intra parotid neuromas: Topics by WorldWideScience.org

Sample records for intra parotid neuromas

Intra-parotid dermoid cyst: excision through a face lift incision.

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Shakeel, M; Keh, S M; Chapman, A; Hussain, A

2014-11-01

Intra-parotid dermoid cysts are extremely rare. Clinically, they present like any other parotid lump and pre-operative diagnosis is rarely possible. A 62 years old Caucasian man presented with a painless lump in his right parotid region. The Magnetic Resonance Imaging (MRI) scan revealed a 3 x 3 cm mass in the parotid tail. Cytological examination was unhelpful. The patient underwent successful excision of the cyst through a small face lift incision. No drain was inserted and the patient was discharged home the same day. The patient made an uneventful recovery and was highly satisfied with the aesthetic outcome. The definite histopathological diagnosis was an intra-parotid dermoid cyst.
Intratemporal facial nerve neuromas and their mimics: CT and MR findings

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Han, Moon Hee; Chang, Kee Hyun; Lee, Kyung Hwan; Cha, Sang Hoon; Kim, Chong Sun [Seoul National University College of Medicine, Seoul (Korea, Republic of); Kim, Sang Joon [Chungang Gil General Hospital, Seoul (Korea, Republic of)

1992-05-15

CT and MR findings of nine cases with intra temporal facial nerve neuromas were described and compared with CT findings of 3 cases with facial nerve palsy and facial nerve canal erosion which may mimic facial nerve neuroma. The tympanic segment of the facial nerve was involved in 8 cases, mastoid segment in 7 cases and labyrinthine segment in 5 cases. The lesions were easily diagnosed with high resolution CT with bone algorithms by showing the expansion of bony structures along the course of the facial nerves. In 4 cases with large vertical segment tumors, extensive destruction of mastoid air cells and external auditory canals posed difficulty in making a diagnosis. Two out of 5 cases with labyrinthine segment involvement were presented as middle cranial fossa masses. MRI with enhancement was performed in 4 cases and was useful in characterizing the lesion as a tumor with its superior sensitivity to enhancement. Three cases of facial neuroma-mimicking lesion including post-inflammatory peri neural thickening, peri neural extension from parotid adenoid cystic carcinoma, and congenita; cholesteatoma showed irregular erosion or mild expansion of the facial nerve canal which may be helpful for differential diagnosis from neuromas.
Probabilistic Multiple-Bias Modeling Applied to the Canadian Data From the Interphone Study of Mobile Phone Use and Risk of Glioma, Meningioma, Acoustic Neuroma, and Parotid Gland Tumors.

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Momoli, F; Siemiatycki, J; McBride, M L; Parent, M-É; Richardson, L; Bedard, D; Platt, R; Vrijheid, M; Cardis, E; Krewski, D

2017-10-01

We undertook a re-analysis of the Canadian data from the 13-country case-control Interphone Study (2001-2004), in which researchers evaluated the associations of mobile phone use with the risks of brain, acoustic neuroma, and parotid gland tumors. In the main publication of the multinational Interphone Study, investigators concluded that biases and errors prevented a causal interpretation. We applied a probabilistic multiple-bias model to address possible biases simultaneously, using validation data from billing records and nonparticipant questionnaires as information on recall error and selective participation. In our modeling, we sought to adjust for these sources of uncertainty and to facilitate interpretation. For glioma, when comparing those in the highest quartile of use (>558 lifetime hours) to those who were not regular users, the odds ratio was 2.0 (95% confidence interval: 1.2, 3.4). After adjustment for selection and recall biases, the odds ratio was 2.2 (95% limits: 1.3, 4.1). There was little evidence of an increase in the risk of meningioma, acoustic neuroma, or parotid gland tumors in relation to mobile phone use. Adjustments for selection and recall biases did not materially affect interpretation in our results from Canadian data. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Facial neuroma masquerading as acoustic neuroma.

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Sayegh, Eli T; Kaur, Gurvinder; Ivan, Michael E; Bloch, Orin; Cheung, Steven W; Parsa, Andrew T

2014-10-01

Facial nerve neuromas are rare benign tumors that may be initially misdiagnosed as acoustic neuromas when situated near the auditory apparatus. We describe a patient with a large cystic tumor with associated trigeminal, facial, audiovestibular, and brainstem dysfunction, which was suspicious for acoustic neuroma on preoperative neuroimaging. Intraoperative investigation revealed a facial nerve neuroma located in the cerebellopontine angle and internal acoustic canal. Gross total resection of the tumor via retrosigmoid craniotomy was curative. Transection of the facial nerve necessitated facial reanimation 4 months later via hypoglossal-facial cross-anastomosis. Clinicians should recognize the natural history, diagnostic approach, and management of this unusual and mimetic lesion. Copyright © 2014 Elsevier Ltd. All rights reserved.
Acoustic Neuroma Association

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Bilateral acoustic neuromas.

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Anand, V T; Byrnes, D P; Walby, A P; Kerr, A G

1993-10-01

This article reviews 12 patients with bilateral acoustic neuromas. The sex incidence was equal and the mean age at diagnosis was 26.2 years. The family history was positive in nine of the patients. Five patients have had incomplete surgical removal of acoustic neuromas on both sides. Two of them are completely deaf and the other three have severe sensorineural hearing loss in one ear and no hearing in the other ear. In five patients the tumour on one side has been operated on and the other side is being observed with at least short-term preservation of good hearing. The remaining two patients died of intra-cranial complications, one of them post-operatively. Four patients developed facial palsy immediately following surgery and one developed facial weakness 6 months after surgery. Guidelines are discussed for the care of these patients including the timing of surgery and alternative treatment options (observation, radio-surgery and chemotherapy). This is essentially a group of young individuals who have had multiple operations for bilateral acoustic tumours and associated manifestations and for whom the disease and the sequelae of treatment can be tragic.
Acoustic Neuroma

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An acoustic neuroma is a benign tumor that develops on the nerve that connects the ear to the brain. ... can press against the brain, becoming life-threatening. Acoustic neuroma can be difficult to diagnose, because the ...
MRI features of peripheral traumatic neuromas

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Ahlawat, Shivani [Johns Hopkins University School of Medicine, Musculoskeletal Radiology Section, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Belzberg, Allan J. [The Johns Hopkins Hospital, Department of Neurosurgery, Baltimore, MD (United States); Montgomery, Elizabeth A. [The Johns Hopkins Hospital, Pathology, Oncology and Orthopedic Surgery, Baltimore, MD (United States); Fayad, Laura M. [Department of Orthopedic Surgery, Department of Radiology and Radiological Science, Musculoskeletal Imaging Section Chief, The Johns Hopkins Medical Institutions, Baltimore, MD (United States); The Johns Hopkins Medical Institutions, Department of Orthopedic Surgery, Baltimore, MD (United States)

2016-04-15

To describe the MRI appearance of traumatic neuromas on non-contrast and contrast-enhanced MRI sequences. This IRB-approved, HIPAA-compliant study retrospectively reviewed 13 subjects with 20 neuromas. Two observers reviewed pre-operative MRIs for imaging features of neuroma (size, margin, capsule, signal intensity, heterogeneity, enhancement, neurogenic features and denervation) and the nerve segment distal to the traumatic neuroma. Descriptive statistics were reported. Pearson's correlation was used to examine the relationship between size of neuroma and parent nerve. Of 20 neuromas, 13 were neuromas-in-continuity and seven were end-bulb neuromas. Neuromas had a mean size of 1.5 cm (range 0.6-4.8 cm), 100 % (20/20) had indistinct margins and 0 % (0/20) had a capsule. Eighty-eight percent (7/8) showed enhancement. All 100 % (20/20) had tail sign; 35 % (7/20) demonstrated discontinuity from the parent nerve. None showed a target sign. There was moderate positive correlation (r = 0.68, p = 0.001) with larger neuromas arising from larger parent nerves. MRI evaluation of the nerve segment distal to the neuroma showed increased size (mean size 0.5 cm ± 0.4 cm) compared to the parent nerve (mean size 0.3 cm ± 0.2 cm). Since MRI features of neuromas include enhancement, intravenous contrast medium cannot be used to distinguish neuromas from peripheral nerve sheath tumours. The clinical history of trauma with the lack of a target sign are likely the most useful clues. (orig.)
What Is an Acoustic Neuroma

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[Operative treatment of painful neuromas].

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Stokvis, Annemieke; Coert, J Henk

2011-01-01

3-5% of patients with traumatic or iatrogenic peripheral nerve injury develop a painful neuroma, especially following trauma of small cutaneous sensory nerve branches. Neuroma pain is difficult to treat and often leads to loss of function and reduction of quality of life. Patients with a painful neuroma present with spontaneous electric, shooting or burning pain, allodynia, hyperalgesia and cold intolerance. The diagnosis is based on the medical history and physical examination, supplemented by Tinel's test and a diagnostic nerve blockade. Lasting pain relief is possible by means of surgical neuroma treatment performed by a plastic surgeon. Surgical treatment consists of repair or denervation of the nerve with relocation of the nerve stump in bone or muscle tissue or a vein. Referral of neuroma patients without delay to a plastic surgeon or multidisciplinary consultation is important, because the symptoms become increasingly difficult to treat over time. 3-5% of patients with traumatic or iatrogenic peripheral nerve injury develop a painful neuroma, especially following trauma of small cutaneous sensory nerve branches. Neuroma pain is difficult to treat and often leads to loss of function and reduction of quality of life. Patients with a painful neuroma present with spontaneous electric, shooting or burning pain, allodynia, hyperalgesia and cold intolerance. The diagnosis is based on the medical history and physical examination, supplemented by Tinel's test and a diagnostic nerve blockade. Lasting pain relief is possible by means of surgical neuroma treatment performed by a plastic surgeon. Surgical treatment consists of repair or denervation of the nerve with relocation of the nerve stump in bone or muscle tissue or a vein. Referral of neuroma patients without delay to a plastic surgeon or multidisciplinary consultation is important, because the symptoms become increasingly difficult to treat over time.
Unilateral multiple tumorous lesions of the parotid gland

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Takahashi, Mitsuaki; Fujita, Takenori; Adachi, Tosihide; Enomoto, Kenichi; Ishii, Hidenori; Yoshida, Chikako; Hokunan, Kazuhiko; Bando, Nobuyuki; Shigyo, Hiroshi.

1997-01-01

Multifocal tumors within the same parotid gland are very rare. We treated 13 patients with multiple tumorous lesions within the unilateral parotid gland. We evaluated the multiple nodules by CT-sialography or magnetic resonance imaging (MRI). These imagings showed clearly two or more distinct nodular-appearing lesions. Recurrent pleomorphic adenoma (6 patients) was predominant, followed by Whartin's tumor (3 patients). The other lesions were two differential parenchymal tumors (polymorphous low grade adenoma/adenoma) within the same gland, a malignant lymphoma, a squamous cell carcinoma metastatic to the gland, and a tuberculous lesion. On palpitation, 9 of the patients had an unilateral tumor, one a palpable parotid mass in the gland, and the other four had two or more tumors in the unilateral gland. The patients with intra-parotid lymph node and metastatic lesions had extra-parotid cervical adenopathy. The clinical features and the differential diagnosis of the unilateral multiple tumors lesions of the parotid gland are discussed. (author)
Acoustic Neuroma Educational Video

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Swimming Training Reduces Neuroma Pain by Regulating Neurotrophins.

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Tian, Jinge; Yu, Tingting; Xu, Yongming; Pu, Shaofeng; Lv, Yingying; Zhang, Xin; DU, Dongping

2018-01-01

Neuroma formation after peripheral nerve transection leads to severe neuropathic pain in amputees. Previous studies suggested that physical exercise could bring beneficial effect on alleviating neuropathic pain. However, the effect of exercise on neuroma pain still remained unclear. In addition, long-term exercise can affect the expression of neurotrophins (NT), such as nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF), which play key roles in nociceptor sensitization and nerve sprouting after nerve injury. Here, we investigated whether long-term swimming exercise could relieve neuroma pain by modulating NT expression. We used a tibial neuroma transposition (TNT) rat model to mimic neuroma pain. After TNT surgery, rats performed swimming exercise for 5 wk. Neuroma pain and tactile sensitivities were detected using von Frey filaments. Immunofluorescence was applied to analyze neuroma formation. NGF and BDNF expressions in peripheral neuroma, dorsal root ganglion, and the spinal cord were measured using enzyme-linked immunosorbent assay and Western blotting. TNT led to neuroma formation, induced neuroma pain, and mechanical allodynia in hind paw. Five-week swimming exercise inhibited neuroma formation and relieved mechanical allodynia in the hind paw and neuroma pain in the lateral ankle. The analgesic effect lasted for at least 1 wk, even when the exercise ceased. TNT elevated the expressions of BDNF and NGF in peripheral neuroma, dorsal root ganglion, and the spinal cord to different extents. Swimming also decreased the elevation of NT expression. Swimming exercise not only inhibits neuroma formation induced by nerve transection but also relieves pain behavior. These effects might be associated with the modulation of NT.
Morton neuroma: MRI diagnostic value

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Yelin, Enrique G.; Aparicio, Rocio; Dutto, Santiago; Rodriguez Lucero, Javier

2004-01-01

Objective: To evaluate the diagnostic value of MRI in Morton's Neuroma (MN). Material and methods: 23 patients with clinical diagnosis of MN were examined under two different protocols, with a 1.5 T Magnet. 1) T1, FSET2, FIR, T1 with contrast enhancement and fat suppression; 2) T1, FSET2, FIR without contrast enhancement (i.v. Gadolinium). Results: In the first group MN was found in 7 patients. In the second group 14 patients were studied, 7 with positive MR for neuroma, and 9 with negative MR. 6 were true-negative and 3 were false-negative. The Fisher Test between both groups was p < 0.05. Conclusion: MRI is effective for the diagnosis of Morton neuroma. The use of gadolinium and fat suppression significantly improved the detection of Morton neuroma, allowing better measurements of the lesion. These findings do not correlate with previous papers that do not encourage the use of i.v. Gadolinium. (author)
[Treatment of giant acoustic neuromas].

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Samprón, Nicolás; Altuna, Xabier; Armendáriz, Mikel; Urculo, Enrique

2014-01-01

To analyze the treatment modality and outcome of a series of patients with giant acoustic neuromas, a particular type of tumour characterised by their size (extracanalicular diameter of 4cm or more) and high morbidity and mortality. This was a retrospective unicentre study of patients with acoustic neuromas treated in a period of 12 years. In our institutional series of 108 acoustic neuromas operated on during that period, we found 13 (12%) cases of giant acoustic neuromas. We reviewed the available data of these cases, including presentation and several clinical, anatomical, and microsurgical aspects. All patients were operated on by the same neurosurgeon and senior author (EU) using the suboccipital retrosigmoid approach and complete microsurgical removal was achieved in 10 cases. In one case, near total removal was deliberately performed, in another case a CSF shunt was placed as the sole treatment measure, and in the remaining case no direct treatment was given. One patient died in the immediate postoperative period. One year after surgery, 4 patients showed facial nerve function of iii or more in the House-Brackman scale. The 4 most important prognostic characteristics of giant acoustic neuromas are size, adhesion to surrounding structures, consistency and vascularity. Only the first of these is evident in neuroimaging. Giant acoustic neuromas are characterised by high morbidity at presentation as well as after treatment. Nevertheless, the objective of complete microsurgical removal with preservation of cranial nerve function is attainable in some cases through the suboccipital retrosigmoid approach. Copyright © 2014 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.
Ultrasonography and magnetic resonance imaging in the diagnosis of Morton's neuroma.

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Fazal, Muhammad Ali; Khan, Ishrat; Thomas, Cherian

2012-01-01

Magnetic resonance imaging (MRI) and ultrasonography are used widely for the diagnosis of Morton's neuroma. The aim of this study was to assess the accuracy of these two modalities as diagnostic tools in Morton's neuroma. Fifty feet of 47 consecutive patients (39 women and 8 men; mean age, 46 years; age range, 36-64 years) who presented between January 1, 2005, and June 30, 2008, were included in the study. Twenty-five feet were investigated with ultrasonography and 25 with MRI. Morton's neuroma was confirmed surgically and histologically in all of the patients. A Student unpaired t test was applied. Twenty-two MRIs were diagnostic (sensitivity, 88%). Three patients with negative MRI findings underwent ultrasonography and were found to have a neuroma smaller than 5 mm. Twenty-four ultrasound scans demonstrated the neuroma (sensitivity, 96%), with five neuromas being smaller than 5 mm. Ultrasonography has a slightly higher sensitivity in the diagnosis of Morton's neuroma, particularly of neuromas smaller than 5 mm, and should be the preferred imaging modality in suspected cases, and MRI should be reserved for cases with equivocal diagnosis.
Palisaded encapsulated neuroma

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Adesh S Manchanda

2015-01-01

Full Text Available Palisaded encapsulated neuroma (PEN is a benign cutaneous or mucosal neural tumor which, usually, presents as a solitary, firm, asymptomatic, papule or nodule showing striking predilection for the face. It occurs commonly in middle age, and there is no sex predilection. Oral PEN are not common, and these lesions must be distinguished from other peripheral nerve sheath tumors such as the neurofibroma, neurilemma (schwannoma, and traumatic neuroma. The major challenge in dealing with lesions of PEN is to avoid the misdiagnosis of neural tumors that may be associated with systemic syndromes such as neurofibromatosis and multiple endocrine neoplasia syndrome type 2B. Here, we present a case of benign PEN of the gingiva in the left anterior mandibular region, laying importance on immunohistochemical staining in diagnosing such lesions.
A free vein graft cap influences neuroma formation after nerve transection.

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Galeano, Mariarosaria; Manasseri, Benedetto; Risitano, Giovanni; Geuna, Stefano; Di Scipio, Federica; La Rosa, Paola; Delia, Gabriele; D'Alcontres, Francesco Stagno; Colonna, Michele R

2009-01-01

: Neuroma formation is a major problem in nerve surgery and consensus about its prevention has not been reached. It has been suggested that vein covering can reduce neuroma formation in transected nerves. In this article, the Authors propose an easy and novel method of covering by nerve stump capping with a free vein graft. : Neuroma-like lesions were created on the rat thigh sectioning the femoral nerve above its division in 16 animals. The proximal nerve stump was invaginated into the lumen of a 1.5 cm long femoral free vein graft on the right side, and the vein was closed on itself by microsurgical sutures to form a cap for the nerve stump. On the left side acting as the control neuroma, the nerve was cut and left uncovered. Histological and immunohistochemical assessment was used to quantify the degree of neuroma formation. : Significant differences were found in both neuroma size and axon-glia organization between the treated and control sides indicating that free vein graft capping reduced neuroma formation in comparison to uncovered nerve stumps. : Our results confirm that vein-covering of a transected nerve stump can be effective in reducing neuroma formation. Moreover, unlike previous works that buried the nerve into an adjacent vein left in place, our experiments showed that also the use of a free vein graft cap can hinder neuroma formation. Although translation of rat experiments to the clinics should be dealt with caution, our data suggest a careful clinical use of the technique. (c) 2009 Wiley-Liss, Inc. Microsurgery, 2009.

Early diagnosis of acoustic neuroma by the vestibular test

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Haid, T; Rettinger, G; Berg, M; Wigand, M E

1981-11-01

In a series of 390 cases with suspicion of acoustic neurinomas 78 such tumors could be diagnosed, including 12 early stage neurinomas. This relatively high detection quote of small neurinomas is due to a special diagnostical programme: Every patient with unilateral and sensoneural hearingloss, independent of vertigo anamnesis or of the result of X-rays must be further examined by a vestibular test. All 78 patients with acoustic neuroma had pathological vestibular findings. The positional test turned out to be the most sensitive examination in the early diagnosis of acoustic neuromas and yields a still higher incidence than the thermic test: 95% of the patients with a neuroma showed pathological findings in the positional test. Every patient suffering from an unidentified unilateral and sensoneural hearingloss combined with a pathological result in the positional test must be further checked by a cisternomeatography or computerized tomography using airinsufflation. Every fifth of these patients showed typical signs of an acoustic neuroma in the neuroradiological tests. 68 neuromas are operated today and verfied histologically, 10 patients are still waiting for surgical treatment.
Early diagnosis of acoustic neuroma by quantitative neurootological and neuroradiological tests

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Haid, C T

1983-02-01

Every patient with unilateral and sensoneural loss of hearing, independent of vertigo anamnesis or X-rays must be further examined by a vestibular test. Between 1974 and 1980, 80 acoustic neuromas could be diagnosed, including 12 early stage neuromas. This relatively high detection quote of small neuromas is due to a special diagnostical program: All 80 patients with acoustic neuroma had a pathological vestibular result. The positional test turned out to be the most sensitive examination in the early diagnosis of acoustic neuromas and yields a still higher incidence than the caloric test: 95% of the patients with a neurinoma showed a pathological result in the positional test. So every patient suffering from an unidentified unilateral and sensoneural hearing loss combined with a pathological result in the positional test must be further examined by a cisternomeatography or computerized tomography (using air-insufflation). Every fifth of these patients showed unique hints of an acoustic neuroma in the neuroradiological test.
Carcinomatous meningitis appearing as acoustic neuromas. Two cases

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Astner, S.T.; Nieder, C.; Grosu, A.L.; Stock, K.; Gaa, J.

2007-01-01

Background: For acoustic neuromas, stereotactic radiotherapy (radiosurgery or stereotactic fractionated radiotherapy) has been established as an important alternative to microsurgery. In most cases initial symptoms are slow progression of unilateral hearing loss, tinnitus or vertigo or acute hearing loss with vertigo. MRI scan shows a contrast-enhancing tumor within the inner auditory channel. If the patient undergoes primary radiotherapy, diagnosis is usually not verified histologically. Therefore, careful evaluation of the medical history is mandatory despite a typical appearance on the MRI scan. If medical history does not match with acoustic neuroma, further diagnostics are necessary to rule out infectious disease or carcinomatous meningitis. Case Report: Two patients with hearing loss, vertigo and the diagnosis of acoustic neuromas by MRI scan were referred for radiotherapy. In both cases the symptoms progressed very rapidly, not typical of acoustic neuromas, and in both patients repeated liquor puncture finally revealed carcinomatous meningitis. One patient died during therapy; in the second patient intrathecal chemotherapy and additional radiotherapy of the skull base led to partial remission continuing for several months. Conclusion: Before primary radiotherapy of small intrameatal lesions diagnosis must be reassessed carefully. This is especially true for bilateral lesions suspicious for acoustic neuromas and rapid progression and persistence of clinical symptoms where carcinomatous meningitis has to be taken into account. (orig.)
Carcinomatous meningitis appearing as acoustic neuromas. Two cases

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Astner, S T; Nieder, C; Grosu, A L [Technical Univ. of Munich (Germany). Dept. of Radiation Oncology; Stock, K [Technical Univ. of Munich (Germany). Dept. of Internal Medicine; Gaa, J [Technical Univ. of Munich (Germany). Dept. of Radiology

2007-05-15

Background: For acoustic neuromas, stereotactic radiotherapy (radiosurgery or stereotactic fractionated radiotherapy) has been established as an important alternative to microsurgery. In most cases initial symptoms are slow progression of unilateral hearing loss, tinnitus or vertigo or acute hearing loss with vertigo. MRI scan shows a contrast-enhancing tumor within the inner auditory channel. If the patient undergoes primary radiotherapy, diagnosis is usually not verified histologically. Therefore, careful evaluation of the medical history is mandatory despite a typical appearance on the MRI scan. If medical history does not match with acoustic neuroma, further diagnostics are necessary to rule out infectious disease or carcinomatous meningitis. Case Report: Two patients with hearing loss, vertigo and the diagnosis of acoustic neuromas by MRI scan were referred for radiotherapy. In both cases the symptoms progressed very rapidly, not typical of acoustic neuromas, and in both patients repeated liquor puncture finally revealed carcinomatous meningitis. One patient died during therapy; in the second patient intrathecal chemotherapy and additional radiotherapy of the skull base led to partial remission continuing for several months. Conclusion: Before primary radiotherapy of small intrameatal lesions diagnosis must be reassessed carefully. This is especially true for bilateral lesions suspicious for acoustic neuromas and rapid progression and persistence of clinical symptoms where carcinomatous meningitis has to be taken into account. (orig.)
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[Treatment of painful neuromas via end-to-side neurorraphy].

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Aszmann, O C; Moser, V; Frey, M

2010-08-01

Management of the painful neuroma has been subject to controversy since the earliest descriptions of this disabling problem. Today, treatment is limited to resection of the neuroma and implantation of the nerve in a muscle at a location where it is safe from irritation and trauma. This however is not attainable in many cases and it is our clinical experience, that nerves without a target remain a source of constant discomfort and pain. Recently we reported of the feasibility of neuroma prevention through end-to-side neurorraphy into adjacent sensory and/or motor nerves to provide a target for axons deprived of their endorgan. Here we report of our first clinical experience with this method in sixteen patients with longstanding upper and lower extremity neuromas. 16 patients were included in this study. All had neuromas of different sensory nerves of both the upper and lower extremity. 11 were of iatrogenic origin, 5 were caused by different traumas. 8 had previous attempts to surgically treat the neuroma. Finally, all were treated by end-to-side neurorraphy into adjacent nerves. Postoperatively quantitative sensorymotor testing was performed to evaluate possible changes of nerve function of the recipient nerves. Pain was evaluated by visual analogue score and changes in pain medication. In no patient a sensory or motor deficit or painful sensations were induced in the target area of the recipient nerve. Some had dysaesthesias for about 6 months, which finally subsided. All but 1 patient improved in their symptoms at a follow-up of more than 2 years. Previous experimental work and present clinical results suggest that axons of a severed peripheral nerve that are provided with a pathway and target through an end-to-side coaptation will either be pruned or establish some type of end-organ contact so that a neuroma can be prevented without inducing sensory or motor dysfunctions in the recipient nerve. Georg Thieme Verlag KG Stuttgart New York.
Factors influencing the parotid function in nasopharyngeal carcinoma treated with parotid-sparing radiotherapy

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Liu Wenshan; Lee Jongkang; Su Maochang; Lee, S.P.; Chen Ginden; Lee Hongshen; Lee Huei

2006-01-01

The background of this study was to evaluate the factors influencing post-irradiation parotid gland function in nasopharyngeal cancer treated with parotid-sparing radiotherapy. This study consisted of 45 patients with nasopharyngeal cancer treated with radiotherapy including 3D conformal radiotherapy, intensity-modulated radiotherapy and high-dose-rate brachytherapy. The mean follow-up time was 37.5 months (range: 15-50 months). Objective parotid gland function was assessed by series sialoscintigraphy pre-irradiation and post-irradiation at 1, 6, 12 and 18 months. Subjective salivary function was recorded by the LENT/SOMA system. Wilcoxon signed-rank test was used to compare the secretion ratio (SR) of parotid gland before and after treatment. Mann-Whitney rank-sum test was used to determine the factors influencing the post-irradiated SR. Chi-square test was used to compare the correlation between subjective grading of xerostomia and objective grading of parotid glands. There was a significant difference between the pre-irradiation and post-irradiation parotid gland's SR at 1 (0.30 versus 0.01, P 0.05) and 18 months (0.30 versus 0.18, P>0.05). There was significant correlation between subjective and objective salivary function (P=0.024) at 12 months after radiotherapy. The factor that impacted the preservation of parotid function was mean dose to the parotid gland >38.0 Gy (P<0.05). Our results demonstrated that parotid function could recover 1 year after treatment with parotid-sparing radiotherapy in patients with nasopharyngeal cancer. The most important factor that influenced parotid function was the mean dose to the parotid gland. (author)
A quantitative evaluation of gross versus histologic neuroma formation in a rabbit forelimb amputation model: potential implications for the operative treatment and study of neuromas

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Kuiken Todd A

2011-10-01

Full Text Available Abstract Background Surgical treatment of neuromas involves excision of neuromas proximally to the level of grossly "normal" fascicles; however, proximal changes at the axonal level may have both functional and therapeutic implications with regard to amputated nerves. In order to better understand the retrograde "zone of injury" that occurs after nerve transection, we investigated the gross and histologic changes in transected nerves using a rabbit forelimb amputation model. Methods Four New Zealand White rabbits underwent a forelimb amputation with transection and preservation of the median, radial, and ulnar nerves. After 8 weeks, serial sections of the amputated nerves were then obtained in a distal-to-proximal direction toward the brachial plexus. Quantitative histomorphometric analysis was performed on all nerve specimens. Results All nerves demonstrated statistically significant increases in nerve cross-sectional area between treatment and control limbs at the distal nerve end, but these differences were not observed 10 mm more proximal to the neuroma bulb. At the axonal level, an increased number of myelinated fibers were seen at the distal end of all amputated nerves. The number of myelinated fibers progressively decreased in proximal sections, normalizing at 15 mm proximally, or the level of the brachial plexus. The cross-sectional area of myelinated fibers was significantly decreased in all sections of the treatment nerves, indicating that atrophic axonal changes proceed proximally at least to the level of the brachial plexus. Conclusions Morphologic changes at the axonal level extend beyond the region of gross neuroma formation in a distal-to-proximal fashion after nerve transection. This discrepancy between gross and histologic neuromas signifies the need for improved standardization among neuroma models, while also providing a fresh perspective on how we should view neuromas during peripheral nerve surgery.

