EN, Whittaker JS, Nicholson A: Salivary tumours -
experience over 30 years. Clinical Otolaryngology 4: 247-
257, 1979
Hancock BD: Pleomorphic adenomas of the parotid, removal
without rupture. Annals of the Royal College of Surgeons of
England 69: 293-295, 1987
Haw CS: Pleomorphic adenoma of the parotid gland. Journal of
the Royal College of Surgeons of Edinburgh 20: 25-29, 1975^
Hawe MJG, Bell DM: Superficial parotidectomy for pleomorphic
parotid adenomas. Clinical Oncology 8: 207-211, 1982
Lam KH, Wei WI, Ho HC, Ho CM: Whole organ sectioning of
mixed parotid tumours. Am J Surg 160: 377-381, 1982
Langdon JD: Parotid surgery in operative maxillofacial surgery.
Eds Langdon JD, Patel MF. London Chapman & Hall
1998B, pp 381-90
Langdon JD: Complications for parotid gland surgery. J
Maxillofac Surg 12: 225-229, 1984
Langdon JD: Tumours of the salivary glands. J Oral Maxillofac
Surg 43: 688-692, 1985
Langdon JD: Salivary gland disorders In pediatric surgery and
urology: Long term outcomes. Eds Stringer MD, Oldham KT,
Mouriquand PDE, Howard ER. London, WB Saunders
1998A, pp 92-103
Lanier VC, McSwain B, Rosenfeld L: Mixed tumours of salivary
glands: A 44 year Study. Southern Medical Journal 65:
1485-1488, 1972
Lefor AT, Ord RA: Multiple synchronous bilateral Warthin's
tumours of the parotid gland with pleomorphic adenoma.
Oral Med, Oral Path 76: 319-324, 1993
Leverstein H, Van Der Wal JE, Tiwari RM, Van Der Wal, L
Snow GB: Surgical management of 246 previously untreated
pleomorphic adenomas of the parotid gland. Br J Surg 85:
399-403, 1997
Maimaris CV, Vail MJ: Treatment of parotid gland tumours by
conservative parotidectomy. Br J Surg 73: 897, 1986
Martin H: The operative removal of tumours of the parotid
salivary gland. Surg. 31: 670-682, 1952
Martis C: Parotid benign tumours: comments on surgical
treatment of 263 cases. Int J Oral Surg 12: 211-220, 1983
Mc Evedy BV, Ross WM: The treatment of mixed parotid
tumours by enucleation and radiotherapy. Br J Surg 63:
341-342, 1976
McEvedy PG: Diseases of the salivary glands. Clinical Journal
63: 334-338, 1934
McFarland J: The mysterious mixed tumour of the salivary
glands. Surgery, Gynaecology & Obstetrics 76: 23-34, 1943
McFarland J: Three hundred tumours of the salivary glands of
which 69 recurred. Surgery, Gynaecology & Obstetrics 63:
457-468, 1936
McGurk M, Renehan A, Gleave EN, Hancock BD: Clinical
significance of the tumour capsule in the treatment of parotid
pleomorphic adenomas. Br J Surg 83: 1747-1749, 1996.
Moody AB, Avery CME, Taylor J, Langdon JD: A comparison of
one hundred and fifty consecutive parotidectomies for
tumours and inflammatory disease. Int J Oral Maxillofac Surg
28:211-215,1999
Natvig K, Soberg R: Relationship intraoperative rupture of pleomorphic adenomas to recurrence: an 11-25 year follow
up study. Head & Neck 16: 213-217, 1994
Patridge M, Langdon JD, Rankin S, Borthwick-Clarke A:
Diagnostic techniques for parotid disease. Br J Oral and
Maxillofac Surg 24: 311-332, 1986
Patey DH, Thackray AC: The treatment of parotid tumours in the
light of a pathological study of parotidectomy material. Br J
Surg 55: 477-487, 1958
Patey DH: The treatment of mixed tumours of the parotid gland.
Br J Surg. 28: 29-38, 1940
Prichard AJN, Barton RPE, Narula AA: Complications of
superficial parotidectomy versus extracapsular lumpectomy
in the treatment of benign parotid lesions. Journal of the
Royal College of Surgeons of Edinburgh 37: 155-158, 1992
Rawson AJ, Howard JM, Royster HP, Horn RC: Tumours of the
salivary glands. A clinicopathological study of 160 cases.
Cancer 3: 445-458, 1950
Seifert G, Miehlke A, Haubrich J, Chilla R: Diseases of the
salivary glands, Stuttgart, Georg Thieme 1986
Seifert G: Histological typing of salivary gland tumours. 2nd Ed
Berlin: World Health Organisation. Springer Verlag 1991
Stea G: Conservative surgical treatment of mixed tumours of the
parotid gland. J Maxillofac Surg 3: 135-137, 1975
Stein I, Geschickter CF: Tumours of the parotid gland. Arch Surg
28: 482-526, 1934
Stevens KL, Hobsley M: The treatment of pleomorphic
adenomas by formal parotidectomy. Br J Surg 69: 1-3, 1982
Tighe JVP, Langdon JD, Stenhouse P: Experience with a
modified rhytidectomy approach for parotidectomy. Br J
Oral Maxillofac Surg 39: 233, 2001
Touquet R, MacKenzie IJ, Carruth JAS: Management of the
parotid pleomorphic adenoma, the problem of exposing
tumour tissue at operation. The logical pursuit of treatment
policies. Br J Oral Maxillofac Surg 28: 404-408, 1990
Wennmo C, Spandow O, Eingard P, Krouthen B: Pleomorphic
adenomas of the parotid gland: Superficial parotidectomy or
limited excision? J Laryngol Otol 102: 603-605, 1988
Wood FC: Mixed tumours of the salivary glands. Ann Surg 39:
57, 1904
Woods JE, Chang GC, Beahrs OH: Experiences with 1360
primary parotid tumours. Am J Surg 130: 460-462, 1975
Yamashita T, Tomoda K, Kumazawa T: The usefulness of partial
parotidectomy for benign parotid gland tumours. Acta
Otolaryngol 500: 113-116, 1993
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