Ultrasound-Guided Hyaluronic Acid Injection for the Management of Morton's Neuroma.

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Lee, Kang; Hwang, Il-Yeong; Ryu, Chang Hyun; Lee, Jae Woo; Kang, Seung Woo

2018-02-01

Morton's neuroma is one of the common causes of forefoot pain. In the present study, hyaluronic acid injection was performed on patients to determine the efficacy and adverse effects of hyaluronic acid in management of Morton's neuroma. Eighty-three patients with Morton's neuroma in their third intermetatarsal space with definite Mulder's click were included in the study. Those with severe forefoot deformities such as forefoot cavus or hallux valgus on plain X-rays were excluded. Ultrasound-guided hyaluronic acid injections were performed on all patients weekly for 3 weeks. Pain during walking using visual analogue scale (VAS) and AOFAS Forefoot Scale were prospectively evaluated preinjection, and at 2, 4, 6, 12 months postinjection. Significant improvement in VAS and AOFAS Forefoot Scale were seen overall at 2 months after hyaluronic acid injections ( P hyaluronic injection was clinically effective for pain relief and functional improvement for at least 12 months in patients with Morton's neuroma. However, numbness associated with Morton's neuroma should be addressed more cautiously since it may persist without much improvement. Level IV, retrospective case series.
The Top 50 Most-Cited Articles on Acoustic Neuroma.

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Alfaifi, Abrar; AlMutairi, Othman; Allhaidan, Maha; Alsaleh, Saad; Ajlan, Abdulrazag

2018-03-01

Acoustic neuroma is the most common extra-axial primary cerebellopontine angle tumor in adults. A plethora of studies have been published on acoustic neuroma, but none of the previous works have highlighted the most influential articles. Our objective was to perform a bibliometric analysis of the 50 most-cited articles on acoustic neuroma. We performed a title-specific search on the Scopus database using the following search terms: "acoustic neuroma," "vestibular schwannoma," and "cerebellopontine angle." We recorded the 50 most-cited articles and reviewed them. The 50 most-cited articles had an average of 175 citations per article. All articles were published between 1980 and 2006, with 1997 the most prolific year, when 7 articles were published. The journals Neurosurgery and Laryngoscope published 10 and 8 of these articles, respectively. The most common study categories were nonsurgical management (17/50) and surgical management (13/50). Studies were predominantly published by otolaryngologists (22/50) and neurosurgeons (14/50). Douglas Kondziolka was the author with the highest number of contributions, with 7 publications. The majority of the articles were produced in the United States (64%). Identifying articles on acoustic neuroma with the most impact provides an important overview of the historical development of treatment methods and publication trends related to this condition. A finalized, comprehensive list of the most important works represents an excellent tool that can serve as a guide for evidence-based clinical practice. Copyright © 2017 Elsevier Inc. All rights reserved.
Ultrasonographic features of traumatic neuromas in breast cancer patients after mastectomy

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Sung, Hwa Sung; Kim, Young Seon [Dept. of Radiology, Yeungnam University College of Medicine, Daegu (Korea, Republic of)

2017-01-15

The purpose of this study was to evaluate the ultrasonographic (US) features of traumatic neuromas in breast cancer patients after mastectomy. This study was performed with approval from our Institutional Review Board, and the requirement for informed consent was waived. Six traumatic neuromas in five patients were included in this study. The US findings of traumatic neuromas were evaluated retrospectively by two radiologists according to the Breast Imaging-Reporting and Data System (BI-RADS) lexicon. The final assessment was also recorded. On US, all six lesions presented as a mass within the pectoralis muscle layer (mean size, 4.8 mm; range, 3.9 to 5.5 mm). Of the six masses, four had an oval shape with a circumscribed margin, and two had an irregular shape and an indistinct margin. They were all hypoechoic. Two lesions showed a non-parallel orientation. On color Doppler examinations, two lesions showed internal vascularity. Strain elastography was performed for four neuromas, resulting in scores of 1 (n=1), 4 (n=2), and 5 (n=1). The final assessment categories were BI-RADS 3 (n=2), 4A (n=2), and 4B (n=2). On US, an oval shape, circumscribed margin, parallel orientation, and hypoechogenicity were the most frequent features of traumatic neuromas in breast cancer patients after mastectomy. Neuromas may show increased vascularity on color Doppler imaging and present as a hard mass on elastography.
Ultrasonographic features of traumatic neuromas in breast cancer patients after mastectomy

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Hwa Sung Sung

2017-01-01

Full Text Available Purpose The purpose of this study was to evaluate the ultrasonographic (US features of traumatic neuromas in breast cancer patients after mastectomy. Methods This study was performed with approval from our Institutional Review Board, and the requirement for informed consent was waived. Six traumatic neuromas in five patients were included in this study. The US findings of traumatic neuromas were evaluated retrospectively by two radiologists according to the Breast Imaging-Reporting and Data System (BI-RADS lexicon. The final assessment was also recorded. Results On US, all six lesions presented as a mass within the pectoralis muscle layer (mean size, 4.8 mm; range, 3.9 to 5.5 mm. Of the six masses, four had an oval shape with a circumscribed margin, and two had an irregular shape and an indistinct margin. They were all hypoechoic. Two lesions showed a non-parallel orientation. On color Doppler examinations, two lesions showed internal vascularity. Strain elastography was performed for four neuromas, resulting in scores of 1 (n=1, 4 (n=2, and 5 (n=1. The final assessment categories were BI-RADS 3 (n=2, 4A (n=2, and 4B (n=2. Conclusion On US, an oval shape, circumscribed margin, parallel orientation, and hypoechogenicity were the most frequent features of traumatic neuromas in breast cancer patients after mastectomy. Neuromas may show increased vascularity on color Doppler imaging and present as a hard mass on elastography.
Biliary stricture due to neuroma after an innocent blunt abdominal trauma.

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Katsinelos, P; Dimiropoulos, S; Galanis, I; Tsolkas, P; Paroutoglu, G; Arvaniti, M; Katsiba, D; Baltaglannis, S; Pilpilidis, I; Papagiannis, A; Vaslliadis, I

2002-10-01

A traumatic neuroma of the biliary tract is rarely associated with biliary obstruction. However, when it arises in the common bile duct (CBD) and is associated with obstructive jaundice, it is difficult to distinguish it from bile duct cancer. We describe a patient who developed obstructive jaundice and itching, due to CBD stricture, 8 years after innocent blunt abdominal trauma. The stricture was resected and hepatico-jejunal anastomosis was performed. Histological examination revealed a traumatic neuroma and a fibrous scar around the common bile duct. Symptoms disappeared following surgical removal of the lesion. Blunt abdominal injury may cause the late onset of a fibrous scar and traumatic neuroma in the common bile duct. To our knowledge, a traumatic neuroma of the biliary tract after blunt abdominal trauma has not been reported previously. We review the clinical picture of this relatively rare problem, along with its diagnosis, pathogenesis and treatment.
Stereotactic radiosurgery for acoustic neuroma: a Canadian perspective

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Ross, I.B.; Tator, C.H.

1998-01-01

Stereotactically delivered radiation is now an accepted treatment for patients with acoustic neuroma. In some cases, patient preference may be the reason for its selection, while in others neurosurgeons may select it for patients who are elderly or have significant risk factors for conventional surgery. The majority of patients with acoustic neuroma treatment with stereotactic radiosurgery have been treated with the Gamma Knife, with follow ups of over 25 years in some instances. Other radiosurgical modalities utilizing the linear accelerator have been developed and appear promising, but there is no long-term: follow up. Canada does not possess a Gamma Knife facility, and its government-funded hospital and medical insurance agencies have made it difficult for patients to obtain reimbursement for Gamma Knife treatments in other countries. We review the literature to date on the various forms of radiation treatment for acoustic neuroma and discuss the current issues facing physicians and patients in Canada who wish to obtain their treatment of choice. (author)
Four cases of acoustic neuromas with normal hearing.

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Valente, M; Peterein, J; Goebel, J; Neely, J G

1995-05-01

In 95 percent of the cases, patients with acoustic neuromas will have some magnitude of hearing loss in the affected ear. This paper reports on four patients who had acoustic neuromas and normal hearing. Results from the case history, audiometric evaluation, auditory brainstem response (ABR), electroneurography (ENOG), and vestibular evaluation are reported for each patient. For all patients, the presence of unilateral tinnitus was the most common complaint. Audiologically, elevated or absent acoustic reflex thresholds and abnormal ABR findings were the most powerful diagnostic tools.
Summary and consensus in 7th International Conference on acoustic neuroma: An update for the management of sporadic acoustic neuromas

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Hao Wu

2016-12-01

Full Text Available Sporadic vestibular schwannoma (acoustic neuroma is a benign tumor arising from cochleovestibular nerve. Nowadays, various specialties and medical centers are treating this disease, and the multidisciplinary collaboration is the trend. In an effort to promote a uniform standard for reporting clinical results, even for treatment indications, the mainly controversies were posed and discussed during the 7th International Conference on acoustic neuroma, and the agreement was summarized by the Committee of this conference. The main symptoms grading and tumor stage should note its name of classification for making them comparable. The goal of the modern managements for vestibular schwannoma is to improve the quality of life with lower mortality, lower morbidity and better neurological function preservation. The experience of surgical team and their preference might be a major factor for the outcome. Because of lacking of long-term follow-up large data after radiotherapy, and with the development of microsurgery, radiotherapy is now less recommended except for recurrent cases or elderly patients. Keywords: Sporadic acoustic neuroma, Vestibular schwannoma, Management, Symptoms grading, Tumor stage, Microsurgery, Radiotherapy
''Dural tail'' adjacent to acoustic neuroma on MRI: a case report

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Lunardi, P.; Mastronardi, L.; Nardacci, B.; Acqui, M.; Fortuna, A.

1993-01-01

A 'dural tail' on Gd-DTPA-enhanced MRI has been often observed adjacent to meningiomas and considered to be useful in distinguishing meningioma of the cerebellopontine angle from acoustic neuroma. However, demonstration of a dural tail adjacent to an acoustic neuroma indicates that this sign is not specific. (orig.)
Histopathologic correlation of parotid tumors

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Ramirez Valverde, Jose Miguel

2014-01-01

Malignization percentage of parotid pleomorphic adenoma is defined with fine needle aspiration biopsy (FNAB), prior negative in patients operated by parotid tumor in the Hospital San Juan de Dios between 2008-2012. Patients diagnosed with pleomorphic adenoma by FNAB are described in time, place and person. The histological type of parotid tumors diagnosed are defined. Management offered to patients diagnosed with parotid tumors is understood in the Hospital San Juan de Dios. Complications associated with surgical procedure in patients are specified. A quarter part the of parotid tumors from the series analyzed have been malignant, a similar percentage described in the literature [es
Hydroxyapatite cement cranioplasty in translabyrinthine acoustic neuroma surgery.

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Arriaga, Moisês A; Chen, Douglas A

2002-05-01

Hydroxyapatite cement cranioplasty (HAC) after translabyrinthine resection of acoustic neuroma is a promising new technique for wound reconstruction. This study reviews the efficacy of HAC for the prevention of cerebrospinal fluid (CSF) leakage and the long-term wound outcomes of HAC versus abdominal fat graft (AFG) reconstruction. This retrospective study of l08 consecutive acoustic neuromas operated on by Pittsburgh Ear Associates uses chart review, telephone interview, and mail questionnaire data. Fifty-four patients received AFG dural repair, and 54 patients received HAC. Seven AFG patients (12.5%) had CSF leaks versus 2 (3.7%) of the overall group of 54 HAC patients. However, none (0%) of the 47 HAC patients had CSF leakage with current HAC techniques. HAC also produced significantly less postauricular wound depression and superior cosmetic results in comparison with AFG. Although HAC patients experienced less postoperative discomfort, wound complications requiring medical or surgical intervention were extremely uncommon in both groups. HAC offers significant CSF leakage control and long-term cosmetic and comfort advantages over AFG alone. We recommend HAC as the standard closure technique for translabyrinthine acoustic neuroma surgery.
Effects of radiation on parotid salivary function

International Nuclear Information System (INIS)

Marks, J.E.; Davis, C.C.; Gottsman, V.L.

1981-01-01

Postoperative electron beam irradiation of patients with parotid cancer has been used regularly at the Mallinckrodt Institute of Radiology to spare the opposite parotid and to preserve salivary function. Only anecdotal reports of amount of radiation required to ablate salivary function exist. To establish a dose-response curve for the human parotid, selective measurements of right and left parotid salivary flow were done for 15 age-matched control patients whose parotids were not irradiated, 17 patients who had both parotids irradiated, and 12 whose parotids were irradiated by unilateral electron beam technique. Point calculations of absorbed dose 1 cm below the surface were done for all 88 parotids and correlated with stimulated parotid salivary flow, pH, and secretory IgA (SIgA). Increasing doses of radiation resulted in progressive reduction of parotid salivary flow, pH, and SIgA. The technique, dosimetry, and clinical application of unilateral electron beam irradiation to spare the opposite parotid will be discussed
Traumatic facial nerve neuroma with facial palsy presenting in infancy.

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Clark, James H; Burger, Peter C; Boahene, Derek Kofi; Niparko, John K

2010-07-01

To describe the management of traumatic neuroma of the facial nerve in a child and literature review. Sixteen-month-old male subject. Radiological imaging and surgery. Facial nerve function. The patient presented at 16 months with a right facial palsy and was found to have a right facial nerve traumatic neuroma. A transmastoid, middle fossa resection of the right facial nerve lesion was undertaken with a successful facial nerve-to-hypoglossal nerve anastomosis. The facial palsy improved postoperatively. A traumatic neuroma should be considered in an infant who presents with facial palsy, even in the absence of an obvious history of trauma. The treatment of such lesion is complex in any age group but especially in young children. Symptoms, age, lesion size, growth rate, and facial nerve function determine the appropriate management.
Repeat Stereotactic Radiosurgery for Acoustic Neuromas

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Kano, Hideyuki; Kondziolka, Douglas; Niranjan, Ajay M.Ch.; Flannery, Thomas J.; Flickinger, John C.; Lunsford, L. Dade

2010-01-01

Purpose: To evaluate the outcome of repeat stereotactic radiosurgery (SRS) for acoustic neuromas, we assessed tumor control, clinical outcomes, and the risk of adverse radiation effects in patients whose tumors progressed after initial management. Methods and Materials: During a 21-year experience at our center, 1,352 patients underwent SRS as management for their acoustic neuromas. We retrospectively identified 6 patients who underwent SRS twice for the same tumor. The median patient age was 47 years (range, 35-71 years). All patients had imaging evidence of tumor progression despite initial SRS. One patient also had incomplete surgical resection after initial SRS. All patients were deaf at the time of the second SRS. The median radiosurgery target volume at the time of the initial SRS was 0.5 cc and was 2.1 cc at the time of the second SRS. The median margin dose at the time of the initial SRS was 13 Gy and was 11 Gy at the time of the second SRS. The median interval between initial SRS and repeat SRS was 63 months (range, 25-169 months). Results: At a median follow-up of 29 months after the second SRS (range, 13-71 months), tumor control or regression was achieved in all 6 patients. No patient developed symptomatic adverse radiation effects or new neurological symptoms after the second SRS. Conclusions: With this limited experience, we found that repeat SRS for a persistently enlarging acoustic neuroma can be performed safely and effectively.
Parotid hybrid tumor

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Bravo C, Gustavo; Seymour M, Camila; Fernandez R, Lara; Villanueva I, Maria Elena; Scott C, Carlos; Celedon L, Carlos

2012-01-01

Tumors of the salivary glands represent 33%-10% of head and neck neoplasms. The most common location is the parotid gland, accounting for 50%-85% of the cases, with 20%-30% of them being malignant. The following are known to be indicative of a malignant tumor: fast growing, painless mass, associated facial paralysis and lymphadenopathy. Most parotid neoplasm derive from a single histological type but eventually the development of more than one type on the same gland can occur. This paper presents a case of a parotid neoplasm with two different histological tumors, with uncharacteristic clinical presentation. The patient presented initially with ear pain and otorrhoea, in the clinical examination highlighted an external auditory canal tumor. The complementary study revealed a parotid neoplasm and a total resection of the gland was performed. The biopsy revealed an adenoid-cystic carcinoma with differentiated basaloid areas. Adjuvant radio-chemotherapy was administered, and the imaging control with PET-CT showed no evidence of recurrence or dissemination of the tumor
A forgotten facial nerve tumour: granular cell tumour of the parotid and its implications for treatment.

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Lerut, B; Vosbeck, J; Linder, T E

2011-04-01

We present a rare case of a facial nerve granular cell tumour in the right parotid gland, in a 10-year-old boy. A parotid or neurogenic tumour was suspected, based on magnetic resonance imaging. Intra-operatively, strong adhesions to surrounding structures were found, and a midfacial nerve branch had to be sacrificed for complete tumour removal. Recent reports verify that granular cell tumours arise from Schwann cells of peripheral nerve branches. The rarity of this tumour within the parotid gland, its origin from peripheral nerves, its sometimes misleading imaging characteristics, and its rare presentation with facial weakness and pain all have considerable implications on the surgical strategy and pre-operative counselling. Fine needle aspiration cytology may confirm the neurogenic origin of this lesion. When resecting the tumour, the surgeon must anticipate strong adherence to the facial nerve and be prepared to graft, or sacrifice, certain branches of this nerve.
Differentiation between Superficial and Deep Lobe Parotid Tumors by Magnetic Resonance Imaging: Usefulness of the Parotid Duct Criterion

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Imaizumi, A.; Kuribayashi, A.; Okochi, K.; Yoshino, N.; Kurabayashi, T. (Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental Univ., Tokyo (Japan)); Ishii, J. (Maxillofacial Surgery, Graduate School, Tokyo Medical and Dental Univ., Tokyo (Japan)); Sumi, Y. (Division of Oral and Dental Surgery, Dept. of Advanced Medicine, National Center for Geriatrics and Gerontology, Aichi (Japan))

2009-08-15

Background: The location of a parotid tumor affects the choice of surgery, and there is a risk of damaging the facial nerve during surgery. Thus, differentiation between superficial and deep lobe parotid tumors is important for appropriate surgical planning. Purpose: To evaluate the usefulness of using the parotid duct, in addition to the retromandibular vein, for differentiating between superficial and deep lobe parotid tumors on MR images. Material and Methods: Magnetic resonance images of 42 parotid tumors in 40 patients were reviewed to determine whether the tumor was located in the superficial or deep lobe. In each case, the retromandibular vein and the parotid duct were used to locate the tumor. The parotid duct was only used in cases where the tumor and the duct were visualized on the same image. Results: Using the retromandibular vein criterion, 71% of deep lobe and 86% of superficial lobe tumors were correctly diagnosed, providing an accuracy of 81%. However, the accuracy achieved when using the parotid duct criterion was 100%, although it could be applied to only 28 of the 42 cases. Based on these results, we defined the following diagnostic method: the parotid duct criterion is first applied, and for cases in which it cannot be applied, the retromandibular vein criterion is used. The accuracy of this method was 88%, which was better than that achieved using the retromandibular vein criterion alone. Conclusion: The parotid duct criterion is useful for determining the location of parotid tumors. Combining the parotid duct criterion with the retromandibular vein criterion might improve the diagnostic accuracy of parotid tumor location compared to using the latter criterion alone
Differentiation between Superficial and Deep Lobe Parotid Tumors by Magnetic Resonance Imaging: Usefulness of the Parotid Duct Criterion

International Nuclear Information System (INIS)

Imaizumi, A.; Kuribayashi, A.; Okochi, K.; Yoshino, N.; Kurabayashi, T.; Ishii, J.; Sumi, Y.

2009-01-01

Background: The location of a parotid tumor affects the choice of surgery, and there is a risk of damaging the facial nerve during surgery. Thus, differentiation between superficial and deep lobe parotid tumors is important for appropriate surgical planning. Purpose: To evaluate the usefulness of using the parotid duct, in addition to the retromandibular vein, for differentiating between superficial and deep lobe parotid tumors on MR images. Material and Methods: Magnetic resonance images of 42 parotid tumors in 40 patients were reviewed to determine whether the tumor was located in the superficial or deep lobe. In each case, the retromandibular vein and the parotid duct were used to locate the tumor. The parotid duct was only used in cases where the tumor and the duct were visualized on the same image. Results: Using the retromandibular vein criterion, 71% of deep lobe and 86% of superficial lobe tumors were correctly diagnosed, providing an accuracy of 81%. However, the accuracy achieved when using the parotid duct criterion was 100%, although it could be applied to only 28 of the 42 cases. Based on these results, we defined the following diagnostic method: the parotid duct criterion is first applied, and for cases in which it cannot be applied, the retromandibular vein criterion is used. The accuracy of this method was 88%, which was better than that achieved using the retromandibular vein criterion alone. Conclusion: The parotid duct criterion is useful for determining the location of parotid tumors. Combining the parotid duct criterion with the retromandibular vein criterion might improve the diagnostic accuracy of parotid tumor location compared to using the latter criterion alone
Parotid enlargement in children with AIDS

International Nuclear Information System (INIS)

Soberman, N.; Leonidas, J.C.; Berdon, W.E.; Haller, J.O.; Posner, M.; Bonagura, V.

1990-01-01

PURPOSE: Painless parotid enlargement has been recently reported as a sign of AIDS, but little is known of the imaging characteristics of parotid involvement in affected children. The aim of this paper is to use US, CT and MR imaging to determine the anatomic changes of the parotid; study their possible association with pulmonary lymphoid hyperplasia (PLH); and define the immunologic parameters and clinical course. Eighteen children were evaluated clinically, radiologically, and immunologically. All patients underwent US of the parotids and chest radiography; some children had CT of the chest and MR imaging of the parotids
Endobronchial neurogenic tumor: A combination of traumatic neuroma and neurofibroma

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Amit Tandon

2017-01-01

Full Text Available Traumatic neuromas are uncommon and benign lesions arising from a peripheral nerve injury during surgery. Here we describe a case with histopathologic features of both a traumatic neuroma and neurofibroma in a patient without integumentary physical exam findings nor prior surgical history. A 54 year old male was admitted for surgical debridement of a foot ulcer. During pre-operative evaluation and review of imaging multiple CT scans revealed a stable, 4 mm endobronchial lesion in the left lower lobe. Given history of nicotine abuse, bronchoscopy was performed. Bronchoscopy showed a pearly, polypoid lesion. Histopathological results showed strong positivity for S-100 protein and spindle cell proliferation. Repeat CT chest showed no new lesions in the bronchial tree. The rarity of this case is noted not only by the limited number of bronchial neurogenic tumors, but the combined features in this case of a traumatic neuroma and neurofibroma which has not been described.

[Epidemic parotiditis, a reportable disease].

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Boverhoff, J C; Baart, J A

2013-01-01

Three consecutive patients with an acute swelling of one of the cheeks, were diagnosed with epidemic parotiditis. The first phase of the diagnostic procedure for an acute cheek swelling is to eliminate the possibility of odontogenic causes. When odontogenic problems have been excluded, non-dentition-related causes may be considered. An acute, progressive swelling in the preauricular area can often be attributed to an inflammation of the parotid gland, but epidemic parotiditis should also be considered. Epidemic parotiditis, or mumps, is caused by the mumps virus. Contamination occurs aerogenically. In the Netherlands, mumps vaccine is an ingredient of the governmental combined mump-measles-rubella inoculation programme. However, in recent years several small-scale parotiditis epidemics have broken out, predominantly among young, inoculated adults. Oropharyngeal mucus and blood samples are needed to diagnose the disease. Each case of the disease should be reported to the community healthcare service.
Penile Traumatic Neuroma: A Late Complication of Penile Dorsal Neurotomy to Treat Premature Ejaculation

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Hyun Jun Park

2016-09-01

Conclusion: The main complications of SDN are recurrence of premature ejaculation, pain or paresthesia on the glans penis, and erectile dysfunction. However, no traumatic neuroma has been reported as a complication. We report that a traumatic neuroma can occur after SDN.
Radiation-induced parotid gland changes in oral cancer patients. Correlation between parotid volume and saliva production

International Nuclear Information System (INIS)

Teshima, Keiko; Murakami, Ryuji; Tomitaka, Etsuji

2010-01-01

The objective of this study was to evaluate whether saliva production reflects the parotid volume during the course of radiation therapy (RT) in patients with head-and-neck cancer. Twenty patients with advanced oral squamous cell carcinomas, who were treated with preoperative chemo-RT, underwent morphological assessment with CT or MRI and functional assessment with the Saxon test. For the Saxon test, saliva production was measured by weighing a gauze pad before and 2 min after chewing without swallowing; the low-normal value is 2 g. Saliva production and parotid volumes before and 2 weeks after RT were compared with the paired t-test, the Spearman rank correlation test and the Fisher exact test. After 30 Gy irradiation, mean saliva production was decreased from 4.2 to 1.0 g (P 3 (P<0.01); the post-RT: pre-RT parotid volume ratio ranged from 54% to 85% (mean 71%). Although the initial parotid volume was correlated with initial saliva production (r=0.47, P=0.04), no significant correlation was noted after RT (r=0.08, P=0.71), and there were considerable individual variations. The parotid volume ratio was inversely correlated with the saliva-reduction amount (r=-0.79, P<0.01). There was a correlation between decreased parotid gland volume and decreased saliva production in patients with head-and-neck cancer undergoing RT. Parotid volume reduction may predict parotid gland function. (author)
Resection planning for robotic acoustic neuroma surgery

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McBrayer, Kepra L.; Wanna, George B.; Dawant, Benoit M.; Balachandran, Ramya; Labadie, Robert F.; Noble, Jack H.

2016-03-01

Acoustic neuroma surgery is a procedure in which a benign mass is removed from the Internal Auditory Canal (IAC). Currently this surgical procedure requires manual drilling of the temporal bone followed by exposure and removal of the acoustic neuroma. This procedure is physically and mentally taxing to the surgeon. Our group is working to develop an Acoustic Neuroma Surgery Robot (ANSR) to perform the initial drilling procedure. Planning the ANSR's drilling region using pre-operative CT requires expertise and around 35 minutes' time. We propose an approach for automatically producing a resection plan for the ANSR that would avoid damage to sensitive ear structures and require minimal editing by the surgeon. We first compute an atlas-based segmentation of the mastoid section of the temporal bone, refine it based on the position of anatomical landmarks, and apply a safety margin to the result to produce the automatic resection plan. In experiments with CTs from 9 subjects, our automated process resulted in a resection plan that was verified to be safe in every case. Approximately 2 minutes were required in each case for the surgeon to verify and edit the plan to permit functional access to the IAC. We measured a mean Dice coefficient of 0.99 and surface error of 0.08 mm between the final and automatically proposed plans. These preliminary results indicate that our approach is a viable method for resection planning for the ANSR and drastically reduces the surgeon's planning effort.
Preservation of parotid function with uncomplicated conformal radiotherapy

International Nuclear Information System (INIS)

Maes, Annelies; Weltens, Caroline; Flamen, Patrick; Lambin, Philippe; Bogaerts, Ria; Liu, Xuan; Baetens, Jan; Hermans, Robert; Van den Bogaert, Walter

2002-01-01

Background and purpose: To evaluate (1) parotid function, (2) subjective xerostomia and (3) pattern of relapses after conformal parotid-sparing radiotherapy (RT) for head and neck cancer. (4) To study dose-response curves of parotid glands. Material and methods: From September 1999 to November 2000, 39 head and neck cancer patients requiring bilateral neck RT were treated with a fairly simple conformal RT technique (three-field set-up+anterior lower neck field; two opposed oblique boost fields). The contralateral parotid was spared. Parotid function was assessed by salivary gland scintigraphies performed before, early (median 4 weeks) and late (median 28 weeks) after RT. Xerostomia was monitored by visual analogue scales (VAS) and LENT SOMA scores. Location of locoregional recurrences was studied in relation to the radiation fields. A dose-response curve of parotids was created using logistic regression. Results: (1) Early after RT, on salivary gland scintigraphy, the mean loss of secretion function in the spared parotid was 67% and total in the non-spared. Late after RT, the mean loss remained 19% in the spared and total in the non-spared parotid. Normal excretion function was regained in 75% of the spared parotids. (2) Late after RT, 78% of patients had no, minimal or acceptable subjective xerostomia. (3) No recurrence was seen near the spared parotid (11/39 locoregional recurrences). (4) The dose-response curve of parotids showed that the mean parotid dose should preferentially be ≤20 Gy, to obtain a good chance (≥70%) for preservation of its function on scintigraphy. Conclusions: An easy conformal parotid-sparing RT technique prevents moderate or severe subjective xerostomia in 78% of patients. In the spared parotids, nearly complete to complete recovery is obtained after 6-12 months
Long-term mobile phone use and acoustic neuroma risk.

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Pettersson, David; Mathiesen, Tiit; Prochazka, Michaela; Bergenheim, Tommy; Florentzson, Rut; Harder, Henrik; Nyberg, Gunnar; Siesjö, Peter; Feychting, Maria

2014-03-01

There is concern about potential effects of radiofrequency fields generated by mobile phones on cancer risk. Most previous studies have found no association between mobile phone use and acoustic neuroma, although information about long-term use is limited. We conducted a population-based, nation-wide, case-control study of acoustic neuroma in Sweden. Eligible cases were persons aged 20 to 69 years, who were diagnosed between 2002 and 2007. Controls were randomly selected from the population registry, matched on age, sex, and residential area. Postal questionnaires were completed by 451 cases (83%) and 710 controls (65%). Ever having used mobile phones regularly (defined as weekly use for at least 6 months) was associated with an odds ratio (OR) of 1.18 (95% confidence interval = 0.88 to 1.59). The association was weaker for the longest induction time (≥10 years) (1.11 [0.76 to 1.61]) and for regular use on the tumor side (0.98 [0.68 to 1.43]). The OR for the highest quartile of cumulative calling time (≥680 hours) was 1.46 (0.98 to 2.17). Restricting analyses to histologically confirmed cases reduced all ORs; the OR for ≥680 hours was 1.14 (0.63 to 2.07). A similar pattern was seen for cordless land-line phones, although with slightly higher ORs. Analyses of the complete history of laterality of mobile phone revealed considerable bias in laterality analyses. The findings do not support the hypothesis that long-term mobile phone use increases the risk of acoustic neuroma. The study suggests that phone use might increase the likelihood that an acoustic neuroma case is detected and that there could be bias in the laterality analyses performed in previous studies.
Filippo Civinini (1805-1844 and the discovery of plantar neuroma

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P. Marson

2011-09-01

Full Text Available Pathological abnormality (neuroma related to the painful foot condition commonly called “Morton’s metatarsalgia” was first observed in 1835 by Filippo Civinini (1805-1844 of Pistoia, in course of a cadaverous dissection, and clearly described in the anatomic letter entitled “Su un nervoso gangliare rigonfiamento alla pianta del piede” (“On the neural gangliar swelling of the foot sole”. In this study a brief review on the history of Morton’s metatarsalgia is carried out, and the importance of Civinini in the discovery of the neuroma of the III intermetatarsal web is underlined.
Unilateral Duplication Of Parotid Duct. A Rare Anatomical Variation

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Humberto Ferreira Arquez

2017-11-01

Full Text Available Background: The paired parotid glands are the largest of the major salivary glands and produces mainly serous secretions. The secretion of this gland reaches the oral cavity through single parotid duct (Stensen’s duct. The parotid duct begins at the anterior border of the gland, crosses the masseter muscle, and then pierces the buccinator muscle to reach the mucosa lining the mouth at the level of the cheek. The purpose of this study is determine the morphologic features of the parotid duct and describe an anatomical variation until now unreported. Methods and Findings: A total of 17 cadavers were used for this study in the Morphology Laboratory at the University of Pamplona. In a cadaver were findings: The main parotid duct originated two conducts: Left superior parotid duct and Left inferior parotid duct, is observed the criss-cross of the ducts, and then perforated the buccinator muscle and entered the oral cavity at a double parotid papilla containing a double opening, separated from each other in 0,98 mm. In the remaining 33 parotid regions (97.06% the parotid duct is conformed to the classical descriptions given in anatomical textbooks. Conclusions: The parotid duct anatomy is important for duct endoscopy, lithotripsy, sialography and trans-ductal facial nerve stimulation in the early stage of facial palsy in some cases. The anatomical variations also has clinical importance for parotid gland surgery and facial cosmetic surgery. To keep in mind the parotid duct variation will reduce iatrogenic injury risks and improve diagnosis of parotid duct injury.
[Clinical and radiological evolution of a group of untreated acoustic neuromas].

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Escorihuela-García, Vicente; Llópez-Carratalá, Ignacio; Orts-Alborch, Miguel; Marco-Algarra, Jaime

2014-01-01

The acoustic neuroma is a benign tumour that originates in the vestibular branch of the eighth cranial nerve. The main treatment is surgery, but many authors suggest that with elderly patients or in small neuromas we can opt for watchful waiting. This was a retrospective study from 2007 to 2013 that included 27 patients diagnosed of acoustic neuroma that had not been treated due to the size of the tumour, age and comorbidities, or by patient choice. We evaluated overall condition, hearing thresholds, degree of canal paresis and central disorders. After 6 years of follow up, clinical manifestations of 18 patients remained unchanged, 5 patients underwent hearing loss and developed tinnitus, 2 cases had more intense tinnitus and 2 cases had dizziness. The radiological controls by magnetic resonance imaging showed that the initial maximum diameters (5-16mm) increased by 1.7mm on average, with annual growth rates below 0.5mm. In selected cases, such as for small neuromas and in elderly patients, the conservative option of close monitoring with magnetic resonance imaging is an important alternative given that, in our cases, clinical features and radiological image did not suffer major changes. If there were any such changes, therapeutic options could be proposed. Copyright © 2013 Elsevier España, S.L. y Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.
Magnetic resonance imaging of parotid tumors, 1

International Nuclear Information System (INIS)

Nakamura, Akihiko; Yamashita, Toshio; Inoue, Toshiya; Kumazawa, Tadami; Kato, Tsutomu; Sawada, Satoshi; Tanaka, Yoshimasa

1987-01-01

We compared the usefulness of magnetic resonance imaging (MRI), with that of X-ray computed tomography in the preoperative diagnosis of parotid tumors. We performed in 13 patients with parotid tumors and 10 of them were operated. The MRI equipment had a magnetic fild of 0.15 Tesla. We used the spine echo acquisition technique and a repetition time of 600, 1000 and 2000 milli-seconds, and echo time of 40 and 80 milli-seconds. We found that the T 1 weighted image well visualized the duct of the parotid gland, the T 2 weighted image provided fine pictures of the parotid tumor. The facial nerve of normal parotid glands could not be visualized by MRI. (author)
assessment Of the effect Of low Level Laser Therapy on Parotid glands of gamma Irradiated Rats

International Nuclear Information System (INIS)

Ahmed, S.F.

2013-01-01

Gamma radiation-induced salivary gland dysfunction has a major deleterious effect on oral health. Aim: This study was carried out to evaluate the possible effect of low level laser therapy (LLLT) on radiation induced oxidative stress in rats’ salivary glands. Material and Methods: Sixty four male Albino rats were divided into two groups. One group where the left parotid gland was exposed to 3 sessions of LLL, then rats were subjected to 3 sessions of whole body gamma-radiation. In the other group, rats were subjected to 3 sessions of gamma-radiation; each was followed by a session of LLL to the left parotid gland. The right gland of both groups was used as irradiated control. Parotid glands were collected 1 day, 3 days, 1 week and 2 weeks after the end of treatment and were subjected to histological examination and immunohistochemical analysis. Results: The parotid gland of both laser groups showed less intra cytoplasmic vacuolisation, slight alteration of acinar architecture and almost even size nuclei as compared to the irradiated gland. LLL either before or parallel to gamma-irradiation was effective in increasing cell proliferation on the third and seventh day, respectively as compared to the gamma irradiated group (P<0.05). Statistically, results revealed significant decrease in optical density of caspase 3 activity in the lased groups on the first week as compared to the control. Conclusion: LLLT attenuates the harmful effect of gamma irradiation on the parotid glands of the rats. Also, it improves gland regeneration through modulation of cell proliferation and apoptosis inflammation
Parotid lymphomas - clinical and computed tomogrphic imaging ...

African Journals Online (AJOL)

Objective. To review the clinical presentation and computed tomography (CT) imaging characteristics of all parotid lymphomas diagnosed at the study institution over a 7-year period. Design. Retrospective chart review of parotid lymphomas diagnosed between 1997 and 2004. Subjects. A total of 121 patients with parotid ...
Large Parotid Gland Lipoblastoma in a Teenager.

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Jandali, Danny; Heilingoetter, Ashley; Ghai, Ritu; Jeffe, Jill; Al-Khudari, Samer

2018-01-01

Lipoblastomas are rare benign neoplasms that arise from fetal white fat cells. They are typically found in children under the age of 3 and have been reported in the mediastinum, extremities, and infrequently in the head and neck. We present a rare case of a lipoblastoma arising from the parotid gland and the first known report of a parotid lipoblastoma in a teenager. A 15-year-old male presented with a painless, slowly enlarging parotid mass and left facial swelling. A fine needle aspiration was non-diagnostic and initial MRI showed a 3.8 cm × 5.0 cm × 4.0 cm fatty lesion involving the superficial and deep lobes of the left parotid gland and masticator space with widening of the stylo-mandibular tunnel and thinning of the adjacent mandibular condyle. The patient was taken to the operating room, and the mass was excised under general anesthesia via a transcervical parotid approach with facial nerve monitoring. The most superficial aspect of the parotid bed was spared and with upper and lower divisions of the facial nerve preserved. The tumor, which primarily involved the deep lobe of the parotid, was entirely excised. Final pathology revealed a 5.2 cm lipoblastoma. The patient did well post-operatively with full function of the facial nerve and 20 months of follow up without evidence of recurrence. This is the first reported case of a lipoblastoma of the parotid gland in a teenager. Although a rare tumor, it should be considered in the differential diagnosis of a parotid mass in this population.
Large Parotid Gland Lipoblastoma in a Teenager

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Danny Jandali

2018-03-01

Full Text Available BackgroundLipoblastomas are rare benign neoplasms that arise from fetal white fat cells. They are typically found in children under the age of 3 and have been reported in the mediastinum, extremities, and infrequently in the head and neck. We present a rare case of a lipoblastoma arising from the parotid gland and the first known report of a parotid lipoblastoma in a teenager.Case presentationA 15-year-old male presented with a painless, slowly enlarging parotid mass and left facial swelling. A fine needle aspiration was non-diagnostic and initial MRI showed a 3.8 cm × 5.0 cm × 4.0 cm fatty lesion involving the superficial and deep lobes of the left parotid gland and masticator space with widening of the stylo-mandibular tunnel and thinning of the adjacent mandibular condyle. The patient was taken to the operating room, and the mass was excised under general anesthesia via a transcervical parotid approach with facial nerve monitoring. The most superficial aspect of the parotid bed was spared and with upper and lower divisions of the facial nerve preserved. The tumor, which primarily involved the deep lobe of the parotid, was entirely excised. Final pathology revealed a 5.2 cm lipoblastoma. The patient did well post-operatively with full function of the facial nerve and 20 months of follow up without evidence of recurrence.ConclusionThis is the first reported case of a lipoblastoma of the parotid gland in a teenager. Although a rare tumor, it should be considered in the differential diagnosis of a parotid mass in this population.
Palisaded Encapsulated (Solitary Circumscribed) Neuroma of the Buccal Mucosa: a Rare Case.

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Atarbashi-Moghadam, Saede; Lotfi, Ali; Salehi Zalani, Saman; Mokhtari, Sepideh

2017-12-01

The rarity of oral soft tissue spindle cell tumors combined with overlapping microscopic patterns can make challenges in their diagnosis and treatment. Oral cavity palisaded encapsulated neuroma is an uncommon lesion which occurs often on the hard palate. It is essential for oral pathologists to be familiar with its histopathology of this lesion is essential since many lesions are probably diagnosed microscopically as neurofibroma or schwannoma. Here, we report a case of oral palisaded encapsulated (solitary circumscribed) neuroma in an unusual site.
Recurrent neuroma formation after lateral arm free flap coverage with neurorraphy to the posteroantebrachial nerve.

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Peterson, Steven L; Gordon, Michael J

2004-09-01

We report a patient with previous wrist trauma and development of a symptomatic neuroma of the palmar cutaneous branch of the median nerve. The patient had previously been successfully treated with lateral arm free flap coverage with neurorrhaphy to a segment of the posteroantebrachial cutaneous nerve carried with the flap. Two years following this procedure the patient experienced re-onset of symptoms prompting surgical exploration of the area. At the time of operation a recurrent neuroma was found at the free distal terminus of the transferred posteroantebrachial cutaneous nerve. The neuroma was repositioned into the distal radius via a burr hole with relief of symptoms.
CT evaluation of mass lesions in the parotid region

International Nuclear Information System (INIS)

Matsumoto, Shunichi; Kishikawa, Takashi; Kudo, Sho; Miyaji, Hiroshi; Kuwano, Haruo; Kaneko, Kuniyuki; Ohuchida, Toshiyuki

1988-01-01

CT findings of 35 patients with proven 31 parotid gland mass lesions (23 benign tumors, 5 malignant tumors, 3 inflammatory diseases) and 4 infraauricular lymphadenopathy (2 inflammatory nodes, 2 neoplastic nodes) were reviewed. CT accurately diagnosed the parotid origin in 29 of 31 parotid gland diseases. In all four patients with infraauricular lymphadenopathy, differentiation from parotid tumor was difficult. CT differentiation between superficial and deep lobe tumors agreed with surgical findings in 18 of 21 parotid gland tumors. Twenty out of 23 benign parotid gland tumors appeared as discrete masses with smooth margins. All five malignant parotid gland tumors appeared as poorly defined masses. It is concluded that when a tumor is located in the superficial lobe and appears as a sharply circumscribed mass on plain CT, it should be diagnosed as a benign lesion and contrast CT is not required. Secondly, contrast CT would be beneficial when a tumor is indistinct, or located in the deep portion of the parotid gland on plain CT. Finally, CT-sialography is considered unnecessary in the diagnosis of parotid masses. (author)
Early evaluation of irradiated parotid glands with intravoxel incoherent motion MR imaging: correlation with dynamic contrast-enhanced MR imaging

International Nuclear Information System (INIS)

Zhou, Nan; Chu, Chen; Dou, Xin; Li, Ming; Liu, Song; Zhu, Lijing; Liu, Baorui; Guo, Tingting; Chen, Weibo; He, Jian; Yan, Jing; Zhou, Zhengyang; Yang, Xiaofeng; Liu, Tian

2016-01-01

Radiation-induced parotid damage is one of the most common complications in patients with nasopharyngeal carcinoma (NPC) undergoing radiotherapy (RT). Intravoxel incoherent motion (IVIM) magnetic resonance (MR) imaging has been reported for evaluating irradiated parotid damage. However, the changes of IVIM perfusion-related parameters in irradiated parotid glands have not been confirmed by conventional perfusion measurements obtained from dynamic contrast-enhanced (DCE) MR imaging. The purposes of this study were to monitor radiation-induced parotid damage using IVIM and DCE MR imaging and to investigate the correlations between changes of these MR parameters. Eighteen NPC patients underwent bilateral parotid T1-weighted, IVIM and DCE MR imaging pre-RT (2 weeks before RT) and post-RT (4 weeks after RT). Parotid volume; IVIM MR parameters, including apparent diffusion coefficient (ADC), pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f); and DCE MR parameters, including maximum relative enhancement (MRE), time to peak (TTP), Wash in Rate, and the degree of xerostomia were recorded. Correlations of parotid MR parameters with mean radiation dose, atrophy rate and xerostomia degree, as well as the relationships between IVIM and DCE MR parameters, were investigated. From pre-RT to post-RT, all of the IVIM and DCE MR parameters increased significantly (p < 0.001 for ADC, D, f, MRE, Wash in Rate; p = 0.024 for D*; p = 0.037 for TTP). Change rates of ADC, f and MRE were negatively correlated with atrophy rate significantly (all p < 0.05). Significant correlations were observed between the change rates of D* and MRE (r = 0.371, p = 0.026) and between the change rates of D* and TTP (r = 0.396, p = 0.017). The intra- and interobserver reproducibility of IVIM and DCE MR parameters was good to excellent (intraclass correlation coefficient, 0.633–0.983). Early radiation-induced changes of parotid glands could be evaluated by IVIM and
Parotid-sparing intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma: Preserved parotid function after IMRT on quantitative salivary scintigraphy, and comparison with historical data after conventional radiotherapy

International Nuclear Information System (INIS)

Hsiung, C.-Y.; Ting, H.-M.; Huang, H.-Y.; Lee, C.-H.; Huang, E.-Y.; Hsu, H.-C.

2006-01-01

Purpose: To evaluate the parotid function after parotid-sparing intensity-modulated radiotherapy (IMRT) in patients with nasopharyngeal carcinoma (NPC). Methods and Materials: From March 2003 to May 2004, 16 patients with nonmetastatic NPC underwent parotid-sparing IMRT. Eight of these patients had Stage III or IV NPC based on the 1997 American Joint Committee on Cancer staging system. The post-IMRT parotid function was evaluated by quantitative salivary scintigraphy and represented by the maximal excretion ratio (MER) of the parotid gland after sialogogue stimulation. The parotid function of 16 NPC patients who were previously treated with conventional radiotherapy was reviewed as the historical control. Results: In the parotid-sparing IMRT group, all 16 patients were alive and without cancer at the end of follow-up period (median, 24.2 months). The mean parotid MER was 53.5% before radiotherapy, 10.7% at 1 month post-IMRT, and 23.3% at 9 months post-IMRT. In the conventional radiotherapy group, the mean parotid MER was 0.6% at 6 to 12 months postradiotherapy. The difference was statistically significant (23.3% vs. 0.6%, p < 0.001, Mann-Whitney test). In the IMRT group, the mean parotid doses ranged from 33.2 Gy to 58.8 Gy (average, 43.9 Gy). The correlation between the mean parotid dose and the percentage decrease of parotid MER at 9 months post-IMRT (dMER) was statically significant (p = 0.008, Pearson correlation). Conclusions: Although the mean parotid doses are relatively high, the significant preservation of parotid function is achieved with IMRT for NPC patients. The significant correlation between mean parotid dose and parotid dMER demonstrates the dose-function relationship of the parotid gland
Novel experimental surgical strategy to prevent traumatic neuroma formation by combining a 3D-printed Y-tube with an autograft.

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Bolleboom, Anne; de Ruiter, Godard C W; Coert, J Henk; Tuk, Bastiaan; Holstege, Jan C; van Neck, Johan W

2018-02-09

OBJECTIVE Traumatic neuromas may develop after nerve injury at the proximal nerve stump, which can lead to neuropathic pain. These neuromas are often resistant to therapy, and excision of the neuroma frequently leads to recurrence. In this study, the authors present a novel surgical strategy to prevent neuroma formation based on the principle of centro-central anastomosis (CCA), but rather than directly connecting the nerve ends to an autograft, they created a loop using a 3D-printed polyethylene Y-shaped conduit with an autograft in the distal outlets. METHODS The 3D-printed Y-tube with autograft was investigated in a model of rat sciatic nerve transection in which the Y-tube was placed on the proximal sciatic nerve stump and a peroneal graft was placed between the distal outlets of the Y-tube to form a closed loop. This model was compared with a CCA model, in which a loop was created between the proximal tibial and peroneal nerves with a peroneal autograft. Additional control groups consisted of the closed Y-tube and the extended-arm Y-tube. Results were analyzed at 12 weeks of survival using nerve morphometry for the occurrence of neuroma formation and axonal regeneration in plastic semi-thin sections. RESULTS Among the different surgical groups, the Y-tube with interposed autograft was the only model that did not result in neuroma formation at 12 weeks of survival. In addition, a 13% reduction in the number of myelinated axons regenerating through the interposed autograft was observed in the Y-tube with autograft model. In the CCA model, the authors also observed a decrease of 17% in the number of myelinated axons, but neuroma formation was present in this model. The closed Y-tube resulted in minimal nerve regeneration inside the tube together with extensive neuroma formation before the entrance of the tube. The extended-arm Y-tube model clearly showed that the majority of the regenerating axons merged into the Y-tube arm, which was connected to the autograft

Novel model for end-neuroma formation in the amputated rabbit forelimb

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Kuiken Todd A

2010-03-01

Full Text Available Abstract Background The forelimb amputee poses many reconstructive challenges in the clinical setting, and there is a paucity of established surgical models for study. To further elucidate the pathogenic process in amputation neuroma formation, we created a reproducible, well-tolerated rabbit forelimb amputation model. Methods Upon approval from the Institutional Animal Care and Use Committee, 5 New Zealand White rabbits underwent left forelimb amputation. During this initial surgery, the median, radial and ulnar nerves were transected 1.6-2.5 (mean 2.0 cm distal to the brachial plexus, transposed onto the anterior chest wall and preserved at length. Six weeks subsequent to the amputation, the distal 5 mm of each neuroma was excised, and the remaining stump underwent histomorphometric analysis. Results The nerve cross sectional areas increased by factors of 1.99, 3.17, and 2.59 in the median (p = 0.077, radial (p Conclusion Given that the surgical model appears well-tolerated by the rabbits and that patterns of morphologic change are consistent and reproducible, we are encouraged to further investigate the utility of this model in the pathogenesis of neuroma formation.
Dosimetry of parotid glands in IMRT plan of nasopharyngeal carcinoma

International Nuclear Information System (INIS)

Lian Jiancheng; Yu Xinsheng; Jiang Guoliang

2007-01-01

Objective: To evaluate the effect of different intensity-modulated radiation therapy (IMRT) plan on the dosimetry of parotid in patients with nasopharyngeal carcinoma. Methods: Under the same constraints and objections, the IMRT plan of nasopharyngeal carcinoma with sparing unilateral parotid and the IMRT plan added plan tumor volume (PTV) margin for parotid gland was investigated. Results: Between conventional IMRT plan and the IMRT plan spared unilateral parotid, their target coverage, homogeneity index and conformal index of PTV 70 is similar. On PTV 60 , D min in the plan of sparing one parotid gland was more than that in normal IMRT plan (P 95 in the plan of sparing one parotid gland have improved (P 50%VOL and D mean of parotid gland were similar between the two plans. Between conventional IMRT plan and the IMRT plan added 2 or 3 mm margin for parotid gland, their target coverage, homogeneity index and conformal index of PTV 70 is similar. D min , D mean and D 95 of PTV 60 have decreased tendency from normal IMRT plan to 2 mm margin plan to 3 mm margin plan. D max of brainstem and spine cord have increased tendency from normal IMRT plan to 2 mm margin plan to 3 mm margin plan. Conclusions: The IMRT plan of nasopharyngeal carcinoma with sparing unilateral parotid may be adopted not to protect both two parotids, while PTV margin for parotid added as parotid move. (authors)
Is parotid saliva sterile on entry to the oral cavity?

DEFF Research Database (Denmark)

Schrøder, Stine A; Bardow, Allan; Eickhardt-Dalbøge, Steffen

2017-01-01

CONCLUSION: The present study indicates that parotid saliva is sterile on entry to the oral cavity. OBJECTIVES: The objective was to investigate if parotid saliva is sterile on entry to the oral cavity and, thus, prior to contamination by oral bacteria. METHOD: Forty healthy volunteers were...... included in sterile parotid saliva collection. Parotid saliva was collected using a sterile Lashley cup, placed over the papilla of the Stensen´s duct, as well as sterile tubes and syringes for collection. All collections were followed by collection of a positive control sample where some of the sterile...... obtained parotid saliva had been exposed to the contralateral mucosal membranes. All samples parotid saliva, as well as the positive controls, were cultivated, and 10 randomly selected parotid saliva samples underwent polymerase chain reaction (PCR) analyses. RESULTS: In 33 of 40 parotid saliva samples...
A comparison of mean parotid gland dose with measures of parotid gland function after radiotherapy for head-and-neck cancer: Implications for future trials

International Nuclear Information System (INIS)

Roesink, Judith M.; Schipper, Maria; Busschers, Wim; Raaijmakers, Cornelis P.J.; Terhaard, Chris H.J.

2005-01-01

Purpose: To determine the most adequate parameter to measure the consequences of reducing the parotid gland dose. Methods and Materials: One hundred eight patients treated with radiotherapy for various malignancies of the head and neck were prospectively evaluated using three methods. Parotid gland function was objectively determined by measuring stimulated parotid flow using Lashley cups and scintigraphy. To assess xerostomia-related quality of life, the head-and-neck cancer module European Organization for Research and Treatment of Cancer QLQ (Quality of Life Questionnaire) H and N35 was used. Measurements took place before radiotherapy and 6 weeks and 12 months after the completion of radiotherapy. Complication was defined for each method using cutoff values. The correlation between these complications and the mean parotid gland dose was investigated to find the best measure for parotid gland function. Results: For both flow and scintigraphy data, the best definition for objective parotid gland toxicity seemed to be reduction of stimulated parotid flow to ≤25% of the preradiotherapy flow. Of all the subjective variables, only the single item dry mouth 6 weeks after radiotherapy was found to be significant. The best correlation with the mean parotid gland dose was found for the stimulated flow measurements. The predictive ability was the highest for the time point 1 year after radiotherapy. Subjective findings did not correlate with the mean parotid dose. Conclusions: Stimulated flow measurements using Lashley cups, with a complication defined as flow ≤25% of the preradiotherapy output, correlated best with the mean parotid gland dose. When reduction of the mean dose to the parotid gland is intended, the stimulated flow measurement is the best method for evaluating parotid gland function
Three Cycles of Radiofrequency Ablation Are More Efficacious Than Two in the Management of Morton's Neuroma.

Science.gov (United States)

Brooks, David; Parr, Adam; Bryceson, William

2018-04-01

Morton's neuroma is a common cause of forefoot pain. Outcomes of conservative therapy are mixed and many patients undergo operative intervention. Radiofrequency ablation has recently gained favor as a treatment option, although the optimal regime is unknown. This study investigates the effectiveness of 2 versus 3 cycles of radiofrequency ablation for the treatment of Morton's neuroma. We surveyed a cohort of patients with Morton's neuroma who had progressed to radiofrequency ablation after failed conservative treatment. Patients received either 2 or 3 cycles of radiofrequency ablation by a single surgeon. We assessed patients based on their change in numerical pain rating scale, symptom improvement, complications, and progression to surgical excision through a series of telephone interviews. Outcomes between the 2 treatment arms were compared by parametric tests. Twenty-eight patients were included in the study. Eighteen patients with 21 neuromas received 2 cycles and 10 patients with 11 neuromas received 3 cycles. Mean time of follow-up was 12.9 months. Overall, 88% of patients were either very or moderately satisfied with their outcome. In patients who received 2 cycles mean numerical pain scores decreased from 7.9 ± 1.1 to 3.4 ± 2.4 postprocedure. Three patients progressed to operative excision. In patients who received 3 cycles, numerical pain scores decreased from 8.0 ± 1.0 to 1.5 ± 2.0 postprocedure. One patient progressed to operative excision. Patients who received 3 cycles had reduced medium-term pain postoperatively compared with 2 cycles (3.4 ± 2.4 vs 1.5 ± 2.0, P = .011). Radiofrequency ablation provides a high rate of patient satisfaction in the treatment of Morton's neuroma with few side effects. It appears that 3 cycles may be superior to 2 cycles but a randomized controlled trial will be required to confirm these results. Intervention, Level III: Comparative study without concurrent controls.
Bilateral parotid gland tuberculosis: A rare occurrence

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Rajendra Takhar

2015-07-01

Full Text Available Parotid gland tuberculosis is an extremely rare form of extrapulmonary tuberculosis, even in countries where tuberculosis is endemic like India; however, it should be included as one of the differentials of discrete parotid swelling as it generally presents as a slow-growing mass indistinguishable from a malignancy and even imaging too, can’t differentiate these clearly. The majority of the previously reported cases were mostly unilateral and diagnosed by histopathological examination of post parotidectomy specimens. Here we are describing a case of tuberculosis of both parotid glands in a 25 year-old male who was referred to us with bilateral parotid region swelling of two month duration. Tubercular parotiditis was confirmed by demonstration of epithelioid granuloma and caseous necrosis compatible with TB on fine needle aspiration cytology (FNAC. He was treated with four drug anti-TB regimen (2HERZ + 4HR leading to full recovery and complete disappearance of swelling and symptoms with no recurrence till one year of follow up. Apart from rarity due to bilateral involvement, this case report highlights the clinical presentation, ultrasonography and other imaging findings, and significance of FNAC in diagnosis of this uncommon entity reinforcing the fact that the diagnosis of parotid gland tuberculosis requires a high degree of clinical suspicion.
Acute parotiditis after cesarean section; case report

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Cristina Moisei

2017-11-01

Full Text Available The enlargement of the parotid gland develops in inflammatory or stenotic conditions but after Cesarean section the symptomatology is unusual. A 38 year old patient with no obstetrical history referred to our clinic for pregnancy, which followed our national program of prenatal care. The outcome of the pregnancy was favorable for both mother and fetus. During labor the fetus developed bradycardia and the patient delivered by Cesarean section a 3400 g baby-boy with 8 Apgar Score; the anesthesia was spinal. 18 hours after delivery the patient presented mild respiratory distress. The symptomatology was caused by the enlargement of the parotid gland. The treatment was supportive and the remission occurred 10 hours after the onset. The initial discussion that raised this case was caused by the viral, infection and stenotic cause of the parotiditis. All these reasons had no medical argument. It was also debated about the anesthesia but, until now, the medical literature didn’t report any case of association between parotiditis and spinal anesthesia. It is also impossible to correlate the parotiditis with IVF procedure. As a conclusion, this case is unique because it represents the parotiditis without unknown case that appeared after Cesarean section and spinal anesthesia in a healthy woman.
Parotid salivary duct stenosis following caudal maxillectomy.

Science.gov (United States)

Mestrinho, Lisa A; Faísca, Pedro B; Niza, Maria M R E

2014-01-01

Parotid salivary duct dilation was diagnosed in a 9-year-old male dog. The dog had undergone caudal maxillectomy on the ipsilateral side 2-years prior to presentation. Treatment consisted of parotid salivary duct excision and superficial parotidectomy that lead to the resolution of clinical signs. Transient facial neuropraxia was observed immediately after surgery and resolved spontaneously after 2-weeks. Parotid salivary duct dilation should be considered as a chronic postoperative complication following caudal maxillectomy.
Whole-brain Irradiation Field Design: A Comparison of Parotid Dose

International Nuclear Information System (INIS)

Wu, Cheng-Chia; Wuu, Yen-Ruh; Jani, Ashish; Saraf, Anurag; Tai, Cheng-Hung; Lapa, Matthew E.; Andrew, Jacquelyn I.S.; Tiwari, Akhil; Saadatmand, Heva J.; Isaacson, Steven R.; Cheng, Simon K.; Wang, Tony J.C.

2017-01-01

Whole-brain radiation therapy (WBRT) plays an important role in patients with diffusely metastatic intracranial disease. Whether the extent of the radiation field design to C1 or C2 affects parotid dose and risk for developing xerostomia is unknown. The goal of this study is to examine the parotid dose based off of the inferior extent of WBRT field to either C1 or C2. Patients treated with WBRT with either 30 Gy or 37.5 Gy from 2011 to 2014 at a single institution were examined. Parotid dose constraints were compared with Radiation Therapy Oncology Group (RTOG) 0615 nasopharyngeal carcinoma for a 33-fraction treatment: mean <26 Gy, volume constraint at 20 Gy (V20) < 20 cc, and dose at 50% of the parotid volume (D50) < 30 Gy. Biologically effective dose (BED) conversions with an α/β of 3 for normal parotid were performed to compare with 10-fraction and 15-fraction treatments of WBRT. The constraints are as follows: mean < BED 32.83 Gy, V15.76 (for 10-fraction WBRT) or V17.35 (for 15-fraction WBRT) < 20 cc, and D50 < BED 39.09 Gy. Nineteen patients treated to C1 and 26 patients treated to C2 were analyzed. Comparing WBRT to C1 with WBRT to C2, the mean left, right, and both parotids' doses were lower when treated to C1. Converting mean dose to BED 3 , the parotid doses were lower than BED 3 constraint of 32.83 Gy: left (30.12 Gy), right (30.69 Gy), and both parotids (30.32 Gy). V20 to combined parotids was lower in patients treated to C1. When accounting for fractionation of WBRT received, the mean corrected V20 volume was less than 20 cc when treating to C1. D50 for C1 was lower than C2 for the left parotid, right parotid, and both parotids. BED 3 conversion for the mean D50 of the left, right, and both parotids was less than 39.09 Gy. In conclusion, WBRT to C1 limits parotid dose, and parotid dose constraints are achievable compared with inferior border at C2. A possible mean parotid dose constraint with BED
Surgical management of epithelial parotid tumours

International Nuclear Information System (INIS)

Obaid, M.A.; Yusuf, A.

2004-01-01

Objective: To describe the clinicopathological presentation and treatment options in epithelial parotid tumours with emphasis on surgery. Subjects and Methods: Epithelial parotid tumours diagnosed and operated by an ENT surgeon and a general surgeon in 10 years during their posting in different teaching hospitals were included in the study. Clinical presentation, preoperative investigations, operative procedure, histopathology report, postoperative complications and further management were recorded. The data was collected and reviewed from the records of all the patients maintained by the authors. Results: Fifty-two patients presented with parotid tumour. Average age was 38 years. Commonest presentation was painless lump over the parotid region (85%), pain (15%), facial palsy, and enlarged neck nodes. Majority of tumours were benign, only two were recurrent. Parotid pleomorphic Adenoma (PPA) was the commonest benign tumour, others being Warthin's tumour and monomorphic adenoma. Adenoid cystic carcinoma was the commonest malignant tumour 29% followed by mucoepidermoid carcinoma. Others were carcinoma in PPA squamous cell carcinoma, malignant mixed tumour, malignant Iymphoepithelioma and undifferentiated carcinoma. Superficial parotidectomy (SP) was the commonest operation performed in 69%. Other procedures were total conservative parotidectomy in 11%, total radical surgery in 9% and enucleation in only one patient earliest in the series. Neck node dissection was done in 2 patients. Except for one child, rest of the 13 patients received postoperative radiotherapy and one patient of Iymphoepithelioma received chemotherapy in addition. Commonest postoperative complication was temporary facial weakness in 35% (18/52). Permanent facial palsy occurred in 08 patients. Of these 07 had a malignant process and only one patient had excision biopsy. Conclusion: Benign and malignant epithelial parotid tumours can be diagnosed by there clinical presentation . supplemented with
T1-nerve root neuroma presenting with apical mass and Horner's syndrome

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Podnar Simon

2007-03-01

Full Text Available Abstract Background The appearance of dumbbell neuroma of the first thoracic root is extremely rare. The extradural component of a T1-dumbbell neuroma may present as an apical mass. The diagnosis of hand weakness is complex and may be delayed in T1-neuroma because of absence of the palpable cervical mass. One-stage removal of a T1-root neuroma and its intrathoracic extension demanded an extended posterior midline approach in the sitting position. Case presentation A 51-year old man had suffered a traumatic partial tendon rupture of his wrist flexor muscles 6 years ago. Since the incident he occasionally felt fullness and tenderness in the affected forearm with some tingling in his fingers bilaterally. During the last two years the hand weakness was continuous and hypotrophy of the medial flexor and intrinsic hand muscles had become apparent. Electrophysiological studies revealed an ulnar neuropathy in addition to mild median and radial nerve dysfunction, including a mild contralateral carpal tunnel syndrome. The diagnostic work-up for multiple mononeuropathy in the upper extremity was negative. Repeated electrophysiological studies revealed fibrillations in the C7 paravertebral muscles on the affected side. Chest x-ray revealed a large round apical mass on the affected side. A Horner's syndrome was noted at this point of diagnostic work-up. MRI of the cervical and thoracic spine revealed a dumbbell T1 neuroma enlarging the intervertebral foramen at T1-2 and a 5 cm large extradural tumor with extension into the apex of the ipsilateral lung. The patient underwent surgery in sitting position using a left dorsal midline approach. Although the T1 root could not be preserved, the patient's neurological condition was unchanged after the surgery. Conclusion Extended posterior midline exposure described here using hemilaminectomy, unilateral facetectomy and costo-transversectomy is efficient and safe for one-stage removal of dumbbell tumors at the T1
Conventionally fractionated stereotactic radiotherapy (FSRT) for acoustic neuromas

International Nuclear Information System (INIS)

Fuss, Martin; Debus, Juergen; Lohr, Frank; Huber, Peter; Rhein, Bernhard; Engenhart-Cabillic, Rita; Wannenmacher, Michael

2000-01-01

Purpose: Analysis of local tumor control and functional outcome following conventionally fractionated stereotactic radiotherapy (FSRT) for acoustic neuromas. Patients and Methods: From 11/1989 to 9/1999 51 patients with acoustic neuromas have been treated by FSRT. Mean total dose was 57.6 ± 2.5 Gy. Forty-two patients have been followed for at least 12 months and were subject of an outcome analysis. Mean follow-up was 42 months. We analyzed local control, hearing preservation, and facial and trigeminal nerve functional preservation. We evaluated influences of tumor size, age, and association with neurofibromatosis Type 2 (NF2) on outcome and treatment related toxicity. Results: Actuarial 2- and 5-year tumor control rates were 100% and 97.7%, respectively. Actuarial useful hearing preservation rate was 85% at 2 and 5 years. New hearing loss was diagnosed in 4 NF2 patients. Pretreatment normal facial nerve function was preserved in all cases. Two cases of new or impaired trigeminal nerve dysesthesia required medication. No other cranial nerve deficit was observed. In Patients without NF2 tumor size or age had no influence on tumor control and cranial nerve toxicity. Diagnosis of NF2 was associated with higher risk of hearing impairment (p 0.0002), the hearing preservation rate in this subgroup was 60%. Conclusion: FSRT has been shown to be an effective means of local tumor control. Excellent hearing preservation rates and 5th and 7th nerve functional preservation rates were achieved. The results support the conclusion that FSRT can be recommended to patients with acoustic neuromas where special attention has to be taken to preserve useful hearing and normal cranial nerve function. For NF2 patients, FSRT may be the treatment of choice with superior functional outcome compared to treatment alternatives.
Traumatic neuroma after torticollis surgery: a rare occurrence

African Journals Online (AJOL)

2 Serrano Falcón C, Serrano Falcn MDM, Ruiz Villaverde R, Linares Solano J,. Serrano Ortega S. Amputation neuromas after neck surgery. Dermatol Online. J 2005; 11:2. 3 Lee IJ, Lim SY, Song HS, Park MC. Complete tight fibrous band release and resection in congenital muscular torticollis. J Plast Reconstr Aes Surg ...
3 T MR 3D fast imaging employing steady state acquisition demonstrating branches of intraparotid facial nerve, parotid duct, and relation with parotid tumors

International Nuclear Information System (INIS)

Li Yan; Li Chuanting; Zhang Dongsheng; Ai Bin; Zhang Weidong; Wu Lebin

2010-01-01

Objective: To investigate the usefulness of 3 T MRI 3D-FIESTA in the evaluation of the intraparotid components of the facial nerve and parotid duct, and compare them with surgical findings. Methods: Twenty-two cases with parotid benign tumors were scanned with conventional and 3D-FIESTA sequences on 3 T MRI scanner. Postprocessed multiplanar images were obtained with the workstation. Parotid ducts and facial nerves and tumors were identified on these images. The relationship of the tumors to the facial nerves and Parotid ducts was confirmed at surgery. Results: Various types of parotid benign tumors had their characteristics on 3 T MR imaging. Parotid benign tumors mainly showed hypo-intensity on T 1 WI in 21 cases, and hyper-intensity on T 2 WI in 22 cases. But on 3D-FIESTA images, they appeared hypointensity (10 cases) or high intensity (12 cases) due to different types. Facial nerves in parotid appeared as linear structures with hypo-inteusity. The indication of the main trunks were 16 and 18 cases for T 1 WI and T 2 WI images, while on 3D-FIESTA images, the main trunks and cervicofacial and temporofacial divisions of the facial nerves were found in 22, 21,22 cases. Parotid ducts appeared as structures with hypo-intensity on T 1 WI and hyper-intensity on multiplanar images (14, 20, 22 cases). Compared with surgical results, the main trunks of the facial nerve were correctly showed by 3D-FIESTA images in 20 cases. However, in 2 cases they were not located in the operation because of shifting. Conclusion: 3 T MR 3D-FIESTA imaging could depict the extracranial facial nerve and the parotid duct in the parotid gland, which is useful for preoperative evaluation of parotid gland tumors. (authors)
Whole-brain Irradiation Field Design: A Comparison of Parotid Dose

Energy Technology Data Exchange (ETDEWEB)

Wu, Cheng-Chia; Wuu, Yen-Ruh; Jani, Ashish; Saraf, Anurag; Tai, Cheng-Hung; Lapa, Matthew E.; Andrew, Jacquelyn I.S.; Tiwari, Akhil; Saadatmand, Heva J. [Department of Radiation Oncology, Columbia University Medical Center, 622 West 168th Street, BNH B-11, New York, NY 10032 (United States); Isaacson, Steven R. [Department of Radiation Oncology, Columbia University Medical Center, 622 West 168th Street, BNH B-11, New York, NY 10032 (United States); Department of Neurological Surgery, Columbia University Medical Center, New York, NY 10032 (United States); Cheng, Simon K., E-mail: sc3225@cumc.columbia.edu [Department of Radiation Oncology, Columbia University Medical Center, 622 West 168th Street, BNH B-11, New York, NY 10032 (United States); Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY 10032 (United States); Wang, Tony J.C., E-mail: tjw2117@cumc.columbia.edu [Department of Radiation Oncology, Columbia University Medical Center, 622 West 168th Street, BNH B-11, New York, NY 10032 (United States); Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY 10032 (United States)

2017-07-01

Whole-brain radiation therapy (WBRT) plays an important role in patients with diffusely metastatic intracranial disease. Whether the extent of the radiation field design to C1 or C2 affects parotid dose and risk for developing xerostomia is unknown. The goal of this study is to examine the parotid dose based off of the inferior extent of WBRT field to either C1 or C2. Patients treated with WBRT with either 30 Gy or 37.5 Gy from 2011 to 2014 at a single institution were examined. Parotid dose constraints were compared with Radiation Therapy Oncology Group (RTOG) 0615 nasopharyngeal carcinoma for a 33-fraction treatment: mean <26 Gy, volume constraint at 20 Gy (V20) < 20 cc, and dose at 50% of the parotid volume (D50) < 30 Gy. Biologically effective dose (BED) conversions with an α/β of 3 for normal parotid were performed to compare with 10-fraction and 15-fraction treatments of WBRT. The constraints are as follows: mean < BED 32.83 Gy, V15.76 (for 10-fraction WBRT) or V17.35 (for 15-fraction WBRT) < 20 cc, and D50 < BED 39.09 Gy. Nineteen patients treated to C1 and 26 patients treated to C2 were analyzed. Comparing WBRT to C1 with WBRT to C2, the mean left, right, and both parotids' doses were lower when treated to C1. Converting mean dose to BED{sub 3}, the parotid doses were lower than BED{sub 3} constraint of 32.83 Gy: left (30.12 Gy), right (30.69 Gy), and both parotids (30.32 Gy). V20 to combined parotids was lower in patients treated to C1. When accounting for fractionation of WBRT received, the mean corrected V20 volume was less than 20 cc when treating to C1. D50 for C1 was lower than C2 for the left parotid, right parotid, and both parotids. BED{sub 3} conversion for the mean D50 of the left, right, and both parotids was less than 39.09 Gy. In conclusion, WBRT to C1 limits parotid dose, and parotid dose constraints are achievable compared with inferior border at C2. A possible mean parotid dose
Radiation effects on the parotid gland of mammals. Pt. 2. Modifications of plasma and parotid amylase activity

Energy Technology Data Exchange (ETDEWEB)

Balzi, M; Cremonini, D; Tomassi, I; Becciolini, A; Giannardi, G [Florence Univ. (Italy). Istituto di Radiologia; Pelu, G [I.N.R.C.A., Florence (Italy). Inst. of Radiology

1979-08-01

The early modifications of the activity of plasma and parotid amylase have been evaluated in rats after whole-body irradiation in different experimental conditions. The modifications observed in the rat are less evident than in humans. The results have shown an initial decrease and a subsequent increase appearing significant 74 hours after irradiation. This could be due to a direct action of ionizing radiation on the parotid glands. However we cannot exclude that the increase of ..cap alpha..-amylase could be determined by the intestinal radiation syndrome. In fact, this syndrome leads to a reduced food uptake, and consequently ..cap alpha..-amylase could accumulate in parotids.
Computed tomographic diagnosis of parotid gland tumor

International Nuclear Information System (INIS)

Matsunaga, Hitoki; Nishimura, Tadao; Takasu, Akihiko; Yagizawa, Mikio; Suzuki, Akio

1983-01-01

Investigation with CT has been performed on 20 cases of parotid gland tumors. The intravenous contrast enhancement method was performed in all cases. Six cases were examined by CT and simultaneous sialography. The results were as follows: 1) If and when the margin of the tumor was indistinct and irregular, malignancy was suspected. However, it was difficult to diagnose malignancy by CT examination only. 2) CT for parotid gland tumor was effective in indentifying invasion of tumor into the parapharyngeal space and intracranial space. 3) CT with simultaneous sialography was very effective in locating the parotid gland tumor. 4) CT of axial sections for parotid gland tumor was more reliable if coronaly sections are taken together. 5) CT of malignant and benign tumors were diffusely enhanced by the intravenous contrast enhancement method. However, this was not an indispensable method. (author)
Tuberculosis of the Parotid Gland: Computed Tomographic Findings

International Nuclear Information System (INIS)

Wei, Y.; Xiao, J.; Pui, M.H.; Gong, Q.

2008-01-01

Background: Tuberculosis (TB) of the parotid gland is rare, even in endemic regions. Approximately 100 cases have been reported in the English literature. The computed tomographic (CT) features, however, have seldom been studied. Purpose: To determine the diagnostic CT features of tuberculosis of the parotid gland. Material and Methods: CT studies of four histologically proven cases of tuberculosis of the parotid gland were retrospectively reviewed. Results: A total of 15 enlarged lymph nodes were found in the superficial lobes of the parotid glands. The nodes were arranged linearly within the gland. Enhancement patterns included homogeneous enhancement (9/15, 60%), homogeneous enhancement with eccentric microcysts (3/15, 20%), and thick-walled rim enhancement with central lucency (3/15, 20%). Thickened adjacent fascial plane and platysma were seen in two patients. Ipsilateral cervical lymphadenopathy was seen in all patients. Conclusion: In patients presenting with unilateral parotid nodules, TB should be considered when linearly arranged enhancing nodules are demonstrated in the superficial lobes of the glands on CT scan
Neuroma prevention by end-to-side neurorraphy: an experimental study in rats.

Science.gov (United States)

Aszmann, Oskar C; Korak, Klaus J; Rab, Matthias; Grünbeck, Matthias; Lassmann, Hans; Frey, Manfred

2003-11-01

The successful treatment of painful neuromas remains a difficult goal to attain. In this report we explore the feasibility of neuroma prevention by insertion of the proximal end of a nerve through an end-to-side neurorraphy into an adjacent mixed nerve to provide a pathway and target for axons deprived of their end organ. Experiments were performed on a total of twenty 250-g Sprague-Dawley rats. Two groups of 10 animals were prepared. Group A served as an anatomic control. In group B the right saphenous nerve was transected and implanted end-to-side through an epineurial window into the tibial nerve distal to the trifurcation of the sciatic nerve. After 12 weeks the corresponding sensory neurons were identified by retrograde labeling techniques and histomorphometric analysis of the proximal and distal tibial nerve segments, and regular histology of the end-to-side site were performed. The results of the retrograde labeling of the corresponding sensory neuron pool of the saphenus nerve showed extensive labelling of the L1 to L3 spinal ganglions after intracutaneous tracer application of the planta pedis. The morphology of the end-to-side coaptation site and histomorphologic analysis prove that sensory neurons penetrate the perineurial sheath and axons regenerate along the tibial Schwann cell tubes toward their targets. Axons of a severed peripheral nerve that are provided with a pathway and target through an end-to-side coaptation will either be pruned or establish some type of end-organ contact so that a neuroma can be prevented. Whether these axons will lead to disturbing sensations such as paresthesia or dysesthesia in the newly found environment or remain silent codwellers, this experiment cannot answer. Long-term results of future clinical work will have to decide whether the prevention of the neuroma through end-to-side coaptation will be an appropriate therapy for this difficult problem.
Ductal carcinoma of the parotid gland.

Science.gov (United States)

Eriksen, H E; Greisen, O; Hastrup, N

1987-06-01

A case of ductal carcinoma of the parotid gland is described. The medical literature contains only 13 previous reports on this kind of adenocarcinoma of the parotid gland. The tumour is characterized by its histologic resemblance to ductal carcinomas of the breast and prostate. The course of previously described cases suggests that this tumour has a highly aggressive biological behaviour.

Branchial cysts within the parotid salivary gland

Science.gov (United States)

2012-01-01

Cystic lesions within the parotid gland are uncommon and clinically they are frequently misdiagnosed as tumours. Many theories have been proposed as to their embryological origin. A 20-year retrospective review was undertaken of all pathological codes (SNOMED) of all of patients presenting with any parotid lesions requiring surgery. After analysis seven subjects were found to have histopathologically proven parotid branchial cysts in the absence of HIV infection and those patients are the aim of this review. Four of the most common embryological theories are also discussed with regard to these cases, as are their management. PMID:22607735
Benign lymphoepithelial lesion arising in the parotid gland

International Nuclear Information System (INIS)

Park, Rae Chung; Choi, Soon Chul; Park, Tae Won; Yoo, Dong Soo

1996-01-01

The authors diagnosed a 33 years old female as benign lymphoepithelial lesion after undergoing clinical, radiological and histopathological examinations and the characteristics were as follows : 1. Clinically, the patient complained of painless bilateral swelling of the parotid glands and dryness of the palate. Rheumatoid facor was detected in her serum. 2. Sialograms showed punctuate or globular collections of contrast media distributed evenly throughout the parotid gland s in so-called 'cherry blossom' or 'fearless fruit-laden tree' appearance. 3. A salivary gland scan showed no uptake of radioisotopes by the parotid glands. 4. At T1-weighted imaging of PNS MRI, the lesions had the same signal intensity as the rest of the gland. At T2-weighted imaging, the lesion could be seen as high signal intensity 1.3 cm and 2.1 cm in diameter in the left and the right parotid gland respectively. 5. Ultrasonogram showed sonolucent lesions 20 X 15 mm and 17 X 14 mm in size in the lower part of the left parotid gland an d another 18 X 11 mm in size in the lower part of the parotid gland AS well as many other small sonolucent lesions. 6. Histopathologically, lymphocytic infiltration replacing the normal acini and lymphoid follicles containing germinal centers could be seen. Epimyoepithelial islands were scattered throughout the lesion and benign lymphoepithelial cysts were also observed.
The radioimmunoassay of biologically active compounds in parotid fluid and plasma

International Nuclear Information System (INIS)

Walker, R.F.; Read, G.F.; Riad-Fahmy, D.

1978-01-01

Parotid fluid collection is a simple stress-free procedure. The potential value of parotid fluid estimations of clomipramine, a tricyclic antidepressant, d-norgestrel, a synthetic contraceptive steroid and cortisol have been evaluated for assessment of clinical status and patient compliance. These compounds circulate bound largely to plasma proteins. Their concentration in parotid fluid, which reflects the non-protein bound fraction, is low but assay sensitivity (10, 1 and 30 pg/tube respectively) is adequate. Excellent agreement (r>0.9) was observed when parotid fluid samples were assayed with and without chromatographic purification. Clomipramine levels following oral dosage (150 mg) rose steadily to a maximum in plasma but showed wide fluctuations in parotid fluid. Clomipramine therapy can only be assessed by plasma assays, but patient compliance may be checked by parotid fluid concentrations. Following an oral dose of d-norgestrel (0.3 mg), parotid fluid levels rose steadily to a maximum but plasma response was biphasic making correlation impossible. The sensitivity and high throughput of the d-norgestrel methodology suggests its use in evaluating patient compliance in large-scale fertility control programmes. Changes in circulating cortisol concentrations were rapidly and accurately reflected in parotid fluid in normal volunteers. Parotid fluid cortisol showed a marked diurnal rhythm, suppression to low levels after dexamethasone, and elevation following Synacthen. Low levels after Synacthen stimulation in a patient with secondary adrenal atrophy and constant high levels in Cushingoid patients indicate that parotid fluid cortisol levels could be used for accurate adrenocortical evaluation. The value in rapid screening procedures is stressed since the assay can be performed directly on only 10 μl of parotid fluid. (author)
Parotid gland lipoma: two case report

International Nuclear Information System (INIS)

Islim, F.; Ors, S.; Salik, A.; Selcuk, H.; Sever, N.

2012-01-01

Full text: Introduction: Lipoma is the most common mesenchymal neoplasm in the human body but very rarely in the parotid gland. Objective: The aim of this study was to document retrospectively the imaging findings of lipomas with the use of computed tomography, ultrasonography, and magnetic resonance imaging. Material and methods: Ultrasonography, Computed Tomography (CT), and Magnetic Resonance Imaging were performed to the patients after clinical evaluation and physical examination. Both for two patients after fine needle aspiration biopsy, surgical excisions were practiced. Case 1: 14-wear-old woman was applied to the hospital with swelling of the right jaw. In physical examination a palpable mass was detected on the parotid gland. In sonography, heterogeneous, hypoechoic solid lesion was observed. This tumor produced strong signals on T1- and T2-weighted MR images and weak signals on fat suppression images. Case 2: 65-wear-old man presented with a 10 month history of a painless, slow growing mass in the left preauricular area. In sonography, heterogeneous, hypoechoic solid lesion with hyperechoic areas was observed. Also this tumor produced strong signals on T1- and T2-weighted MR images and weak signals on fat suppression images with low ADC level. Both for two patients after fine-needle aspiration biopsy, surgical excisions were practiced, superficial parotidectomy was performed. Histopathological examination showed parotid lipoma. Conclusion: Lipomas are common soft tissue neoplasms but found very rarely in the parotid gland, and so, are after not considered in the initial differential diagnosis of parotid gland tumor
Parotid gland as an initial site of metastasis

International Nuclear Information System (INIS)

Borg, Martin F.

2004-01-01

The parotid gland is an uncommon site of metastasis from carcinomas arising outside the head and neck region. Involvement of the parotid gland as an initial site of metastasis or presentation is rare. The present case report is the first, to our knowledge, to describe the management and outcome of an elderly man whose first presentation of an asymptomatic squamous cell carcinoma of the lung was that of a rapidly growing fungating left parotid mass Copyright (2004) Blackwell Publishing Asia Pty Ltd
A STUDY ON PAROTID SWELLINGS

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Alli Muthiah

2017-03-01

Full Text Available BACKGROUND Swellings of the parotid gland are of special interest to a surgeon’s keen eye. These lesions are not only involved in diseases isolated to the parotid, but can also present as a part of a generalised systemic disorder, medical or surgical. For a surgeon, the interests lie in the probable origin of the swelling, its involvement of the facial nerve, the variability in behaviour, regarding the operability criteria and its postoperative complications. 1 A comprehensive knowledge of the anatomy of the parotid and the prediction of the swelling behaviour can help not only in the diagnosis, but also in ensuring an apt management of the lesion and the patient. 2 This cohort study was conducted to analyse the following in our institution. The incidence of various parotid swellings to discuss accuracy of FNAC in comparison to the histopathological reports. The various surgical modalities of treatment of parotid swellings applied. MATERIALS AND METHODS The cohort study, which included 45 patients was conducted at Kilpauk Medical College Hospital and Government Royapettah Hospital from September 2010 to October 2012. Data was collected from the patients after obtaining an informed consent. The demographic details of the patients and history of their swelling was taken. The patients were examined and basic investigations performed. Details regarding the FNAC report, surgical and nonsurgical management were noted. Postoperative complications were documented. The final histopathological report was analysed and compared with the FNAC report. RESULTS Parotid lesions are commonest cases in our study. Benign tumours are more common than malignant lesions. This study found to correlate with world statistics. Investigations, clinical findings and treatment correlate well with world statistical records. CONCLUSION The analysis of the data of the study conducted at our institution provided us with the following results- Parotid lesions comprised of the
Effects of different tastants on parotid saliva flow and composition

NARCIS (Netherlands)

Neyraud, E.; Heinzerling, C.I.; Bult, J.H.F.; Mesmin, C.; Dransfield, E.

2009-01-01

Saliva from parotid glands plays a role in taste perception. Parotid saliva is also stimulated by tastants. The aim of this work is to investigate the effects of different tastants on the parotid salivary response in six subjects. Five tastants were given in different concentrations in solution and
Remission of severe restless legs syndrome and periodic limb movements in sleep after bilateral excision of multiple foot neuromas: a case report

Directory of Open Access Journals (Sweden)

Lettau Ludwig A

2010-09-01

Full Text Available Abstract Introduction Restless legs syndrome is a sensorimotor neurological disorder characterized by an urge to move the legs in response to uncomfortable leg sensations. While asleep, 70 to 90 percent of patients with restless legs syndrome have periodic limb movements in sleep. Frequent periodic limb movements in sleep and related brain arousals as documented by polysomnography are associated with poorer quality of sleep and daytime fatigue. Restless legs syndrome in middle age is sometimes associated with neuropathic foot dysesthesias. The causes of restless legs syndrome and periodic limb movements in sleep are unknown, but the sensorimotor symptoms are hypothesized to originate in the central nervous system. We have previously determined that bilateral forefoot digital nerve impingement masses (neuromas may be a cause of both neuropathic foot dysesthesias and the leg restlessness of restless legs syndrome. To the best of our knowledge, this case is the first report of bilateral foot neuromas as a cause of periodic limb movements in sleep. Case presentation A 42-year-old Caucasian woman with severe restless legs syndrome and periodic limb movements in sleep and bilateral neuropathic foot dysesthesias was diagnosed as having neuromas in the second, third, and fourth metatarsal head interspaces of both feet. The third interspace neuromas represented regrowth (or 'stump' neuromas that had developed since bilateral third interspace neuroma excision five years earlier. Because intensive conservative treatments including repeated neuroma injections and various restless legs syndrome medications had failed, radical surgery was recommended. All six neuromas were excised. Leg restlessness, foot dysesthesias and subjective sleep quality improved immediately. Assessment after 18 days showed an 84 to 100 percent reduction of visual analog scale scores for specific dysesthesias and marked reductions of pre-operative scores of the Pittsburgh sleep
The accuracy of ultrasonography and magnetic resonance imaging for the diagnosis of Morton's neuroma: a systematic review

International Nuclear Information System (INIS)

Xu, Z.; Duan, X.; Yu, X.; Wang, H.; Dong, X.; Xiang, Z.

2015-01-01

Aim: To determine the accuracy of MRI versus ultrasound for Morton's neuroma. Materials and methods: A search was undertaken for clinical studies published in any language in PubMed up to the date of December 2013. Studies assessing the accuracy of the ultrasound or MRI for the diagnosis of Morton's neuroma were included. Data were pooled for meta-analysis. Study selection, data collection, and extraction were performed independently by two authors. Meta-disc 1.4 and Revman 5.2 software were applied for statistical analysis. Results: The study included 12 studies; 217 patients underwent MRI and 241 underwent ultrasound examinations. There appeared greater diagnostic accuracy for ultrasound than MRI for the diagnosis of Morton's neuroma (ultrasound sensitivity 90%, specificity 88%, positive likelihood ratio 2.77, negative likelihood ratio 0.16 versus MRI sensitivity 93%, specificity 68%, positive likelihood ratio 1.89, negative likelihood ratio 0.19). Conclusions: The available evidence suggests that ultrasound can provide better accuracy for the diagnosis of Morton's neuroma than MRI
[Sialoendoscopy-assisted sialolithectomy for large parotid stones].

Science.gov (United States)

Zhao, Jian; Zhang, Lei; Liu, Deng-gao; Zhang, Zu-yan; Yu, Guang-yan

2014-02-18

To explore the clinical application of endoscope-assisted operative retrieval of large parotid stones as a minimally invasive alternative. From January 2010 to April 2013, 6 patients (male: 5, female: 1, age from 30-62 years, and median age: 49.5 years)suffering from recurred swelling of parotid gland due to sialoliths were treated by endoscope-assisted parotid surgery in Peking University School and Hospital of Stomatology. All of the patients underwent clinical, ultrasonographic and cone-beam CT (CBCT) examinations to get the detailed information of the number, location and size of stones, which was recorded in the medical records. endoscope-assisted parotid surgery was performed under general anesthesia in all the 6 cases after the failure of basket or forcep retrieval firstly. During the operation, sialoendoscope was used to locate the stone exactly and then the calculus was exposed through a pre-auricular approach and released by incising the duct. The postoperative complications were recorded and observed during the follow-up periods. Preoperative radiological examinations showed that all of the sialoliths were near the hilum of parotid gland ducts in the 6 cases, which were 5-9 mm in diameter. All of the stones were removed successfully by endoscope-assisted operative retrieval. The incisions healed smoothly in all the 6 cases. There were no cases of facial nerve weakness, infection or salivary fistula. After a mean follow-up of 19 months (ranging from 6-36 months), 5 patients remained asymptomatic and 1 patient had mild obstructed or infective symptoms. The final results were satisfied. It is suggested that endoscope-assisted operative retrieval is a viable minimally invasive alternative to remove the large or recalcitrant parotid stones with a high successful rate and low complications.
The radioimmunoassay of biologically active compounds in parotid fluid and plasma

International Nuclear Information System (INIS)

Walker, R.F.; Read, G.F.; Riad-Fahmy, D.

1977-01-01

The potential value of parotid fluid estimations of clomipramine, d-norgestrel, and cortisol have been evaluated for assessment of clinical status and patient compliance. Excellent agreement (r > 0.9) was observed when parotid fluid samples were assayed with and without chromatographic purification. Clomipramine levels following oral dosage (150mg) rose steadily to a maximum in plasma but showed wide fluctuations in parotid fluid. Following an oral dose of d-norgestrel(0.3mg), parotid fluid levels rose steadily to a maximum but plasma response was biphasic making correlation impossible. The sensitivity and high throughput of the d-norgestrel methodology suggests its use in evaluating patient compliance in large scale fertility control programmes. Changes in circulating cortisol concentrations were rapidly and accurately reflected in parotid fluid in normal volunteers. Parotid fluid cortisol showed a market diurnal rythm, suppression to low levels after dexamethasone, and elevation following Synacthen. Low levels after Synacthen stimulation in a patient with secondary adrenal atrophy and constant high levels in Cushingoid patients indicate that parotid fluid cortisol levels could be used for accurate adrenocortical evaluation. The value in rapid screening procedures is stressed since the assay can be performed directly on only 10μl of parotid fluid. (orig./AJ) [de
Diabetes insípida post-parotiditis

OpenAIRE

Pila Pérez, Rafael; Rivero Sánchez, Miguel; Peralta Ventura, Ricardo; Carbonell Perdomo, Diego; Pila Peláez, Rafael; Guerra Rodríguez, Carmen

2001-01-01

Se describe un caso de diabetes insípida post parotiditis, entidad sumamente rara en nuestro medio. Se destaca el diagnóstico y la terapéutica de esta entidad, así como la causa etiológico y forma de presentación. A case of diabetes insipidus post-parotiditis is described entity totally rare in our midicu. Diagnostics and therapeutics are stressed a well as the ethiologic antecedent and way of presentation.
Ultrasound-guided needle aspiration of parotid abscess

Directory of Open Access Journals (Sweden)

André Takahashi

2012-01-01

Full Text Available Ultrasound (US has been used as a tool for parotid abscess diagnosis and treatment. The present article aimed to report a case of 72-year-old woman with parotid abscess treated by US-guided needle aspiration and conventional surgical drainage. Along with the clinical report, indications, advantages, and limitations of the method are discussed.
The treatment for acoustic neuromas. Indication and results of gamma knife radiosurgery and surgery

International Nuclear Information System (INIS)

Iwai, Yoshiyasu; Yamanaka, Kazuhiro; Uyama, Taichi; Morikawa, Toshie; Honda, Yuji; Matsusaka, Yasuhiro; Komiyama, Masaki; Yasui, Toshihiro

2004-01-01

We evaluated the treatment results of acoustic neuromas in the era of radiosurgery. We treated acoustic neuromas using the following strategy. Small to medium size tumors (below 3 cm) were treated by gamma knife radiosurgery and large tumors (above 3 cm) were treated using a combination of surgery and radiosurgery. Using gamma knife radiosurgery we were able to achieve 96.4% of clinical tumor growth control with 0.7% incidence of trigeminal neuropathy (without new facial neuropathy). We used low dose radiosurgery (average tumor marginal dose 11.8 Gy) with a follow-up of an average of 54 months. For the 17 patients with large tumors treated by the combination of surgery and radiosurgery who could be followed up for over 24 months after radiosurgery, we were able to preserve normal facial function (House-Brackmann grade I-II) in 70.6% of the patients after subtotal removal. High clinical tumor growth control for residual tumor was achieved in 94.1% of subjects with an average of 40 months follow-up. By using this strategy, the treatment outcome for acoustic neuroma is improved from the standpoint of functional outcome and maintaining the patient's quality of life. (author)
Calculating the tumor volume of acoustic neuromas: comparison of ABC/2 formula with planimetry method.

Science.gov (United States)

Yu, Yi-Lin; Lee, Meei-Shyuan; Juan, Chun-Jung; Hueng, Dueng-Yuan

2013-08-01

The ABC/2 equation is commonly applied to measure the volume of intracranial hematoma. However, the precision of ABC/2 equation in estimating the tumor volume of acoustic neuromas is less addressed. The study is to evaluate the accuracy of the ABC/2 formula by comparing with planimetry method for estimating the tumor volumes. Thirty-two patients diagnosed with acoustic neuroma received contrast-enhanced magnetic resonance imaging of brain were recruited. The volume was calculated by the ABC/2 equation and planimetry method (defined as exact volume) at the same time. The 32 patients were divided into three groups by tumor volume to avoid volume-dependent overestimation (6 ml). The tumor volume by ABC/2 method was highly correlated to that calculated by planimetry method using linear regression analysis (R2=0.985). Pearson correlation coefficient (r=0.993, pABC/2 formula is an easy method in estimating the tumor volume of acoustic neuromas that is not inferior to planimetry method. Copyright © 2013 Elsevier B.V. All rights reserved.
CT and MRI of haemorrhage into intracranial neuromas

Energy Technology Data Exchange (ETDEWEB)

Asari, S. (Dept. of Neurological Surgery, Okayama Univ. Medical School, Okayama City (Japan)); Katayama, S. (Dept. of Neurological Surgery, Okayama Univ. Medical School, Okayama City (Japan)); Itoh, T. (Dept. of Neurological Surgery, Okayama Univ. Medical School, Okayama City (Japan)); Tsuchida, S. (Dept. of Neurological Surgery, Okayama Univ. Medical School, Okayama City (Japan)); Ohmoto, T. (Dept. of Neurological Surgery, Okayama Univ. Medical School, Okayama City (Japan))

1993-04-01

Six patients with haemorrhage into intracranial neuromas were studied by computed tomography (CT) and magnetic resonance imaging (MRI) at 0.5 T with spin-echo pulse sequences. The nature of the tumour and the presence of a haematoma were confirmed by surgery and microscopic examination in all cases. Four neuromas arose from the acoustic nerves and two from the trigeminal. Four of the six patients suffered from sudden onset or rapid worsening of symptoms including headache, vertigo and/or hemifacial motor and sensory disturbances. CT in the acute stage revealed a hyperdense area or a fluid-fluid level (FFL). The hyperdense area disappeared on CT repeated in the chronic stage. On MRI in subacute and chronic stages the haemorrhage showed hyperintensity on both T1 and T2 weighting in five cases examined between 16 and 46 days after the onset, and isointensity on T1 weighting and an FFL on T2 weighting in one case examined 12 days after the onset of symptoms. A well-defined low intensity rim indicating prior haemorrhage was observed on T2-weighted images in three cases. MRI was more effectie than CT in detecting haemorrhage into the tumours and in staging it. (orig.)
Contemporary Management of Benign and Malignant Parotid Tumors.

Science.gov (United States)

Thielker, Jovanna; Grosheva, Maria; Ihrler, Stephan; Wittig, Andrea; Guntinas-Lichius, Orlando

2018-01-01

To report the standard of care, interesting new findings and controversies about the treatment of parotid tumors. Relevant and actual studies were searched in PubMed and reviewed for diagnostics, treatment and outcome of both benign and malignant tumors. Prospective trials are lacking due to rarity of the disease and high variety of tumor subtypes. The establishment of reliable non-invasive diagnostics tools for the differentiation between benign and malignant tumors is desirable. Prospective studies clarifying the association between different surgical techniques for benign parotid tumors and morbidity are needed. The role of adjuvant or definitive radiotherapy in securing loco-regional control and improving survival in malignant disease is established. Prospective clinical trials addressing the role of chemotherapy/molecular targeted therapy for parotid cancer are needed. An international consensus on the classification of parotid surgery techniques would facilitate the comparison of different trials. Such efforts should lead into a clinical guideline.
Traumatic Neuroma in a Breast Cancer Patient After Modified Radical Mastectomy: A Case Report

International Nuclear Information System (INIS)

Kim, Eun Young; Kang, Doo Kyoung; Kim, Tae Hee; Kim, Ku Sang; Yim, Hyunee

2011-01-01

Traumatic neuromas are rare benign lesions that develop from non-neoplastic proliferation of axons, schwann cells, and fibroblasts at the proximal end of transected or injured nerves as a result of trauma or surgery. We present the case of a traumatic neuroma in a 47-year-old female who was treated with a right modified radical mastectomy for breast cancer 14 years ago. Ultrasound examination revealed an oval-shaped hypoechoic nodule at the 9-O'clock position in the right chest wall. Color Doppler imaging showed no increased blood flow and a positron emission tomography-computed tomography examination revealed no fluorodeoxyglucose uptake in this nodule. The typical histologic findings were present.
MR of acoustic neuromas

International Nuclear Information System (INIS)

Suzuki, Masayuki; Takashima, Tsutomu; Kadoya, Masumi; Takahashi, Shiroh; Miyayama, Shiroh; Taira, Sakae; Kashihara, Kengo; Yamashima, Tetsumori; Itoh, Haruhide

1989-01-01

In this report, the relationship of acoustic neuromas to the adjacent cranial nerves is discussed. On T 1 -weighted images, the trigeminal nerve was detected in all 13 cases. Mild to marked compression of these nerves by the tumors was observed in eight cases. The extent of compression did not always correspond to the clinical symptoms. In four cases with a maximum tumor diameter of 2 cm or less, the 7th and 8th cranial nerves were identified. There was no facial palsy in these patients. Two patients with a tumor diameter of more than 2 cm also had no facial palsy. All patients, including those with small tumors, complained of hearing loss and/or tinnitus. While MR imaging has some limitations, it is an effective imaging modality for showing the relationship between tumors and nerves. (author)
A RARE CASE OF PAROTID CYST

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Rambabu

2015-09-01

Full Text Available A 28 years old male presented with a case of painless soft fluctuant swelling of right parotid gland is reported to our hospital. The lesion was found to be a cystic lesion through the pre - operative examinations and investigations. The cyst was completely excised, taking care not to injure the lower division of the facial nerve. Po st recovery was uneventful with no defect of the facial nerve functions. The histologic picture confirmed that the cyst was lymphoepithelial cyst which is so called “branchial cyst”. Through the literature reviews of parotid lymphoepit h elial cyst the discu ssions on prevalence, origin, diagnosis, histological finding, investigation and the modes of treatment are made. The ultra sound was found to be valuable in the pre - operative evaluation of the parotid swelling furthermore it is non - invasive, harmless, pai nless and relatively quick

Interventional sialendoscopy for parotid ductal calculi: our preliminary experience.

Science.gov (United States)

Singh, P P; Gupta, Neelima; Goyal, Arun; Tomar, Sanjeev

2012-09-01

With this article we present our initial experience with interventional sialendoscopy of the parotid duct for the parotid calculi. We carried out a prospective study of patients of parotid calculi in a tertiary referral centre. Diagnostic and interventional sialendoscopy was performed in five cases of parotid calculi. The outcome was classified on the basis of clearance of the lumen of the duct and resolution of symptoms. Diagnostic sialendoscopy was able to diagnose the calculus in all cases. Interventional sialendoscopy was done under general anesthesia in all cases and calculus was successfully removed. The average size of sialolith was 8.2 mm. No complications occurred in any of the cases. Check sialendoscopy was done in all cases after a minimum follow up of 6 months, which showed the duct lumen to be free of stone with no stricture of the duct. Sialendoscopy is an optimal technique for removal of intraductal parotid calculi and avoids removal of the gland. In our series there was no associated morbidity and complication.
New models of experimental parotitis and parotid gland distension in rats.

Science.gov (United States)

Okada-Ogawa, Akiko; Shinoda, Masamichi; Honda, Kuniya; Iwata, Koichi

2012-01-01

A significant reduction of the escape threshold to mechanical stimulation of the lateral facial skin was observed bilaterally at days 2 and 3 after unilateral complete Freund's adjuvant (CFA) administration into parotid gland. A slight reduction of mechanical escape threshold was also observed in rats with saline administration. The parotid gland inflammation was verified and quantified by measuring the tissue Evans' blue dye extravasation. The Evans' blue concentration in the parotid gland tissues was significantly greater in the CFA-injected rats than that of the saline-injected rats at 72 h after treatment. On day 10 after CFA administration into the parotid gland, the Evans' blue concentration was recovered to the control level. The administration of capsaicin into the parotid gland did not alter neuronal activities in the transition zone between the trigeminal spinal subnucleus interpolaris and caudalis (Vi/Vc). In contrast, capsaicin administration induced significant increases in the receptive field size and mechanical and cold responses of neurons located in superficial laminae of the C1/C2. The subgroup of C1/C2 neurons responded to mechanical distension of the parotid gland, whereas no Vi/Vc neurons responded to parotid distension.
3D-FIESTA MRI at 3 T demonstrating branches of the intraparotid facial nerve, parotid ducts and relation with benign parotid tumours

International Nuclear Information System (INIS)

Li Chuanting; Li Yan; Zhang Dongsheng; Yang Zhenzhen; Wu Lebin

2012-01-01

Aim: To investigate the usefulness of three-dimensional (3D) fast imaging employing steady state precession (FIESTA) magnetic resonance imaging (MRI) at 3 T in evaluating the intraparotid components of the facial nerve and parotid ducts, and to compare the MRI images with surgical findings. Materials and methods: Thirty-one cases of benign parotid tumours were studied with conventional and 3D FIESTA MRI sequences at 3T using a head coil. The most clinically useful 3D FIESTA images were acquired at parameters of 4.9 ms repetition time (TR); 1.5 effective echo time (TEeff); a flip of 55°, a field of view of 18 to 20 cm, a matrix of 512 × 320, an axial plane, no gaps, and a section thickness of 1 mm. Post-processed multiplanar images were obtained with an Advantage Windows (AW sdc 4.3) workstation. Parotid ducts, facial nerves, and tumours were identified on these images. The relationship of the tumours to the facial nerves and parotid ducts was confirmed at surgery. Results: The facial nerves appeared as linear structures of low intensity. The main trunk of the facial nerve was identified bilaterally in 93.5% of the 3D-FIESTA sequence images. Parotid ducts appeared as structures of high intensity on multiplanar 3D-FIESTA images (100%). The relationships of the tumours with the cervicofacial and temporofacial divisions of the facial nerve were correctly diagnosed in 26 of 31 cases (83.9%) using 3D-FIESTA sequence images. Conclusion: 3D-FIESTA MRI at 3 T depicted the main trunk, cervicofacial and temporofacial divisions of the facial nerve, and the main parotid duct. It is useful for preoperative evaluation of parotid gland tumours.
Parotid Abscess with Involvement of Facial Nerve Branches.

Science.gov (United States)

Ozkan, Adile; Ors, Ceyda Hayretdag; Kosar, Sule; Ozisik Karaman, Handan Isin

2015-08-01

Facial nerve paresis is only rarely seen with benign diseases of the parotid gland. A 22-year male had muscle loss in the preauricular region of the right side of his face that extended towards the mandibular angle for the last 6 months. The neurological examination did not reveal any pathology other than right preauricular region muscle atrophy that was limited by the mandibular angle. The Electroneuronography (EnoG) provided a ratio of 55.38%, compared the affected side to left side. Ultrasonography of the defined region showed two mass lesions 13.5 x 7 mm and 10 x 5 mm in size in the anteromedial section of the right parotid gland that were close to each other, without internal calcific foci, and heterogenous hyperechogenic structure without internal vascularization. Fine needle aspiration obtained many polymorphonuclear leukocytes, cell debris, a few mononuclear inflammatory cells and many crystalloid structures. The lesion was diagnosed as a parotid abscess. Antibiotic treatment was started for the parotid gland abscess.
Self-induced parapharyngeal and parotid emphysema: A case of pneumoparotitis

Directory of Open Access Journals (Sweden)

Javier GonzÃ¡lez Lagunas

2017-12-01

Full Text Available Swelling of the parotid suggests pathological change. Enlargement of the parotid gland may result from infections, duct obstruction, benign or malignant tumors, allergies, autoimmune or systemic disease syndromes or lymphoproliferative diseases. Acute swelling is typically associated with viral infection or recurrent chronic parotitis. A rare cause of acute swelling is insufflation of air from the mouth via Stensenâs duct into the parotid region. We report a case of recurrent self-induced chronic pneumoparotitis with parapharyngeal extension in a teenager. Pneumoparotitis is rare and is often misdiagnosed and mistreated. Patients typically present with unilateral or bilateral painless swelling and tenderness in the parotid region. Imaging, including computer tomography scans, shows air within the parotid system that extends into the neighboring areas in cases of rupture of the parotid fascia. Salivary gland enlargement resolves spontaneously over 1â3 days. Some authors recommend anti-inflammatory drugs and prophylactic antibiotics to avoid superinfection. Several surgical treatments have been suggested for chronic and recurrent pneumoparotid. However, the primary challenge is to educate the patient to prevent an increase in intraoral pressure. Keywords: Pneumoparotitis, Pneumoparotiditis, Teenager, Head-and-neck emphysema
CT findings of tuberculous lymphadenifis in parotid gland

International Nuclear Information System (INIS)

Wang Changfu; Wang Binjie; Zhang Heping; Jin Haiying; Nie Peng; Chang Liang; Wei Haigang; Zou Ling

2008-01-01

Objective: To analyze the CT findings of tuberculous lymphadenitis in parotid gland, so as to improve the diagnostic accuracy of tuberculosis of parotid gland. Methods: Nine cases with tuberculous lymphadenitis in parotid gland confirmed by surgical pathology and acid-fast bacilli after preoperative spiral CT plain scan and two phases dynamic enhancement scan were retrospectively analyzed. Imaging findings of CT were reviewed and compared with surgical pathology. Results: Seven of the 9 cases of tuberculosis of the parotid gland occurred in the left side, and 2 in the right side, and superficial lobe involvement occurred in 8 cases and deep lobe in 1 case. The lesion was classified as tumour type (8 cases) and infiltration type (1 case). In turnout type, the number of lesion was from 1 to 4, and the size was from 2.7 to 5.3 cm in diameter. One case of infiltration type measured 3.4 cm in diameter. On CT plain scan, the lesions showed homogeneous slight high-density with regular edge in 5 cases and irregular low-density in 4 cases, and 2 of them with partly blurred edge. On CT enhanced scan, uniform moderate enhancement was seen in 3 cases, circular enhancement in 4 cases, inhomogeneous enhancement in 1 case, and lace-like enhancement in 1 case. Local infiltration occurred in 6 cases. Lymphadenovarix in the same side of lesion occurred in 2 cases. Conclusion: CT findings of tuberculous lymphadenitis in parotid gland present diversification, which correlate well with pathological changes. Understanding of characteristic CT findings of tuberculous lymphadenitis in parotid gland is helpful for differential diagnosis, but final diagnosis still depends on pathology and acid-fast bacilli. (authors)
Geometric factors influencing dosimetric sparing of the parotid glands using IMRT

International Nuclear Information System (INIS)

Hunt, Margie A.; Jackson, Andrew; Narayana, Ashwatha; Lee, Nancy

2006-01-01

Purpose/Objective: To determine the relationship between the parotid volume, parotid-planning target volume (PTV) overlap, and dosimetric sparing of the parotid with intensity-modulated radiation therapy (IMRT). Methods and Materials: Parotid data were collected retrospectively for 51 patients treated with simultaneous boost IMRT. Unresectable patients received 54 or 59.4 Gy to subclinical disease, 70 Gy to gross disease. Patients treated postoperatively received 54, 60, and 66 Gy to low-risk, high-risk, and tumor bed regions. Volume and mean dose of each gland and gland segments outside of and overlapping the PTV were collected. Proximity of each gland to each PTV was recorded. Results: Dosimetric sparing (mean dose ≤26.5 Gy) was achieved in 66 of 71 glands with ≤21% parotid-PTV overlap and 8 of 23 glands with >21% overlap (p = 21%. Median mean dose was 25.9 Gy to glands overlapping PTV 54 or PTV 59 alone and 30.0 Gy to those abutting PTV 7 (p 7 was associated with higher parotid dose, satisfactory sparing was achieved in 24 of 43 ipsilateral glands. Conclusions: Dosimetric sparing of the parotid is feasible when the parotid-PTV overlap is less than approximately 20%. With more overlap, sparing may result in low doses within the overlap region, possibly leading to inadequate PTV coverage. Gland proximity to the high-dose PTV is associated with higher mean dose but does not always preclude dosimetric sparing
Stereotactic radiosurgery using the gamma knife for acoustic neuromas

International Nuclear Information System (INIS)

Foote, Robert L.; Coffey, Robert J.; Swanson, Jerry W.; Harner, Stephen G.; Beatty, Charles W.; Kline, Robert W.; Stevens, Lorna N.; Hu, Theresa C.

1995-01-01

Purpose: To assess the efficacy and toxicity of stereotactic radiosurgery using the gamma knife for acoustic neuromas. Methods and Materials: Between January 1990 and January 1993, 36 patients with acoustic neuromas were treated with stereotactic radiosurgery using the gamma knife. The median maximum tumor diameter was 21 mm (range: 6-32 mm). Tumor volumes encompassed within the prescribed isodose line varied from 266 to 8,667 mm 3 (median: 3,135 mm 3 ). Tumors ≤ 20 mm in maximum diameter received a dose of 20 Gy to the margin, tumors between 21 and 30 mm received 18 Gy, and tumors > 30 mm received 16 Gy. The dose was prescribed to the 50% isodose line in 31 patients and to the 45%, 55%, 60%, 70%, and 80% isodose line in one patient each. The median number of isocenters per tumor was 5 (range: 1-12). Results: At a median follow-up of 16 months (range: 2.5-36 months), all patients were alive. Thirty-five patients had follow-up imaging studies. Nine tumors (26%) were smaller, and 26 tumors (74%) were unchanged. No tumor had progressed. The 1- and 2-year actuarial incidences of facial neuropathy were 52.2% and 66.5%, respectively. The 1- and 2-year actuarial incidences of trigeminal neuropathy were 33.7% and 58.9%, respectively. The 1- and 2-year actuarial incidence of facial or trigeminal neuropathy (or both) was 60.8% and 81.7%, respectively. Multivariate analysis revealed that the following were associated with the time of onset or worsening of facial weakness or trigeminal neuropathy: (a) patients five isocenters. The 1- and 2-year actuarial rates of preservation of useful hearing (Gardner-Robertson class I or II) were 100% and 41.7% ± 17.3, respectively. Conclusion: Stereotactic radiosurgery using the gamma knife provides short-term control of acoustic neuromas when a dose of 16 to 20 Gy to the tumor margin is used. Preservation of useful hearing can be accomplished in a significant proportion of patients
Parotid Duct Repair with Intubation Tube: Technical Note

Science.gov (United States)

Öztürk, Muhammed Beşir; Barutca, Seda Asrufoğlu; Keskin, Elif Seda; Atik, Bekir

2017-01-01

The parotid duct can be damaged in traumatic injuries and surgical interventions. Early diagnosis and treatment of a duct injury is of great importance because complications such as sialocele and salivary gland fistula may develop if the duct is not surgically repaired. We think the cuff of an intubation tube is an ideal material in parotid duct repair, because of its technical characteristics, easiness of availability, and low-cost. In this paper, we described the use of the cuff cannula of an intubation tube for the diagnosis and treatment of parotid duct laceration, as a low-cost and easy to access material readily available in every operating room. PMID:28713751
Parotid gland tumours: a six years experience

International Nuclear Information System (INIS)

Malik, K.A.

2006-01-01

To find out the different types of Parotid tumours in out setup and their prevalence in different age groups. All patients admitted with Parotid swellings, irrespective of age and sex. The detailed data of the patients was collected and analyzed. A total of 27 patients, 15 males and 12 females, with ages ranging from 15 to 65 years were included in the study. Most of the patients were in the 31-50 years of age group. Pleomorphic adenoma was the commonest benign tumour with an incidence of 66.6%, while Mucoepidermoid Carcinoma with an incidence of 11.11% was the most common malignant tumour. Parotid gland is the principal site of salivary gland tumours. Males are affected more and Pleomorphic adenoma is the most common benign and Mucoepidermoid carcinoma the most common malignant tumour. (author)
Ultrasound versus magnetic resonance imaging for Morton neuroma: systematic review and meta-analysis

Energy Technology Data Exchange (ETDEWEB)

Bignotti, Bianca; Martinoli, Carlo [University of Genoa, Radiology Department, Genoa, Genova (Italy); Signori, Alessio; Sormani, Maria Pia [University of Genoa, Institute of Statistics, Department of Health Sciences, Genoa (Italy); Molfetta, Luigi [University of Genoa, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics (DINOGMI), Genoa (Italy); Tagliafico, Alberto [University of Genoa, Institute of Anatomy, Department of Experimental Medicine, Genoa (Italy)

2015-08-15

To compare ultrasound (US) and magnetic resonance imaging (MRI) in the diagnosis of Morton's neuroma. Studies that assessed the diagnostic accuracy of US and MRI for Morton's neuroma were retrieved from major medical libraries independently by two reviewers up to 1 April 2014. Predefined inclusion and exclusion criteria were adopted. 277 studies were initially found, and the meta-analysis was conducted on 14 studies. US sensitivity was studied in five studies, MRI sensitivity in three studies, and both in six studies. All studies used surgery as the reference standard. A high sensitivity (SE) of diagnostic testing was observed for both US (SE (95 % CI) = 0.91 (0.83-0.96)) and MRI (SE (95 % CI) = 0.90 (0.82-0.96)) with no significant differences between the two modalities in diagnosis (Q test p = 0.88). For MRI, specificity of test was 1.00 with a pooled estimation of 1.00 (0.73-1.00), while the pooled specificity was 0.854 (95 % CI: 0.41-1.00) for US. No differences were observed between US and MRI in study design (p = 0.76). This meta-analysis shows that the SE of US (0.91) is equal to (p = 0.88) that of MRI (0.90) for identification of Morton's neuroma. (orig.)
Traumatic Neuroma in a Breast Cancer Patient After Modified Radical Mastectomy: A Case Report

Energy Technology Data Exchange (ETDEWEB)

Kim, Eun Young; Kang, Doo Kyoung; Kim, Tae Hee [Dept. of Radiology, Ajou University School of Medicine, Suwon (Korea, Republic of); Kim, Ku Sang [Dept. of Surgery, Ajou University School of Medicine, Suwon (Korea, Republic of); Yim, Hyunee [Dept. of Pathology, Ajou University School of Medicine, Suwon (Korea, Republic of)

2011-05-15

Traumatic neuromas are rare benign lesions that develop from non-neoplastic proliferation of axons, schwann cells, and fibroblasts at the proximal end of transected or injured nerves as a result of trauma or surgery. We present the case of a traumatic neuroma in a 47-year-old female who was treated with a right modified radical mastectomy for breast cancer 14 years ago. Ultrasound examination revealed an oval-shaped hypoechoic nodule at the 9-O'clock position in the right chest wall. Color Doppler imaging showed no increased blood flow and a positron emission tomography-computed tomography examination revealed no fluorodeoxyglucose uptake in this nodule. The typical histologic findings were present.
Cell phone use and parotid salivary gland alterations: no molecular evidence.

Science.gov (United States)

de Souza, Fabrício T A; Correia-Silva, Jeane F; Ferreira, Efigênia F; Siqueira, Elisa C; Duarte, Alessandra P; Gomez, Marcus Vinícius; Gomez, Ricardo S; Gomes, Carolina C

2014-07-01

The association between cell phone use and the development of parotid tumors is controversial. Because there is unequivocal evidence that the microenvironment is important for tumor formation, we investigated in the parotid glands whether cell phone use alters the expression of gene products related to cellular stress. We used the saliva produced by the parotid glands of 62 individuals to assess molecular alterations compatible with cellular stress, comparing the saliva from the gland exposed to cell phone radiation (ipsilateral) to the saliva from the opposite, unexposed parotid gland (contralateral) of each individual. We compared salivary flow, total protein concentration, p53, p21, reactive oxygen species (ROS), and salivary levels of glutathione (GSH), heat shock proteins 27 and 70, and IgA between the ipsilateral and contralateral parotids. No difference was found for any of these parameters, even when grouping individuals by period of cell phone use in years or by monthly average calls in minutes. We provide molecular evidence that the exposure of parotid glands to cell phone use does not alter parotid salivary flow, protein concentration, or levels of proteins of genes that are directly or indirectly affected by heat-induced cellular stress. ©2014 American Association for Cancer Research.
Incidental benign parotid lesions on FDG-PET: prevalence and clinico-pathologic findings

International Nuclear Information System (INIS)

Lim, Il Han; Lee, Won Woo; Chung, Jin Haeng; Park, So Yeon; Kim, Sang Hee; Kim, Yu Kyeong; Kim, Sang Eun

2007-01-01

Incidental parotid lesions on F-18 FDG-PET can mimic distant metastasis of underlying malignancy. The prevalence and the clinico-pathologic findings of PET positive parotid lesions have not been known. We investigated how often incidental parotid lesions are found on clinical FDG-PET studies and what the clinico-pathologic characteristics of those parotid lesions are in the present study. We retrospectively reviewed 3,344 cases of FDG-PET which had been obtained in our hospital from May 2003 to Dec 2006. The indications of FDG-PET were: evaluation of known/suspected cancer (n = 3,212) or screening of cancer in healthy subjects (n = 132). Incidental parotid lesion on FDG-PET was defined as an un-expected FDG uptake in one of parotid glands which was not primary target lesion of current FDG/PET. FDG uptake was represented by maximum standardized uptake value (maxSUV). Final diagnosis was made by pathologic analysis or clinical follow-up assessment. Fifteen (0.45% = 15/3,344) incidental parotid lesions were found and they were all benign lesions. The maxSUV ranged from 1.7 to 8.6 (mean ± s.d. = 3.7 ± 1.9). Final diagnoses of the incidental parotid lesions were; Warthin's tumor (n = 2), pleomorphic adenoma (n = 1), other un-specified benign lesion (n 1), and benign lesions under bases of imaging studies (n = 3) and of clinical follow-up (n = 8). All of incidentally found parotid lesions in clinical FDG-PET studies were confirmed as benign lesions with prevalence of 0.45%. Close follow up using PET or CT might be a reasonable approach for determining the nature of incidentally found parotid lesions
MR imaging of the parotid gland

International Nuclear Information System (INIS)

Vogl, T.; Dresel, S.; Lissner, J.; Grevers, G.; Riederer, A.

1989-01-01

In this study MR imaging combined with Gd-DTPA as a new effective diagnostic tool is compared with plain MR imaging. Seventy-two patients with lesions of the parotid gland were examined. In the author's patient group, they found 25 malignant tumors, 19 benign lesions, 20 Sjogren syndromes, and eight inflamed parotid glands. Axial and coronal images were acquired with long (TR = 1,600 msec, TE = 25/90 msec) and short (TR = 500 msec, TE = 25 msec) spin-echo sequences before and after Gd-DTPA
Isolated Light Chain Amyloidosis Involving the Parotid Gland: A Case Report.

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Gareb, Barzi; Perry, Michael; Tadrous, Paul Joseph

2018-03-08

Amyloidosis in the parotid gland is rare and is usually associated with systemic amyloidosis. Localized amyloidosis in the parotid gland is extremely rare. We present a case of localized light chain amyloidosis of the parotid gland without systemic involvement. A 70-year-old woman presented with an asymptomatic swelling of the right parotid region. The findings of a physical examination, hematologic and biochemical investigations, imaging, and cytology were inconclusive. The patient underwent an extracapsular dissection of the right parotid gland. Histologic analysis showed that the tissue of the right parotid gland mostly consisted of amyloid deposition. The amyloid stained with antibodies to lambda light chains. Additional investigations showed no systemic involvement. The patient is asymptomatic 5 months after surgery. Clinicians should be aware of the possibility of localized amyloid light chain amyloidosis in the parotid gland, especially if magnetic resonance imaging, computed tomography imaging, and ultrasound findings are inconclusive, and they should recognize, evaluate, and treat it accordingly. Copyright © 2018 American Association of Oral and Maxillofacial Surgeons. All rights reserved.
BATH AND SHOWER EFFECTS IN THE RAT PAROTID GLAND EXPLAIN INCREASED RELATIVE RISK OF PAROTID GLAND DYSFUNCTION AFTER INTENSITY-MODULATED RADIOTHERAPY

NARCIS (Netherlands)

van Luijk, Peter; Faber, Hette; Schippers, Jacobus M.; Brandenburg, Sytze; Langendijk, Johannes A.; Meertens, Harm; Coppes, Robert P.

2009-01-01

Purpose: To assess in a rat model whether adding a subtolerance dose in a region adjacent to a high-dose irradiated subvolume of the parotid gland influences its response (bath-and-shower effect). Methods and Materials: Irradiation of the whole, cranial 50%, and/or the caudal 50% of the parotid
Dose and diameter relationships for facial, trigeminal, and acoustic neuropathies following acoustic neuroma radiosurgery

International Nuclear Information System (INIS)

Flickinger, John C.; Kondziolka, Douglas; Lunsford, L. Dade

1996-01-01

Purpose and objective: To define the relationships between dose and tumor diameter for the risks of developing trigeminal, facial, and acoustic neuropathies after acoustic neuroma radiosurgery, a large single-institution experience was analyzed. Materials and methods: Two hundred and thirty-eight patients with unilateral acoustic neuromas who underwent Gamma knife radiosurgery between 1987-1994 with 6-91 months of follow-up (median 30 months) were studied. Minimum tumor doses were 12-20 Gy (median 15 Gy). Transverse tumor diameter varied from 0.3-5.5 cm (median 2.1 cm). The relationships of dose and diameter to the development of cranial neuropathies were delineated by multivariate logistic regression. Results: The development of post-radiosurgery neuropathies affecting cranial nerves V, VII, and VIII were correlated with minimum tumor dose and transverse tumor diameter (P min for VIII where P=0.10). A comparison of the dose-diameter response curves showed the acoustic nerve to be the most sensitive to doses of 12-16 Gy and the facial nerve to be the least sensitive. Conclusion: The risks of developing trigeminal, facial, and acoustic neuropathies following acoustic neuroma radiosurgery can be predicted from the transverse tumor diameter and the minimum tumor dose using models constructed from data presently available
A safe transoral surgical approach to parapharyngeal tumor arising from deep lobe of parotid gland

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Manuele Casale

2016-12-01

Full Text Available The management of parapharyngeal tumor is surgical, but the approach remains a challenge. Attention should be paid to avoidance intra-operative bleeding or cranial nerves damage. We report a case of a 67-year-old male complaining of left-ear fullness. A submucosal mass arising from the lateral wall of oropharynx on the left side was observed. Magnetic resonance imaging detected a mass arising from the parotid gland, in particular from the deep lobe, and a fine needle biopsy was compatible with “Warthin tumor.” We performed a mini-invasive transoral approach under magnification, previous isolation of homolateral vessels. The decision on which surgical approach to be used is determined by site, size vascularity, and histology of the tumor. A literature review of the main surgical approaches was performed. We performed a combined transoral dissection under magnification with cervicotomic exposure of the neck vascular bundle allowing to dissect the tumor and manage any intra-operative complications.
Influence of Handheld Mobiles on Parotid: A Cohort Study

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Gracelin E Ranjitha

2017-01-01

Full Text Available Introduction: Mobile phones generate heat and radiofrequency radiation. The parotid gland is one potential target, because mobile phones are pressed against the side of the face where the gland is located. Aims and Objectives: To compare the effect of mobile phone radiation on parotid gland volume, systolic velocity, salivary flow rate, and protein concentration between the dominant and the nondominant side of mobile phone usage among heavy mobile phone users. Materials and Methods: Ultrasonography of the superior lobe of parotid was performed bilaterally to measure gland volume. Systolic velocity of the external carotid artery in gland was calculated bilaterally using color Doppler imaging. Saliva flow rate was measured bilaterally with modified Schrimer strip. Carlson-Crittenden device was used to collect 0.5 ml saliva sample from the duct and biuret assay was done to determine the protein concentration. Settings and Design: A cohort study was conducted with 50 undergraduate students of a dental college based on the inclusion and exclusion criteria. Statistical Analysis Used: Pearson correlation test was used to correlate and compare changes in the parameters of parotid gland and analyzed to a significant level of 0.05. Results: The volume, systolic velocity of blood flow of the external carotid artery, the salivary flow rate, and protein concentration of the parotid gland were significantly more by 11.9, 18, 23, and 8%, respectively, on the dominant side than the nondominant side of mobile phone usage. Conclusion: The study emphasized that prolonged mobile phone usage causes biological changes in parotid gland.

Replanning Criteria and Timing Definition for Parotid Protection-Based Adaptive Radiation Therapy in Nasopharyngeal Carcinoma

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Wei-Rong Yao

2015-01-01

Full Text Available The goal of this study was to evaluate real-time volumetric and dosimetric changes of the parotid gland so as to determine replanning criteria and timing for parotid protection-based adaptive radiation therapy in nasopharyngeal carcinoma. Fifty NPC patients were treated with helical tomotherapy; volumetric and dosimetric (Dmean, V1, and D50 changes of the parotid gland at the 1st, 6th, 11th, 16th, 21st, 26th, 31st, and 33rd fractions were evaluated. The clinical parameters affecting these changes were studied by analyses of variance methods for repeated measures. Factors influencing the actual parotid dose were analyzed by a multivariate logistic regression model. The cut-off values predicting parotid overdose were developed from receiver operating characteristic curves and judged by combining them with a diagnostic test consistency check. The median absolute value and percentage of parotid volume reduction were 19.51 cm3 and 35%, respectively. The interweekly parotid volume varied significantly (p<0.05. The parotid Dmean, V1, and D50 increased by 22.13%, 39.42%, and 48.45%, respectively. The actual parotid dose increased by an average of 11.38% at the end of radiation therapy. Initial parotid volume, initial parotid Dmean, and weight loss rate are valuable indicators for parotid protection-based replanning.
The effects of diabetes on the rat parotid gland

International Nuclear Information System (INIS)

Park, Chull Jea; Hwang, Eui Hwan; Lee, Sang Rae

1996-01-01

The purpose of the study was to observe microscopic change of salivary gland tissue, which is a cause of xerostomia in diabetic condition; for this target, the author injected streptozotocin 0.1 ml/100 gm b.w. on the rat, Sprague Dawley, to induce diabetes, and then observed microscopic changes in parotid gland tissue using light microscopy and electron microscopy. The results were as follows: 1. Parotid gland tissue of the diabetic rat was atrophied or degenerated in lapse of experimental time, but began to re pair from 14 days alter diabetic induction. 2. In the basal lamina of the vessel of parotid gland tissue in the diabetic rat, lamina lucida was discontinued and la mina densa was increased in thickness, but the number of capillary was gradually increased and dilated. 3. In acinic and intercalated ductal cells of parotid gland in the diabetic rat, changes of mitochondria, RER, secretor y granule, free ribosome were prominent. In conclusion, the present study demonstrated that degenerative changes of the parotid gland tissue were due to not completely thickening of the basal lamina of vessels, but many other causal factors, because thickness of the basal lamina of vessels was not related with degenerative changes.
[Recurrent chronic parotiditis in childhood: An update of the literature].

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Donoso-Hofer, Francisca; Gutiérrez Díaz, Rodrigo; Ortiz Cárdenas, Rodrigo; Osorio Herrera, Gustavo; Landaeta Mendoza, Mirtha

2017-01-01

Recurrent childhood chronic parotiditis (RCCP) is a relevant pathology. Its diagnosis is mainly clinical, but it relies on imaging tests. The current treatment approach is diverse. The aim of this article is to update the clinical features, complementary tests, etiopathogenic models and therapeutic protocols of this disease. A bibliographic search was performed in PUBMED using the free terms and MESH terms: RCCP, recurrent parotiditis, chronic parotiditis and parotiditis. The filters used were human patients, up to 18 years old, with abstract. In SCIELO the free terms included were Parotiditis and chronic. Articles published in English, Spanish or Portuguese until 2017 were included. In PUBMED 119 articles were found and 44 were included. The exclusion of the remaining articles was due to language, access to the article or absence of relationship between the article and the proposed revision. In SCIELO 6 articles were found 6 of which 5 were selected. The multidisciplinary asses of patients with RCCP is considered the appropriate treatment. Its diagnosis is clinical but it relies on imaging tests, such as echography and sialography. The current treatment approach is conservative, and the best available evidence supports the use of sialendoscopy with irrigation and administration of antibiotics and/or corticosteroids via the parotid duct. However, there would be proper results with intraglandular lavage with physiological solutions without the need for a sialendoscope.
Radiological study on the change of duct-ligated parotid gland

International Nuclear Information System (INIS)

Ohnishi, Takashi

1994-01-01

The change of the parotid gland with time following ligation of the main duct was investigated. The duct-ligated parotid gland in rabbit was examined by salivary gland scintigraphy with 99m Tc-pertechnetate ( 99m TcO 4 - ), sialography and microscopic observation. The third day after ligation of the main duct, the outward form of the parotid gland on the static scintigram was not well-defined. On the seventh day, 99m TcO 4 - accumulation was decreased slightly. On the 14th day, atrophy of the parotid gland occurred. The degree of atrophy produced by ligation increases as the duration of the ligation increases. On the 42nd day, the presence of the parotid gland was not recorded practically. The main duct was dilated on the third day. On the seventh day, the intraglandular ducts were bent and strictured. Disappearance of the peripheral duct and atrophy of the parotid gland parenchyma was observed. On microscopic observation, the intraglandular tributaries and the lumen were dilated on the third day. And the reticular fiber was observed that was irregularly formed in parts. The acinar cells were pressed by large and small dilated lumen on the seventh day. On the 14th day, the collagenous fiber around the acini and the duct was increased still more. In addition, fibrosis of the lobule interspace was observed. The degree of atrophy of the acini and lobule was increased maximally on the 42nd day. These results of the salivary gland scintigraphy closely connected with sialograms and microscopic findings. The parotid gland tissue decreases and changings of the duct system were indicated by these imaging methods in detail. (author)
Benign Fibrous Tumour of the Parotid Gland

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S.S. Sreetharan

2005-01-01

Full Text Available The case of a 44-year-old man with left parotid enlargement that was initially diagnosed as cementifying fibroma is presented. The lesion was found in the deep lobe of the parotid gland and was successfully removed. Postoperatively, the patient recovered well with intact facial nerve function and remained asymptomatic after 1 year. Subsequent histology revealed the mass to be a benign fibrous tumour. The diagnosis and management of this rare entity are discussed.
Morphological pattern of parotid gland tumors

International Nuclear Information System (INIS)

Musani, M.A.; Zafar, A.; Malik, S.

2008-01-01

To determine the morphological pattern of parotid tumours. During this study, 204 patients with parotid tumours were registered. The patients of all ages and both gender were included in this study. All patients were evaluated by history, clinical examination, F.N.A.C. and ultrasound, C.T/MRI was done in selected cases. All patients were surgically managed and their tumour specimen was sent for histopathology. Classification of individual tumour was based on 1991 World Health Organization Classification. Discrete data was presented in percentage and proportions. Out of 204 cases, 152 (74.5%) were benign and 52 (25.5%) were malignant. Of these, 117 (57.35%) patients were females and 87 (42.65%) males. Benign tumours were more common in females whereas malignant tumours were common in males. The mean age of patients was 34 years and 42 years for benign and malignant tumours respectively. Pleomorphic adenoma was most common benign tumor (83.5%), followed by Warthins tumour. The most common malignant tumour was mucoepidermoid carcinoma (60%), followed by adenoid cystic carcinoma. Superficial lobe of parotid gland was the commonest site, 120 benign and all 52 malignant tumours arising from it while 32 benign tumours originated from deep lobe. Parotid swelling for years was main feature of benign tumours, whereas malignant tumours presented with pain, fixation to skin or underlying structure, cervical lymphadenopathy and facial palsy. Pleomorphic adenoma was the most common benign tumour and mucoepidermoid carcinoma was most common malignant tumour. The morphological patterns and distribution followed the known pattern. (author)
Necrotizing sialometaplasia of the parotid gland associated with facial nerve paralysis.

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Haen, P; Ben Slama, L; Goudot, P; Schouman, T

2017-02-01

Necrotizing sialometaplasia is a benign inflammatory lesion involving most frequently the minor salivary gland of the hard palate. Involvement of the parotid gland is rare, involvement of the parotid gland associated with facial palsy is exceptional. A 56-year-old male patient with Marfan syndrome presented with swelling and inflammation of the left parotid gland associated with progressively complete facial nerve paralysis. CT scan and MRI showed a parotid collection with hyper signal of the nearest tissues associated with erosion of the styloid process. A malignant tumor was suspected. The histological examination of a biopsy showed a lobulocentric process with necrosis, squamous metaplasia, and inflammation. The immunohistochemical examination supported a final diagnosis of necrotizing sialometaplasia. Necrotizing sialometaplasia of the parotid gland associated with facial nerve paralysis presents like a malignant neoplasm, both clinically and histologically. Only advanced immunohistochemical examination can really confirm the diagnosis. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
Reexcision Perineural Invasion and Epithelial Sheath Neuroma Possibly on a Spectrum of Postinjury Reactive Hyperplasia Mediated by IL-6.

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Wang, James Y; Nuovo, Gerard; Kline, Mitchell; Magro, Cynthia M

2017-01-01

Epithelial sheath neuroma is a rarely recognized but established entity in the medical literature. First described in 2000 by Requena et al, there have only been 7 published cases to date, mostly in female patients and presenting as symptomatic solitary lesions on the back without a known history of trauma. In 2006, Beer et al described and reviewed a dozen cases in which epithelial sheath neuroma-like features were seen in the advent of a surgical procedure, which was termed "re-excision perineural invasion" and attributed to possible eccrine duct implantation during surgery. Our case is a 66-year-old male patient who underwent an excision of a melanocytic neoplasm in which a reactive epithelial sheath neuroma was incidentally discovered in the excision specimen, adjacent to the biopsy site cicatrix. Histologically, there was benign cutaneous nerve hyperplasia with a proliferation of squamous epithelium in intimate apposition to the nerve bundles in the superficial dermis. We postulate that the process active in the formation of re-excision perineural invasion is the same as in epithelial sheath neuroma and that minor trauma not appreciable on histologic examination is responsible in the latter entity. We performed IL-6 staining and documented that IL-6 was upregulated at the interface of the nerve and reactive epithelium, but was absent in nerves distant from the site of surgery, suggesting that IL-6 may be essential to the lesion's development. The recognition of reactive epithelial sheath neuroma including the subcategory of re-excision perineural invasion is crucial for the dermatopathologist to prevent mislabeling this reactive entity as a perineural squamous cell carcinoma, which has clinical consequences for the patient such as wider re-excision and radiation treatment. Additionally, we have identified a potential pathophysiologic basis for this lesion.
Fractionated stereotactic radiotherapy for acoustic neuromas: A prospective monocenter study of about 158 cases

International Nuclear Information System (INIS)

Litre, Fabien; Rousseaux, Pascal; Jovenin, Nicolas; Bazin, Arnaud; Peruzzi, Philippe; Wdowczyk, Didier; Colin, Philippe

2013-01-01

Purpose: To evaluate long-term outcomes and efficacy of fractionated stereotactic radiotherapy in the treatment of acoustic neuromas. Material and methods: Between January 1996 and December 2009, 158 acoustic neuromas were treated by FSR in 155 patients. They received a dose of 50.4 Gy, with a safety margin of 1–2 mm with a median tumor volume at 2.45 mL (range: 0.17–12.5 mL) and a median follow-up duration at 60 months (range: 24–192). Results: FSR was well tolerated in all patients with mild sequelae consisting in radiation-induced trigeminal nerve impairments (3.2%), Grade 2 facial neuropathies (2.5%), new or aggravated tinnitus (2.1%) and VP shunting (2.5%). The treatment failed in four patients (2.5%) who had subsequent surgery respectively at 20, 38, 45 and 84 months post-FSR. The local tumor control rates were respectively 99.3%, 97.5% and 95.2% at 3, 5 and >7-year of follow-up. For initial Gardner–Robertson Grade 1 and 2 ANs, the preservation of useful hearing was possible in 54% of the cases; only Grade 1 ANs had stabilized during the course of the follow-up with 71% >7 years. However, hearing preservation was not correlated to the initial Koos Stage and to the radiation dose delivered to the cochlea. Tinnitus (70%), vertigo (59%), imbalance (46%) and ear mastoid pain (43%) had greatly improved post-FRS in most patients. Tumor control, hearing preservation and FRS toxicity were quite similar in patients with NF2, cystic acoustic neuroma, prior surgical resection and Koos Stage 4 AN. No secondary tumors were observed. Conclusion: FSR is a safe and effective therapeutic for acoustic neuromas and could be an alternative to microsurgery. Compared to radiosurgery, there are no contraindications for fractioned doses of stereotactic radiotherapy especially for Stage-4 tumors and patients at high risk of hearing loss
Fractionated stereotactic radiotherapy for acoustic neuromas: A prospective monocenter study of about 158 cases

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Litre, Fabien [Hôpital Maison Blanche, Reims Cedex (France); Rousseaux, Pascal [Hôpital Maison Blanche, Reims Cedex (France); Jovenin, Nicolas [Institut Jean Godinot, Reims Cedex (France); Bazin, Arnaud; Peruzzi, Philippe [Hôpital Maison Blanche, Reims Cedex (France); Wdowczyk, Didier; Colin, Philippe [Institut du Cancer Reims Courlancy, Reims (France)

2013-02-15

Purpose: To evaluate long-term outcomes and efficacy of fractionated stereotactic radiotherapy in the treatment of acoustic neuromas. Material and methods: Between January 1996 and December 2009, 158 acoustic neuromas were treated by FSR in 155 patients. They received a dose of 50.4 Gy, with a safety margin of 1–2 mm with a median tumor volume at 2.45 mL (range: 0.17–12.5 mL) and a median follow-up duration at 60 months (range: 24–192). Results: FSR was well tolerated in all patients with mild sequelae consisting in radiation-induced trigeminal nerve impairments (3.2%), Grade 2 facial neuropathies (2.5%), new or aggravated tinnitus (2.1%) and VP shunting (2.5%). The treatment failed in four patients (2.5%) who had subsequent surgery respectively at 20, 38, 45 and 84 months post-FSR. The local tumor control rates were respectively 99.3%, 97.5% and 95.2% at 3, 5 and >7-year of follow-up. For initial Gardner–Robertson Grade 1 and 2 ANs, the preservation of useful hearing was possible in 54% of the cases; only Grade 1 ANs had stabilized during the course of the follow-up with 71% >7 years. However, hearing preservation was not correlated to the initial Koos Stage and to the radiation dose delivered to the cochlea. Tinnitus (70%), vertigo (59%), imbalance (46%) and ear mastoid pain (43%) had greatly improved post-FRS in most patients. Tumor control, hearing preservation and FRS toxicity were quite similar in patients with NF2, cystic acoustic neuroma, prior surgical resection and Koos Stage 4 AN. No secondary tumors were observed. Conclusion: FSR is a safe and effective therapeutic for acoustic neuromas and could be an alternative to microsurgery. Compared to radiosurgery, there are no contraindications for fractioned doses of stereotactic radiotherapy especially for Stage-4 tumors and patients at high risk of hearing loss.
Submandibular gland function and parotid gland function in Bell's palsy, 3

International Nuclear Information System (INIS)

Ino, Chiyonori; Yamashita, Toshio; Kato, Mako; Kumazawa, Tadami

1986-01-01

With the use of sup(99m)Tc, we attempted to measure simultaneously submandibular gland function and parotid gland function, which is thought not to be controlled by the facial nerve, in patients with unilateral Bell's palsy. For comparison, the lachrymal gland function of some patients was measured by the thread method. We found that facial palsy sometimes affects parotid gland function as well as submandibular gland function. In 60 % of the patients the function of the two glands tended to be affected in the same way. Lachrymal gland function tended to be affected in a similar way to parotid gland function. We conclude that the chorda tympani and the greater petrosal nerve may influence parotid gland function. (author)
Surgical options in benign parotid tumors: a proposal for classification.

Science.gov (United States)

Quer, Miquel; Vander Poorten, Vincent; Takes, Robert P; Silver, Carl E; Boedeker, Carsten C; de Bree, Remco; Rinaldo, Alessandra; Sanabria, Alvaro; Shaha, Ashok R; Pujol, Albert; Zbären, Peter; Ferlito, Alfio

2017-11-01

Different surgical options are currently available for treating benign tumors of the parotid gland, and the discussion on optimal treatment continues despite several meta-analyses. These options include more limited resections (extracapsular dissection, partial lateral parotidectomy) versus more extensive and traditional options (lateral parotid lobectomy, total parotidectomy). Different schools favor one option or another based on their experience, skills and tradition. This review provides a critical analysis of the literature regarding these options. The main limitation of all the studies is the bias of selection for different surgical approaches. For this reason, we propose a staging system that could facilitate clinical decision making and the comparison of results. We propose four categories based on the size of the tumor and its location within the parotid gland. Category I includes tumors up to 3 cm, which are mobile, close to the outer surface and close to the parotid borders. Category II includes deeper tumors up to 3 cm. Category III comprises tumors greater than 3 cm involving two levels of the parotid gland, and category IV tumors are greater than 3 cm and involve more than 2 levels. For each category and for the various pathologic types, a guideline of surgical extent is proposed. The objective of this classification is to facilitate prospective multicentric studies on surgical techniques in the treatment of benign parotid tumors and to enable the comparison of results of different clinical studies.
Impact of facial paralysis on patients with acoustic neuroma.

Science.gov (United States)

Cross, T; Sheard, C E; Garrud, P; Nikolopoulos, T P; O'Donoghue, G M

2000-09-01

To assess the psychological distress, the ways of coping with that stress, and the self-esteem of patients with facial paralysis after acoustic neuroma surgery. Possible predictors and associations between these measures were also explored. Four validated questionnaires were completed by patients with facial paralysis after acoustic neuroma surgery: 1) the Derriford Appearance Scale (DAS) to measure psychological distress, 2) the COPE questionnaire to measure how patients cope with facial paralysis, 3) the Personal Report questionnaire to measure the self-esteem of patients, and 4) the Facial Paralysis Questionnaire (FPQ) to measure the severity of facial paralysis. One hundred three patients with facial paralysis after surgical removal of acoustic tumors. Distress spanned a wide range in these patients. There was no statistically significant association between the level of distress and the grade of facial paralysis or between time since operation and levels of distress. Women had higher levels of distress (P = .02) and a significant negative correlation was found between levels of distress and age (r = -0.28, P = .005). High levels of distress were associated with low levels of self-esteem, as shown by the significant negative correlation between level of distress and self-esteem (r = -0.59, P = .01). A significant correlation between distress and maladaptive coping (r = 0.31, P = .002) was also found. Stepwise multiple regression of the distress scores revealed that self-esteem was the most important contributing factor (standardized coefficient beta -0.60, P = .0001), followed by age (beta -0.24, P = .006) and sex (beta -0.21, P = .04). This model explained 44% of the distress variance. Clinicians must be aware of the distress felt by some patients experiencing facial palsy after acoustic neuroma surgery and that the level of distress may not be related to the clinical grade of the facial nerve paralysis. People with low self-esteem, young people, and women
MRI features of bilateral parotid haemangiomas of infancy

International Nuclear Information System (INIS)

Andronikou, Savvas; Jadwat, Saaleeha; McHugh, Kieran; Linward, Jane

2003-01-01

The aim of this article is to report the MRI features of bilateral parotid haemangiomas of infancy and highlight the diagnostic and prognostic value of MRI especially with regard to those lesions that may cause respiratory compromise. Retrospective review of MRI scans in six infants with bilateral parotid haemangiomas. The bilateral haemangiomas were symmetrical in all but one patient. On T1-weighted images the masses were isointense to muscle and on T2 they were hyperintense with numerous small vessels giving a septated appearance. There was vivid enhancement with gadolinium in all cases. In three patients, deep bilateral extensions were demonstrated involving the parapharyngeal spaces resulting in respiratory compromise which required tracheostomy. Bilateral parotid haemangiomas are rare, but when present may have deep extensions, which can result in respiratory compromise requiring tracheostomy. (orig.)
MRI features of bilateral parotid haemangiomas of infancy

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Andronikou, Savvas; Jadwat, Saaleeha [Institute of Child Health, University of Cape Town, Klipfontein Road, Rondebosch, 7700, Cape Town (South Africa); McHugh, Kieran; Linward, Jane [Department of Radiology, Great Ormond Street Hospital for Children, London, WC1N 3JH (United Kingdom)

2003-04-01

The aim of this article is to report the MRI features of bilateral parotid haemangiomas of infancy and highlight the diagnostic and prognostic value of MRI especially with regard to those lesions that may cause respiratory compromise. Retrospective review of MRI scans in six infants with bilateral parotid haemangiomas. The bilateral haemangiomas were symmetrical in all but one patient. On T1-weighted images the masses were isointense to muscle and on T2 they were hyperintense with numerous small vessels giving a septated appearance. There was vivid enhancement with gadolinium in all cases. In three patients, deep bilateral extensions were demonstrated involving the parapharyngeal spaces resulting in respiratory compromise which required tracheostomy. Bilateral parotid haemangiomas are rare, but when present may have deep extensions, which can result in respiratory compromise requiring tracheostomy. (orig.)
SERUM AND PAROTID FLUIS UREA-LEVELS IN UNREALOADED HEALTHY YOUNG ADULTS

Science.gov (United States)

Forty-four healthy young adult male subjects were given oral doses of urea, and parotid fluid and serum urea levels were studied for 1 to 3 hours. A...highly significant correlation between urea in serum and in parotid fluid (r equals 0.982) was found. The indication was that, with flow rate...carefully controlled, parotid fluid could be used interchangeably with serum in urea determination, regardless of the magnitude of the blood concentration. (Author)
Unilateral parotid concentration of radiogallium: Comparison with bilateral uptake and with pertechnetate imaging

International Nuclear Information System (INIS)

Levy, H.A.; Sziklas, J.J.; Spencer, R.P.; Rosenberg, R.J.

1983-01-01

Unilateral parotid accumulation of radioactivity was noted in 4 elderly (80-95 years) patients after intravenous administration of 67 Ga citrate. In 2 of these individuals, it was possible to carry out pertechnetate salivary gland imaging. The involved glands were functional in terms of pertechnetate accumulation, although no drainage was noted after lemon stimulation. A retrospective analysis of 72 radiogallium studies failed to show unilateral parotid uptake in any of them. However, ten cases (14%) had bilateral parotid accumulation of radiogallium. Probable causes of the bilateral parotid concentration of 67 Ga were discussed. These were compared with poor oral hygiene and dehydration as possible contributing factors to unilateral parotid radiogallium concentration in the elderly. (orig.) [de
Unilateral parotid concentration of radiogallium: Comparison with bilateral uptake and with pertechnetate imaging

Energy Technology Data Exchange (ETDEWEB)

Levy, H.A.; Sziklas, J.J.; Spencer, R.P.; Rosenberg, R.J.

1983-12-01

Unilateral parotid accumulation of radioactivity was noted in 4 elderly (80-95 years) patients after intravenous administration of /sup 67/Ga citrate. In 2 of these individuals, it was possible to carry out pertechnetate salivary gland imaging. The involved glands were functional in terms of pertechnetate accumulation, although no drainage was noted after lemon stimulation. A retrospective analysis of 72 radiogallium studies failed to show unilateral parotid uptake in any of them. However, ten cases (14%) had bilateral parotid accumulation of radiogallium. Probable causes of the bilateral parotid concentration of /sup 67/Ga were discussed. These were compared with poor oral hygiene and dehydration as possible contributing factors to unilateral parotid radiogallium concentration in the elderly.
Age-dependent difference in the computed tomography numbers of the normal parotid gland of Koreans

International Nuclear Information System (INIS)

Jeong, Ho Gul; Lee, Eun Sook; Kim, Kee Deog; Park, Chang Seo

1999-01-01

To determine normal CT number range of parotid gland by analyzing the change by age increase and the difference among individuals and between both sexes in CT number of normal parotid gland. 134 subjects who took the CT scan between the period of Jan. 1996 and Dec. 1997 at Yonsei University, Dental Hospital were selected. Criteria for selection were that the patients must be within the normal range clinically and radiologically, and the entire parotid gland on the axial view must be shown. Among the axial views, the one showing the greatest parotid gland size was selected and its CT number was recorded. Also, CT numbers from both masseter muscle were recorded as its control. There was statistically significant correlation between CT number of right and left of parotid glands and masseter muscles. With the increase of age, there is a significant decrease in the CT number of parotid gland (p 0.05). As age increases, CT number of parotid gland has a tendency to decrease, and there is no significant difference in the CT numbers between left and right parotid gland. Therefore in the CT scan of patients suspected of having an salivary gland disease of the parotid gland, to consider normal range of the age-dependent CT numbers of parotid gland and compare the CT numbers of the right and left parotid gland might be useful in diagnosing the disease.
An intraoperative diagnosis of parotid gland tumors using Raman spectroscopy and support vector machine

International Nuclear Information System (INIS)

Yan, Bing; Wen, Zhining; Li, Yi; Li, Longjiang; Xue, Lili

2014-01-01

The preoperative and intraoperative diagnosis of parotid gland tumors is difficult, but is important for their surgical management. In order to explore an intraoperative diagnostic method, Raman spectroscopy is applied to detect the normal parotid gland and tumors, including pleomorphic adenoma, Warthin’s tumor and mucoepidermoid carcinoma. In the 600–1800 cm −1 region of the Raman shift, there are numerous spectral differences between the parotid gland and tumors. Compared with Raman spectra of the normal parotid gland, the Raman spectra of parotid tumors show an increase of the peaks assigned to nucleic acids and proteins, but a decrease of the peaks related to lipids. Spectral differences also exist between the spectra of parotid tumors. Based on these differences, a remarkable classification and diagnosis of the parotid gland and tumors are carried out by support vector machine (SVM), with high accuracy (96.7∼100%), sensitivity (93.3∼100%) and specificity (96.7∼100%). Raman spectroscopy combined with SVM has a great potential to aid the intraoperative diagnosis of parotid tumors and could provide an accurate and rapid diagnostic approach. (paper)

CT-diagnosis for mass lesions in the parotid gland and cervical region

International Nuclear Information System (INIS)

Matsuyama, Fumihiko; Taniguchi, Satomi; Horii, Masaru; Suzuki, Shigemi; Shiba, Yuko

1982-01-01

Thirty patients suffering from mass lesion in the parotid gland or cervical region were examined by computed tomography (CT). The photographed images were compared with the findings and pathological diagnoses obtained by surgical procedures. The conclusions were as follows: 1) Plain CT demonstrated the location of the parotid tumor. Contrast enhancement seemed to delineate the margin of the tumor more clearly. 2) By contrast enhancement, the branchiogenic cyst was differentiated from the parotid tumor, as a low density mass with an enhanced cyst wall. 3) Parotid tumors enhanced by contrast material did not always appear as solid tumors. 4) In some cases, CT numbers indicated the contents of the tumor. 5) The extension of the tumor to the parapharyngeal space was clearly depicted on CT. 6) It seemed to be difficult to evaluate the relationship of the parotid tumor to the facial nerve on plain CT. (author)
CT-diagnosis for mass lesions in the parotid gland and cervical region

Energy Technology Data Exchange (ETDEWEB)

Matsuyama, F.; Taniguchi, S.; Horii, M.; Suzuki, S.; Shiba, Y. (Kobe Central Municipal Hospital (Japan))

1982-02-01

Thirty patients suffering from mass lesion in the parotid gland or cervical region were examined by computed tomography (CT). The photographed images were compared with the findings and pathological diagnoses obtained by surgical procedures. The conclusions were as follows: 1) Plain CT demonstrated the location of the parotid tumor. Contrast enhancement seemed to delineate the margin of the tumor more clearly. 2) By contrast enhancement, the branchiogenic cyst was differentiated from the parotid tumor, as a low density mass with an enhanced cyst wall. 3) Parotid tumors enhanced by contrast material did not always appear as solid tumors. 4) In some cases, CT numbers indicated the contents of the tumor. 5) The extension of the tumor to the parapharyngeal space was clearly depicted on CT. 6) It seemed to be difficult to evaluate the relationship of the parotid tumor to the facial nerve on plain CT.
Parasympathetic denervation increases responses to VIP in isolated rat parotid acini

International Nuclear Information System (INIS)

McMillian, M.K.; Talamo, B.R.

1989-01-01

Vasoactive intestinal peptide (VIP) is a putative neurotransmitter found in the salivary glands of many species, including the rat parotid gland. Parasympathetic denervation has been reported to deplete VIP in the rat parotid gland and to lead to supersensitivity to this peptide in vivo. We have compared the effects of VIP on acini isolated from parasympathetically denervated and unoperated parotid glands to examine possible supersensitivity to the peptide in vitro. VIP normally produced responses similar to those obtained with a low concentration of the beta adrenergic agonist isoproterenol (ISO), but strikingly different from the effects obtained with the muscarinic agonist carbachol (CARB). In parotid membrane preparations, VIP stimulated adenylate cyclase activity. Dissociated acini treated with VIP showed increases in cAMP accumulation and amylase release which were potentiated by forskolin and also by inhibition of phosphodiesterase. After parasympathetic denervation, maximal effects of VIP on adenylate cyclase, cAMP accumulation and amylase release in intact cells were increased two- to five-fold over contralateral control (or unoperated) parotid responses. The increase in adenylate cyclase-mediated responses after denervation was specific to VIP; there was no increased response nor increased sensitivity of any of these responses to ISO. Specific [125I]VIP binding to parotid acini increased two-fold per gland and three-fold per mg of protein after denervation; this probably explains the observed increases in the response to VIP
Preauricular infratemporal fossa approach for advanced malignant parotid tumors.

Science.gov (United States)

Leonetti, John P; Benscoter, Brent J; Marzo, Sam J; Borrowdale, Richard W; Pontikis, George C

2012-09-01

The aims of this study were to demonstrate the surgical technique involved in the preauricular infratemporal fossa (ITF) approach, outline the clinical indications for use of this technique, and present the results in using this approach in 159 patients with malignant parotid tumors. At the conclusion of this article, the reader should be able to understand the utility of the preauricular infratemporal fossa approach in the management of patients with advanced malignant parotid tumors. This was a retrospective chart review of 159 patients treated at a tertiary care academic medical center following institutional review board approval. A comprehensive medical records review was performed for all patients with malignant parotid tumors who underwent a preauricular ITF approach between July 1988 and July 2010. The most common presenting symptoms were pain and trismus, whereas the presence of a parotid mass and facial paralysis were the most common clinical signs. Mucoepidermoid and adenoid cystic carcinoma accounted for 63% of the tumors, and perineural invasion was found in nearly 71% of the patients. Despite negative surgical margins in 92% of the patients, local or regional tumor recurrence was found in 17% of the cases. The mean follow-up time was 12.8 years. The preauricular ITF approach should be used in the surgical extirpation of advanced malignant parotid neoplasms. This technique provides proximal facial nerve identification, internal carotid artery protection, and negative tumor margins at the skull base. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
Parotid gland shrinkage during IMRT predicts the time to Xerostomia resolution.

Science.gov (United States)

Sanguineti, Giuseppe; Ricchetti, Francesco; Wu, Binbin; McNutt, Todd; Fiorino, Claudio

2015-01-17

To assess the impact of mid-treatment parotid gland shrinkage on long term xerostomia during IMRT for oropharyngeal SCC. All patients treated with IMRT at a single Institution from November 2007 to June 2010 and undergoing weekly CT scans were selected. Parotid glands were contoured retrospectively on the mid treatment CT scan. For each parotid gland, the percent change relative to the planning volume was calculated and combined as weighted average. Patients were considered to be xerostomic if developed GR2+ dry mouth according to CTCAE v3.0. Predictors of the time to xerostomia resolution or downgrade to 1 were investigated at both uni- and multivariate analysis. 85 patients were selected. With a median follow up of 35.8 months (range: 2.4-62.6 months), the actuarial rate of xerostomia is 26.2% (SD: 5.3%) and 15.9% (SD: 5.3%) at 2 and 3 yrs, respectively. At multivariate analysis, mid-treatment shrink along with weighted average mean parotid dose at planning and body mass index are independent predictors of the time to xerostomia resolution. Patients were pooled in 4 groups based on median values of both mid-treatment shrink (cut-off: 19.6%) and mean WA parotid pl-D (cut-off: 35.7 Gy). Patients with a higher than median parotid dose at planning and who showed poor shrinkage at mid treatment are the ones with the outcome significantly worse (3-yr rate of xerostomia ≈ 50%) than the other three subgroups (3-yr rate of xerostomia ≈ 10%). For a given planned dose, patients whose parotids significantly shrink during IMRT are less likely to be long-term supplemental fluids dependent.
Enhanced intrinsic radiosensitivity after treatment with stereotactic radiosurgery for an acoustic neuroma

International Nuclear Information System (INIS)

Adams, Gerard; Martin, Olga A.; Roos, Daniel E.; Lobachevsky, Pavel N.; Potter, Andrew E.; Zacest, Andrew C.; Bezak, Eva; Bonner, William M.; Martin, Roger F.; Leong, Trevor

2012-01-01

Enhanced radiosensitivity is an uncommon phenomenon attributable to deficient DNA repair after radiotherapy which can be assessed with the γ-H2AX assay. Reports of radiosensitivity after stereotactic radiosurgery (SRS) are uncommon. We describe a case where the clinical, radiological and laboratory findings suggest enhanced radiosensitivity after SRS for an acoustic neuroma.
Giant Parotid Pleomorphic Adenoma Involving Parapharyngeal Space

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Sukri Rahman

2013-09-01

Full Text Available AbstrakLatar belakang: Pleomorfik adenoma parotis merupakan tumor jinak kelenjar liur yang paling sering ditemukan, namun pleomorfik adenoma parotis yang sangat besar sehingga melibatkan ruang parafaring (RPF sangat jarang. Diagnosis ini sulit ditegakkan karena gejala klinisnya tidak khas. Penatalaksanaanya harus hati-hati mengingat banyak struktur vital yang beresiko mengalami trauma. Tujuan: Bagaimana menegakkan diagnosis dan penatalaksanaan pleomorfik adenoma parotis yang melibatkan RPF. Kasus: Seorang pasien perempuan 27 tahun ditegakkan diagnosis pleomorfik adenoma parotis kanan dengan melibatkan RPF. Terdapat pembengkakan pada leher yang bersifat asimtomatis dan gejala pendorongan faring dan laring yang menyebabkan disfonia, disfagia, dan defisit saraf kranial IX,X,XII. Penatalaksanaan: Pasien telah dilakukan operasi parotidektomi pendekatan transervikal–transparotid dengan preservasi arteri karotis eksterna dan saraf fasialis. Kesimpulan: Biopsi Aspirasi Jarum Halus (BAJAH dan radiologi merupakan pemeriksaan yang penting untuk menegakkan diagnosis. Penatalaksanaan pleomorfik adenoma parotis yang melibatkan RPF adalah bedah ekstirpasi komplit dengan beberapa pendekatan. .Kata kunci: tumor jinak kelenjar liur, pleomorfik adenoma, ruang parafaringAbstractBackground: Parotid pleomorphic adenoma is the most common benign salivary gland tumor, while giant parotid pleomorphic adenoma involving the parapharyngeal space (PPS is rare. It was difficult to diagnose because the clinical presentation of this tumor can be subtle. The management must be performed carefully due to anatomy relation to complex vital structure lead to traumatic injury highrisk. Purposes: How to make diagnosis and management parotid pleomorphic adenoma involving PPS. Case: A female 27 years old with diagnosis was giant parotid pleomorphic adenoma involving PPS. There was asymptomatic swelling of the neck and presence of pushing the pharynx and larynx medially causes
Malignant fibrous histiocytoma of the parotid gland associated with polycythemia

NARCIS (Netherlands)

van Wingerden, J. J.; van Rensburg, P. G.; Coetzee, B. P.

1986-01-01

Although malignant fibrous histiocytoma (MFH) is thought to be the most common soft tissue tumor of late adult life, it is extremely uncommon in the parotid gland. A case of MFH in the parotid is reported, associated with polycythemia, which remitted following surgical extirpation of the tumor
Parotid-Absorbed Doses: A Comparison Between Spiral Tomography and Panoramic

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Ehsan Hekmatian

2016-07-01

Full Text Available Background Jaws spiral tomography and panoramic radiography have wide applications in dentistry, and the parotid gland is one of the most sensitive organs of the head and neck. Objectives The aim of this study was to evaluate and compare the parotid-absorbed dose in spiral tomography and panoramic radiographs using a thermoluminescent dosimeter. Materials and Methods A radiation analog dosimetry phantom was placed in a Cranex Tome radiograph device, and a parotid absorbed dose was measured in both techniques. Thermoluminescent dosimeters were placed bilaterally in the parotid region (on the tube side and the opposite side. Spiral tomography dosimetry was done for the upper and lower jaws in the anterior and posterior regions. Each region contained four slices of 2 mm and four slices of 4 mm in thickness. The results were analyzed by a Wilcoxon test. Results For the tube side parotid, the average absorbed doses in spiral tomography of the anterior and posterior parts of the maxilla and mandible, with the 2 mm slice thickness, were 1.70/1.40 and 1.65/1.60 mGy, respectively. The average absorbed doses with the 4mm slices were 1.65/1.70 and 1.75/1.57 mGy, respectively. For the opposite parotid, the average absorbed dose in spiral tomography of the anterior and posterior parts of the maxilla and mandible, with the 2 mm slice thickness, were 1.40/1.30 and 1.40/1.67 mGy, respectively. The average absorbed doses with the 4mm slices were 1.50/1.66 and 1.40/1.50 mGy, respectively. The average absorbed dose of the panoramic radiograph was 1.40 mGy. Conclusions There was no statistically significant difference in the parotid absorbed dose between spiral tomography and a panoramic radiograph (P value = 0.18. The overall results of this study were similar to other studies.
Two cases of cystic lesions in the parotid region diagnosed by CT sialogram

International Nuclear Information System (INIS)

Kubo, Masahiko; Ukai, Kotaro; Itoh, Hiroshi; Miyoshi, Yasuro; Itoh, Yukiko; Kohdera, Urara; Taki, Norio; Furukawa, Yuichi.

1985-01-01

This is a case report of two patients with cystic lesions in the parotid region. The diagnostic value of CT sialogram is discussed. A 62-year-old male had a swelling in the left parotid region which felt cystic on manual palpation. A CT sialogram clearly demonstrated a cystic mass superficial to the parotid gland. Histologically, the mass was an epidermoid cyst. A 9-year-old male had pain and swelling in the right parotid region which was not reduced by antibiotic therapy. An extraparotid abscess was diagnosed by CT sialogram 14 days after the onset. CT sialogram is effective in differentiating intrinsic from extrinsic parotid lesions and also shows the relationship of the tumor mass to the facial nerve and helps to differentiate between benign and malignant neoplasms. (author)
Haemorrhagic acoustic neuroma with features of a vascular malformation. A case report

Energy Technology Data Exchange (ETDEWEB)

Benhaiem-Sigaux, N. [Dept. of Pathology, Hopital Henri Mondor, Creteil (France); Ricolfi, F. [Dept. of Neuroradiology, Henri Mondor Hospital, Creteil (France); Torres-Diaz, A.; Keravel, Y. [Dept. of Neurosurgery, Henri Mondo Hospital, Creteil (France); Poirier, J. [Dept. of Histology, Pitie-Salpetriere Hospital, Paris (France)

1999-10-01

A 55-year-old man with hearing loss presented with vertigo and vomiting. CT tomography and MRI demonstrated a cerebellopontine angle mass with foci of haemorrhage. An angiomatous tumour, with large abnormal veins adhering to the capsule, was completely removed. Histologically, the tumour was an acoustic neuroma with abnormal vascularisation and limited intratumoral haemorrhage. (orig.)
Haemorrhagic acoustic neuroma with features of a vascular malformation. A case report

International Nuclear Information System (INIS)

Benhaiem-Sigaux, N.; Ricolfi, F.; Torres-Diaz, A.; Keravel, Y.; Poirier, J.

1999-01-01

A 55-year-old man with hearing loss presented with vertigo and vomiting. CT tomography and MRI demonstrated a cerebellopontine angle mass with foci of haemorrhage. An angiomatous tumour, with large abnormal veins adhering to the capsule, was completely removed. Histologically, the tumour was an acoustic neuroma with abnormal vascularisation and limited intratumoral haemorrhage. (orig.)
Serie de 8 casos de parotiditis supurada aguda neonatal

Directory of Open Access Journals (Sweden)

Manuel Díaz Álvarez

Full Text Available La parotiditis supurada aguda es una infección poco frecuente en la práctica del pediatra y neonatólogo. El objetivo es mostrar nuestra experiencia en la atención de serie de casos con parotiditis supurada aguda en el período neonatal, y describir sus características de presentación. Se presentan los hallazgos clínicos en 8 pacientes con parotiditis supurativa neonatal, quienes estuvieron ingresados en el Servicio de Neonatología del Hospital Pediátrico Universitario "Juan Manuel Márquez", durante el período de 22 años (desde el año 1992 hasta el año 2013, y se contrasta con los reportes publicados en la literatura internacional. Las características de presentación de la parotiditis aguda supurada de nuestros casos concuerdan con la literatura revisada en muchos aspectos, y se demuestra que es, además, una infección poco frecuente en el período neonatal. Es la primera publicación sobre esta entidad en neonatos en Cuba, y la mayor serie de casos en el ámbito latinoamericano.
Fractal Dimension Of CT Images Of Normal Parotid Glands

International Nuclear Information System (INIS)

Lee, Sang Jin; Heo, Min Suk; You, Dong Soo

1999-01-01

This study was to investigate the age and sex differences of the fractal dimension of the normal parotid glands in the digitized CT images. The six groups, which were composed of 42 men and women from 20's, 40's and 60's and over were picked. Each group contained seven people of the same sex. The normal parotid CT images were digitized, and their fractal dimensions were calculated using Scion Image PC program. The mean of fractal dimensions in males was 1.7292 (+/-0.0588) and 1.6329 (+/-0.0425) in females. The mean of fractal dimensions in young males was 1.7617, 1.7328 in middle males, and 1.6933 in old males. The mean of fractal dimensions in young females was 1.6318, 1.6365 in middle females, and 1.6303 in old females. There was no statistical difference in fractal dimension between left and right parotid gland of the same subject (p>0.05). Fractal dimensions in male were decreased in older group (p 0.05). The fractal dimension of parotid glands in the digitized CT images will be useful to evaluate the age and sex differences.
Effects of isoflurane anesthesia and pilocarpine on rat parotid saliva flow

DEFF Research Database (Denmark)

Knudsen, Jacob Dronninglund; Nauntofte, Birgitte; Josipovic, M

2011-01-01

The purpose of this study was to investigate the effects of isoflurane on unstimulated and pilocarpine-stimulated parotid saliva secretion. Ten male Sprague-Dawley rats weighing 350-400 g were randomized into two groups, and the saliva flow rate and lag phase were measured at two doses of isoflur......The purpose of this study was to investigate the effects of isoflurane on unstimulated and pilocarpine-stimulated parotid saliva secretion. Ten male Sprague-Dawley rats weighing 350-400 g were randomized into two groups, and the saliva flow rate and lag phase were measured at two doses...... of isoflurane in a crossover study design. Increasing the isoflurane concentration from 1% to 2% was associated with a 19% decrease in saliva secretion rate, and the lag to saliva secretion was increased by 155%. To clarify whether the effect of isoflurane (1.5%) on the parotid flow varied with stimulus...... intensity, we measured the parotid flow induced by seven different doses of pilocarpine on sham-irradiated rats and rats irradiated with single doses of 15 Gy. A maximal pilocarpine response was obtained with 1.5 mg/kg in both irradiated and sham-irradiated rats; however, the parotid flow of the irradiated...
Texture analysis for the assessment of structural changes in parotid glands induced by radiotherapy

International Nuclear Information System (INIS)

Scalco, Elisa; Fiorino, Claudio; Cattaneo, Giovanni Mauro; Sanguineti, Giuseppe; Rizzo, Giovanna

2013-01-01

Background and purpose: During radiotherapy (RT) for head-and-neck cancer, parotid glands undergo significant anatomic, functional and structural changes which could characterize pre-clinical signs of an increased risk of xerostomia. Texture analysis is proposed to assess structural changes of parotids induced by RT, and to investigate whether early variations of textural parameters (such as mean intensity and fractal dimension) can predict parotid shrinkage at the end of treatment. Material and methods: Textural parameters and volumes of 42 parotids from 21 patients treated with intensity-modulated RT for nasopharyngeal cancer were extracted from CT images. To individuate which parameters changed during RT, a Wilcoxon signed-rank test between textural indices (first and second RT week; first and last RT week) was performed. Discriminant analysis was applied to variations of these parameters in the first two weeks of RT to assess their power in predicting parotid shrinkage at the end of RT. Results: A significant decrease in mean intensity (1.7 HU and 3.8 HU after the second and last weeks, respectively) and fractal dimension (0.016 and 0.021) was found. Discriminant analysis, based on volume and fractal dimension, was able to predict the final parotid shrinkage (accuracy of 71.4%). Conclusion: Textural features could be used in combination with volume to characterize structural modifications on parotid glands and to predict parotid shrinkage at the end of RT
Radioprotection of the rat parotid gland by cAMP

International Nuclear Information System (INIS)

Sodicoff, M.; Conger, A.D.

1983-01-01

Most earlier studies showing a radioprotective effect by cAMP show only slight degrees of protection. The present study demonstrates a substantial protective effect (DMF, 1.63) of exogenously administered cAMP on the rat parotid gland and supports the mechanism suggested previously for protection afforded the parotid glands by the β-adrenergic agonist isoproterenol, which is known to elevate endogenous intracellular cAMP
Parotid carcinoma

DEFF Research Database (Denmark)

Godballe, Christian; Schultz, Joyce H; Krogdahl, Annelise

2003-01-01

-year recurrence-free survival of the entire study group was 63%, disease-specific survival was 69%, and crude survival was 52%. In univariate analysis, tumor size, histological appearance, T status, stage, the presence of lymph node metastases, distant metastases, pain, and facial nerve dysfunction had...... a significant influence on survival. CONCLUSIONS: A thorough histological revision is pivotal in retrospective parotid carcinoma studies, and tumor size; histological appearance; T, N, and M status; stage; facial nerve dysfunction; and pain from the face and/or neck seem to be significant prognostic indicators...
Position modification and actual radiation dose in parotids for head and neck cancers treated with TomoTherapy

International Nuclear Information System (INIS)

Jiang Huayong; Zhang Yongqian; Wang Yadi; Xu Weidong; Gao Junmao; Zhang Fuli; Yao Bo

2014-01-01

Objective: To analyze the impact of parotid's position and volume changing on radiation dose for head and neck cancer treated with TomoTherapy. Methods: Totally 12 patients with head and neck cancer were treated with TomoTherapy. Before the treatment, the dose distribution was recalculated with MVCT images, which would obtain the parameters of position, volume and actual radiation dose for parotids. Results: The volume of parotids in Plan2 was significantly lower than in Plan1, and the percentage reduction was 29.06% and 31.78% for left and right parotid, respectively (Z = 6.77, 3.06, P < 0.05). Distance between the COM(center of mass) of parotids and the midline of body was significantly smaller in Plan2 than in Plan1, and the percentage reduction was 6.72% and 6.19% (t = 5.14, 5.80, P < 0.05) at left and right side, respectively. Average dose and V_2_6 for both parotids were higher than those in Plan1, increasing by an average of 37.74%, 25.08% (Z = -6.03, -5.31, P < 0.05) for left parotid and 30.45%, 19.33% (Z = -5.43, -3.26, P < 0.05) for right parotid, respectively. Conclusions: The actual radiation dose to parotids was significantly increased during the radiation therapy for patients with head and neck cancer. There was a linear correlation between the decrease of distance between the COM of parotids and the midline of body and the percentage increase of parotids' radiation dose. No correlation between the reduction of parotids' volume and dose to parotids. In order to reduce the parotids' radiation dose, modification of treatment plan at the appropriate time is essential. (authors)
Parotid Gland Sparing With Helical Tomotherapy in Head-and-Neck Cancer

International Nuclear Information System (INIS)

Voordeckers, Mia; Farrag, Ashraf; Everaert, Hendrik; Tournel, Koen; Storme, Guy; Verellen, Dirk; De Ridder, Mark

2012-01-01

Purpose: This study evaluated the ability of helical tomotherapy to spare the function of the parotid glands in patients with head-and-neck cancer by analyzing dose–volume histograms, salivary gland scintigraphy, and quality of life assessment. Methods and Materials: Data from 76 consecutive patients treated with helical tomotherapy (Hi-Art Tomotherapy) at University Hospital Brussel were analyzed. During planning, priority was given to planning target volume (PTV) coverage: ≥95% of the dose must be delivered to ≥95% of the PTV. Elective nodal regions received 54 Gy (1.8 Gy/fraction). A dose of 70.5 Gy (2.35 Gy/fraction) was prescribed to the primary tumor and pathologic lymph nodes (simultaneous integrated boost scheme). Objective scoring of salivary excretion was performed by salivary gland scintigraphy. Subjective scoring of salivary gland function was evaluated by the European Organization for Research and Treatment of Cancer quality of life questionnaires Quality of Life Questionnaire—C30 (QLQ-C30) and Quality of Life Questionnaire—Head and Neck 35 (H and N35). Results: Analysis of dose–volume histograms (DVHs) showed excellent coverage of the PTV. The volume of PTV receiving 95% of the prescribed dose (V95%) was 99.4 (range, 96.3–99.9). DVH analysis of parotid gland showed a median value of the mean parotid dose of 32.1 Gy (range, 17.5–70.3 Gy). The median parotid volume receiving a dose <26 Gy was 51.2%. Quality of life evaluation demonstrated an initial deterioration of almost all scales and items in QLQ-C30 and QLQ-H and N35. Most items improved in time, and some reached baseline values 18 months after treatment. Conclusion: DVH analysis, scintigraphic evaluation of parotid function, and quality of life assessment of our patient group showed that helical tomotherapy makes it possible to preserve parotid gland function without compromising disease control. We recommend mean parotid doses of <34 Gy and doses <26 Gy to a maximum 47% of the

Adenoid cystic carcinoma associated with mucous retention cyst of the parotid gland.

Science.gov (United States)

Hebbale, Manjula Advisha; Halli, Rajshekhar C; Kini, Yogesh K; Kharkar, Viraj R; Metgud, Rashmi

2011-09-01

Mucous retention cysts of the parotid gland are rare, and a coexistent adenoid cystic carcinoma is even an unusual occurrence. Such coexistent adenoid cystic carcinomas with mucous retention cyst of the parotid gland are difficult to diagnose clinically and, at times, stage difficulty in their management. We report a rare case of adenoid cystic carcinoma associated with mucous retention cyst of the parotid gland with its diagnostic and management dilemma in a 14-year-old adolescent girl.
SEASONAL VARIATIONS IN HUMAN PAROTID FLUID FLOW RATE IN A SUBTROPICAL CLIMATE.

Science.gov (United States)

Parotid fluid was collected under conditions of very minimal stimulation from 3,868 systemically healthy young adult males over a period of two...calendar years. The study was carried out in a subtropical climate in which the only thermal discomfort resulted from the summer heat. Parotid flow rate...fall. During the summer months the mean rate of parotid flow was 0.031 ml./minute; during the winter the flow rate mean increased by 35% to 0.042 ml
Geometric changes of parotid glands caused by hydration during chemoradiotherapy

International Nuclear Information System (INIS)

Kager, Petronella M.; Weerdenburg, Sanne C. C. van; Kranen, Simon R. van; Beek, Suzanne van; Lamers-Kuijper, Elisabeth A.; Heemsbergen, Wilma D.; Hamming-Vrieze, Olga; Remeijer, Peter

2015-01-01

Plan adaptation during the course of (chemo)radiotherapy of H&N cancer requires repeat CT scanning to capture anatomy changes such as parotid gland shrinkage. Hydration, applied to prevent nephrotoxicity from cisplatin, could temporarily alter the hydrogen balance and hence the captured anatomy. The aim of this study was to determine geometric changes of parotid glands as function of hydration during chemoradiotherapy compared to a control group treated with radiotherapy only. This study included an experimental group (n = 19) receiving chemoradiotherapy, and a control group (n = 19) receiving radiotherapy only. Chemoradiotherapy patients received cisplatin with 9 l of saline solution during hydration in the first, fourth and seventh week. The delineations of the parotid glands on the planning CT scan were automatically propagated to Cone Beam CT scans using deformable image registration. Relative volume and position of the parotid glands were determined at the second chemotherapy cycle (week four) and at fraction 35. When saline solution was administrated, the volume temporarily increased on the first day (7.2 %, p < 0.001), second day (10.8 %, p < 0.001) and third day (7.0 %, p = 0.016). The gland positions shifted lateral, the distance between glands increased on the first day with 1.5 mm (p < 0.001), on the second day 2.2 mm (p < 0.001). At fraction 35, with both groups the mean shrinkage was 24 % ± 11 % (1SD) and the mean medial distance between the parotid glands decreased by 0.47 cm ± 0.27 cm. Hydration significantly modulates parotid gland geometry. Unless, in the context of adaptive RT, a repeat CT scan is timed during a chemotherapy cycle, these effects are of minor clinical relevance
Modification of parotids in case of conformal ORL irradiation

International Nuclear Information System (INIS)

Louvel, G.; Lafond, C.; Manens, J.P.; Jouyaux, F.; Williaume, D.; Le Prise, E.; Crevoisier, R. de; Cazoulat, G.; Simon, A.; Haigron, P.

2009-01-01

The objective of the study is to analyze the anatomical modifications of the parotids in case of tumors irradiation of the O.R.L. area. In case of irradiation of the O.R.L. area the parotids reduce about one third of their volume, by moving inwards and backwards. The dose received by these glands at the end of irradiation can be different from this one initially planned. (N.C.)
Caso clínico: Un tratamiento alternativo a la parotiditis crónica

OpenAIRE

Arregui V,Rodrigo; Tamblay N,Natalia; Esquivel C,Patricia

2008-01-01

La parotiditis crónica conocida también como parotiditis juvenil recurrente, se define como la inflamación recurrente de la glándula parótida, asociada a la aparición de sialectasias o dilataciones no obstructivas de los conductos glandulares. Como tratamiento se emplea habitualmente la sialografía que tiene una tasa de éxito que va de 62% a 94%. Se presenta aquí un caso de un niño de 4 años de edad con parotiditis crónica, que persiste con episodios de parotiditis, pese a la realización de d...
Features of Parotid Gland Diseases and Surgical Results in Southern Taiwan

Directory of Open Access Journals (Sweden)

Wen-Hsiang Chan

2010-09-01

Full Text Available Various parotid gland diseases are seen clinically, including inflammation, sialolithiasis, and benign and malignant tumors. It is important to differentiate between these to make a correct diagnosis and for proper management. Here, we investigated the relationship between tumor characteristics and pathology, and considered whether the former could be used to differentiate malignant from benign parotid gland diseases. We retrospectively reviewed the charts and data of 316 patients who underwent surgery in Kaohsiung Medical University Chung-Ho Memorial Hospital from January 1, 1998 to December 31, 2008. Two hundred and eighty-one patients (88.9% had benign disease, and 35 (11.1% had malignant disease. The most common benign disease was pleomorphic adenoma (115 cases, 36.4%, but the most common disease in male patients was Warthin's tumor, a finding which, as far as we aware, has not been previously been reported in the literature. The incidence of Warthin's tumor seems to be increasing. In malignant disease, the most common was acinic cell carcinoma (8 cases, 22.9%. Compared with benign disease, malignant parotid gland disease more often presents as a hard, painful, fixed and large mass (> 3 cm, and more often involves the deep lobe of the parotid gland. Partial parotidectomy was adequate for most tumors, including pleomorphic adenoma. The most common postoperative complication was temporary facial palsy, followed by permanent facial palsy. However, there was no difference in transient facial palsy rate between benign and malignant parotid gland disease, although parotid gland cancer had a higher incidence of permanent facial palsy postoperatively.
[Predictors of malignancy in the management of parotid tumors: about 76 cases].

Science.gov (United States)

Bouaity, Brahim; Darouassi, Youssef; Chihani, Mehdi; Touati, Mohamed Mliha; Ammar, Haddou

2016-01-01

Salivary gland tumor pathology is complex and poses a diagnostic and therapeutic problem. A good analysis of predictive factors for malignancy in parotid tumors seems currently necessary for better therapeutic planning. The aim of this study was to investigate the predictive factors for malignancy in parotid tumors through a retrospective study of 76 cases of parotid tumor treated in a service of Otorhinolaryngology and Cervico Facial Surgery of Avicenne military hospital of Marrakech between January 2000 and December 2012. The study involved 40 women and 36 men. The average age was 44 years for benign tumours whereas it was 50 years for malignant tumours. The median of consultation time was 24 months for benign tumors and 16 month for malignant tumours. Swelling in the area of the parotid was always a patient detecting sign. Malignancy is clinically suspected based on pain, facial paralysis, surface structure and deeper structure fixity and on the presence of adenopathy. MRI has become the methodology of choice for evaluating parotid tumors due to its good diagnostic value in the assessment of benignity and malignancy. Fine needle aspiration biopsy has no value unless it is positive. Explorative parotidectomy with extemporaneous anatomopathological examination remains the key to positive diagnosis. Parotid benign tumors represent the most frequent entity (80%) and pleomorphic adenoma remains the predominant histologic type (61%). With regard to malignant tumors, they are rare, mainly dominated by mucoepidermoid carcinomas (6,5%). Surgical treatment is the first choice and it is often associated with lymph node dissection and radiation therapy for malignant tumors. Facial paralysis is the most common complication of parotid surgery.
Intensity-modulated radiation therapy for nasopharyngeal carcinoma parotid sparing with euivalent uiform dose optimization

International Nuclear Information System (INIS)

Yue Weiyou; Dai Jianrong; Gao Li

2006-01-01

Objective: The aim of this study was to evaluate the role of an euivalent uiform dose (EUD) based optimization algorithm in sparing the parotids of patients with nasopharyngeal carcinoma (NPC) when they are treated with intensity-modulated radiation therapy (IMRT). Methods: 12 patients were randomly selected from the NPC patients who received IMRT treatments. For these patients, the treatment plans were designed with physical optimization constraints (dose/dose-volume constraints). Based on these plans, new plans were designed through replacing the physical constraints with maximum EUD for parotids, while keeping the physical objectives for targets and other organs at risk(OARs) unchanged. Comparison was then made between the new plan, which had EUD constraints to parotids, and the former for each individual patient. Results: While maintaining the dose to the targets and the other OARs un- changed, optimization with EUD constraints to parotids decreased the mean dose and V 30 of parotids significantly, simultaneously, the dose of target volume and other organs at risk keep stable, the values of probability were less than 0.05 by T-test. Conclusions: The doses to parotids can be reduced through optimization with EUD constraints. This finding is quite helpful to reduce the occurrence rate of parotid complications, and to provide spaces for escalating target dose. (authors)
Ten-year study on varieties of parotid tumors in pediatrics

International Nuclear Information System (INIS)

Verdecia Cannizares, Caridad; Cubero Melendez, Osiris; Alonso Pirez, Magda; Portugues Diaz, Andres Manuel

2011-01-01

Parotid tumors are uncommon because they account for 0.5 % of all types of cancer in pediatrics. They generally occur as increased local asymptomatic volume, occasionally accompanied by pain and inflammatory signs. A retrospective, longitudinal and descriptive study was carried out to determine the frequency and forms of presentation of parotid tumors diagnosed in 0-18 years-old patients, who had been admitted to the oncological surgery service of 'William Soler' pediatric hospital from February 2001 to December 2010. The variables taken into account were sex, forms of presentation, response to treatment as well as the histological variants presented, with the objective of giving information about these variants of parotid tumors in pediatrics, which, despite their rareness, represent a high risk group when occur. Seven patients were diagnosed, of whom 3 were pleomorphic adenomas, one adenocarcinoma, one mucoepidermoid carcinoma of the gland, one parotid Hodgkin lymphoma and one mixed tumor with atypical cells of the gland. The onset of all the tumors was the presence of a parotid mass in 6 asymptomatic cases and in one case suffering local pain. They were all performed gland ultrasound and aspiration fine needle biopsy. Males prevailed over the females (ratio of 5:2) and the average age of presentation was 12.3 years. Surgery is the main therapeutic weapon in most of cases. It was recommended to closely follow the patients because of their high rate of local recurrence
Lymphoma type MALT of the parotid gland

International Nuclear Information System (INIS)

Frometa Neirai, Carlos; Gonzalez Gomez, Juan Manuel; Arredondo Lopez, Miguel

2010-01-01

The lymphomas type MALT or the mucosa-associated lymphoid tissue, are the most recent variety of non-Hodgkin lymphomas present mainly in the gastric mucosa associated with Helycobacter pylori infection and in the thyroid gland in relation to Hashimoto's thyroiditis. Frequently the origin of this lesion can't be determined only by cytology study, thus it is necessary the histopathology analysis for a definitive diagnosis in most cases. Present paper includes the case of male patient with bilateral volume increase of both parotid glands and a diagnosis cytopathological of a benign lymphoepithelial process and the development of a type MALT lymphoma in relation to the right parotid gland. (author)
Influence of Handheld Mobiles on Parotid: A Cohort Study

OpenAIRE

Gracelin E Ranjitha; Ravi David Austin; Sarvathikari Ramasamy; Chinnappa Saravana Bharathi; Deepthi Angeline; Sakthivel Sambasivam

2017-01-01

Introduction: Mobile phones generate heat and radiofrequency radiation. The parotid gland is one potential target, because mobile phones are pressed against the side of the face where the gland is located. Aims and Objectives: To compare the effect of mobile phone radiation on parotid gland volume, systolic velocity, salivary flow rate, and protein concentration between the dominant and the nondominant side of mobile phone usage among heavy mobile phone users. Materials and Methods: Ultrasono...
VACCINATION OF CHILDREN AGAINST MEASLES, PAROTIDITIS AND VITAMINOTHERAPY

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S.M. Kharit

2007-01-01

Full Text Available The researchers observed 45 children inoculated with the Russian divalent vaccine (measles–parotiditis. 25 children received mineral and vitamin complex «jungle» for a month since the date of vaccination. The application of «jungle» medication was efficient and conduced to prophylaxis of the complication of the vaccination, prevention of the inter current diseases among the vaccinated, as well as positively affected the intensity of the special antibody formation because of activation of cellular and antiviral mechanisms.Key words: vaccination, measles, parotiditis, prevention, mineral and vitamin complex, children.
Diagnosis value of parotid sialography in Sjogren's syndrome

International Nuclear Information System (INIS)

Zheng Guo; Zhang Xue; Liu Rongxin; Wang Yali; Zhong Zhicheng; Wang Haiwen

2006-01-01

Objective: To study the diagnosis value of parotid sialography in Sjogren's syndrome (SS). Methods: Two hundred and two cases were chosen in the study, 149 cases were SS, 14 cases were chronic parotitis, 2 were parotid benign hypertrophy, and 37 cases were normal. The international classification criteria (2002) for primary Sjogren's syndrome was used to perform the diagnostic test of parotid sialography. Results: In SS, the incidence rate of pathdogical changes of the twiggy canula is the highest (80.20%, 239/298 side), pathological changes of the main canula showed rough fringe(28.19%, 84/298 side), or canula cavity ectasia but not rough fringe(13.09%, 39/298 side), and also can showed mix form of the two kinds of pathological changes, but not often(2.68%, 8/298 side). The branch canula resembled as the main canula in the pathological changes, but observation effect was affected by extensive degree of the twiggy canula in the pathological changes. 0 stage to V stage was seen in SS, the cases with different stage changes in bilateral side were occupied 25.98% (33/127 side). Chronic parotitis had twiggy canula expansion (7/28 side), branch canula expansion (10/28 side), main canula expandsion (11/28 side), but had not the sign of rough fringe. Others of non-SS had no canula pathological changes. Results of the diagnostic test: diagnosis specificity of the branch canula or the main canula rough fringe was 100%, and sensitivity of the twiggy canula expansion and Youden's index were the highest. Conclusion: To diagnose SS as the pathological changes of parotid canula, the twiggy canula expansion was perfect filtration diagnosis criteria, the branch canula and the main canula rough fringe was certain diagnosis criteria. The value of parotid sialography in SS were affected by the form of canula pathological changes and whether two sides examined at the same time. (authors)
Horner’s syndrome associated with parotid duct obstruction in a sheep

OpenAIRE

Loste, Araceli; Ramos, Juan J.; Ferrer, Luis M.; Climent, Salvador; Latre, María V.

2006-01-01

A 9-year old, Rasa Aragonesa ewe was presented with a left-sided, facial, soft fluctuant swelling. The postmortem examination showed grass awns filling the entire length of the parotid gland duct. The presence of parotid duct obstruction with Horner’s syndrome, previously unreported in sheep, is discussed.
Individual radiation response of parotid glands investigated by dynamic 11C-methionine PET

International Nuclear Information System (INIS)

Buus, Simon; Grau, Cai; Munk, Ole Lajord; Rodell, Anders; Jensen, Kenneth; Mouridsen, Kim; Keiding, Susanne

2006-01-01

Background and Purpose: Previously, we showed that the net metabolic clearance of 11 C-methionine of the parotid gland, K, calculated from dynamic 11 C-methionine PET, can be used as a measure of parotid gland function. The aim of this study was to investigate by dynamic 11 C-methionine PET the individual radiation dose response relationship of parotid glands in head and neck cancer patients. Patients and methods: Twelve head and neck cancer patients were examined by dynamic 11 C-methionine PET after radiotherapy. Parametric images of K were generated, co-registered and compared voxel-by-voxel with the 3D radiation dose plan within the parotid gland to assess the individual radiation dose-function relationship. Results: In each patient, voxel-values of K decreased with increasing radiation dose. Population based analysis showed a sigmoid dose response relationship of parotid gland, from which we estimated a threshold radiation dose of 16 Gy and a mean TD 5 of 30 Gy. TD 5 ranged from 7 to 50 Gy in the group of patients. Conclusions: Individual radiation dose response of parotid glands can be measured by dynamic 11 C-methionine PET. The dose response analysis revealed a sigmoid relationship, a threshold radiation dose of 16 Gy, and a mean TD 5 of 30 Gy
Influence of intensity-modulated radiation therapy on parotid function in nasopharyngeal carcinoma

International Nuclear Information System (INIS)

Cui Tiantian; Wu Shaoxiong; Han Fei; Lu Lixia; Huang Shaomin; Deng Xiaowu; Lu Taixiang; Zhao Chong

2009-01-01

Objective: To evaluate the effect of intensity-modulated radiation therapy (IMRT) on parotid function in nasopharyngeal carcinoma (NPC). Methods: Eighty-three NPC patients received prima- ry IMRT between 2001 and 2003. Xerostomia before radiotherapy, at the end of radiotherapy, at 6-month, 1-, 2-,3-,4- and 5-year after radiotherapy were investigated, respectively. The relation between xerostomia and parotid dose distribution was analyzed. Results: Of all the patients, 4, 31, 31 and 17 had stage I, II, III and IV A disease, respectively. Sixteen patients received chemo-radiotherapy. The median followed-up time was 65 months. The 5-year local control and regional control rate were 96% and 95%, respectively. The 5- year overall survival rate was 80%. The mild xerostomia rate at the seven time points was 42%, 51%, 71%, 77%, 58%, 38% and 26%. The corresponding moderate xerostomia rate was 52%, 53%, 21%, 8%, 3%, 2% and 2%, respectively. No serious xerostomia was observed. The mean dose of the bilateral parotid glands was 34.34 Gy. Xerostomia at 6-month after radiotherapy was positively correlated with the mean dose of the parotid glands, and D 50 was the independent factor in predicting the xerostomia. Parotid function was well protected when the mean dose and D 50 were no more than 33 Gy and 29 Gy, respectively. Conclusions: IMRT can improve the local-regional control of NPC and protect the parotid glands from radiation-induced injury. (authors)
Contemporary management of benign parotid tumours - the increasing evidence for extracapsular dissection.

Science.gov (United States)

Brennan, P A; Ammar, M; Matharu, J

2017-01-01

Benign parotid tumours have historically often been managed surgically by superficial parotidectomy. While this approach usually gives a generous cuff of surrounding normal parotid tissue to increase tumour margins, it requires a much larger incision than the increasingly used extracapsular dissection (ECD) technique. Furthermore, superficial parotidectomy can result in marked facial hollowing, Frey syndrome and an increased risk of both temporary and permanent facial nerve weakness. ECD has been popularised as a safe alternative to parotidectomy primarily for the removal of mobile, benign parotid tumours with safe outcomes and reduced risk to the facial nerve. In this article, we review the growing body of evidence for ECD and include our own experience confirming the move away from superficial parotidectomy in contemporary practice for the treatment of benign parotid tumours. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Multifocal Adenomatous Oncocytic Hyperplasia of the Parotid Gland

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Kinoshita, Yuichi; Harada, Hiroshi; Kobayashi, Tadao K.; Yoshizawa, Katsuhiko; Yuri, Takashi; Takasu, Kosho; Tsubura, Airo; Shikata, Nobuaki

2014-01-01

Multifocal adenomatous oncocytic hyperplasia (MAOH) is a non-neoplastic lesion that is classified as oncocytosis. MAOH is a rare entity of the parotid gland and accounts for approximately 0.1% of salivary gland lesions. Here, we report a case of MAOH of the parotid gland. The patient was a 71-year-old woman who presented with discomfort at the left side of her neck. Fine-needle aspiration cytology of the parotid gland revealed a loose sheet-like cluster of round to polygonal cells with granular cytoplasm against a hemorrhagic background. The cells had round to oval, centrally located nuclei with granular chromatin and without distinct nucleoli. Histologically, the lesion was formed of many variable-sized nodules, comprising oncocyte-like cells with small round nuclei and eosinophilic granular cytoplasm that was positive for mitochondrial antibodies. The diagnosis of MAOH is difficult to make by cytology alone, because the findings overlap with those of other oncocytic lesions. In particular, the cytological findings of MAOH have not been sufficiently reported to date. A correlation of cytology and histology was expected. PMID:25580104
Multifocal Adenomatous Oncocytic Hyperplasia of the Parotid Gland

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Yuichi Kinoshita

2014-12-01

Full Text Available Multifocal adenomatous oncocytic hyperplasia (MAOH is a non-neoplastic lesion that is classified as oncocytosis. MAOH is a rare entity of the parotid gland and accounts for approximately 0.1% of salivary gland lesions. Here, we report a case of MAOH of the parotid gland. The patient was a 71-year-old woman who presented with discomfort at the left side of her neck. Fine-needle aspiration cytology of the parotid gland revealed a loose sheet-like cluster of round to polygonal cells with granular cytoplasm against a hemorrhagic background. The cells had round to oval, centrally located nuclei with granular chromatin and without distinct nucleoli. Histologically, the lesion was formed of many variable-sized nodules, comprising oncocyte-like cells with small round nuclei and eosinophilic granular cytoplasm that was positive for mitochondrial antibodies. The diagnosis of MAOH is difficult to make by cytology alone, because the findings overlap with those of other oncocytic lesions. In particular, the cytological findings of MAOH have not been sufficiently reported to date. A correlation of cytology and histology was expected.
Primary parotid gland lymphoma: a case report

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Paraskevas Katsaronis

2011-08-01

Full Text Available Abstract Introduction Mucosa associated lymphoid tissue lymphomas are the most common lymphomas of the salivary glands. The benign lymphoepithelial lesion is also a lymphoproliferative disease that develops in the parotid gland. In the present case report, we describe one case of benign lymphoepithelial lesion with a subsequent low transformation to grade mucosa associated lymphoid tissue lymphoma appearing as a cystic mass in the parotid gland. Case presentation A 78-year-old Caucasian female smoker was referred to our clinic with a non-tender left facial swelling that had been present for approximately three years. The patient underwent resection of the left parotid gland with preservation of the left facial nerve through a preauricular incision. The pathology report was consistent with a low-grade marginal-zone B-cell non-Hodgkin lymphoma (mucosa associated lymphoid tissue lymphoma following benign lymphoepithelial lesion of the gland. Conclusions Salivary gland mucosa associated lymphoid tissue lymphoma should be considered in the differential diagnosis of cystic or bilateral salivary gland lesions. Parotidectomy is recommended in order to treat the tumor and to ensure histological diagnosis for further follow-up planning. Radiotherapy and chemotherapy should be considered in association with surgery in disseminated forms or after removal.

The use of multimedia as an adjunct to the informed consent process for Morton's neuroma resection surgery.

Science.gov (United States)

Wang, Calvin; Ammon, Peter; Beischer, Andrew D

2014-10-01

The purpose of this study was to assess if a computer-based multimedia education module (MEM) improved patients' comprehension when used as an adjunct to the standard verbal consent process for Morton's neuroma resection surgery. Nineteen patients (15 females and 4 males) considered candidates for Morton's neuroma resection surgery were prospectively recruited. A standardized verbal discussion was had with each patient regarding risks and benefits of surgery, alternative treatments, and the usual postoperative course. Patient understanding was then assessed with a questionnaire. Each patient subsequently viewed the MEM and the questionnaire was repeated. Patients also rated ease of understanding and satisfaction with both methods of patient education. Patients answered a significantly greater proportion of correct answers after viewing the MEM module (85%), compared to verbal discussion alone (61%) (P = .002). Patients rated both the ease of understanding of the module and amount of information provided by the module as a mean of 9.3 cm on a 10 cm Visual Analog Scale (VAS). The majority of patients (76%) rated the multimedia tool as having answered their questions about surgery as well or better than the treating surgeon. An interactive multimedia educational tool was a useful adjunct to the informed consent process for patients considering Morton's neuroma resection surgery. Level II, prospective cohort study. © The Author(s) 2014.
Acoustic neuroma: predominance of Antoni type B cells in tumors of patients with vestibular paresis.

NARCIS (Netherlands)

Stipkovits, E.M.; Graamans, K.; Jansen, G.H.; Velthof, M.A.

2001-01-01

OBJECTIVE: This study aimed to investigate whether in patients with acoustic neuroma (AN), the presence or absence of vestibular symptoms is related to the histologic characteristics of the tumor. STUDY DESIGN: The study design was a retrospective clinical study. SETTING: The study was conducted at
Calculation of cranial nerve complication probability for acoustic neuroma radiosurgery

International Nuclear Information System (INIS)

Meeks, Sanford L.; Buatti, John M.; Foote, Kelly D.; Friedman, William A.; Bova, Francis J.

2000-01-01

Purpose: Estimations of complications from stereotactic radiosurgery usually rely simply on dose-volume or dose-diameter isoeffect curves. Due to the sparse clinical data available, these curves have typically not considered the target location in the brain, target histology, or treatment plan conformality as parameters in the calculation. In this study, a predictive model was generated to estimate the probability of cranial neuropathies as a result of acoustic schwannoma radiosurgery. Methods and Materials: The dose-volume histogram reduction scheme was used to calculate the normal tissue complication probability (NTCP) from brainstem dose-volume histograms. The model's fitting parameters were optimized to provide the best fit to the observed complication data for acoustic neuroma patients treated with stereotactic radiosurgery at the University of Florida. The calculation was then applied to the remainder of the patients in the database. Results: The best fit to our clinical data was obtained using n = 0.04, m = 0.15, and no. alphano. /no. betano. = 2.1 Gy -1 . Although the fitting parameter m is relatively consistent with ranges found in the literature, both the volume parameter, n, and no. alphano. /no. betano. are much smaller than the values quoted in the literature. The fit to our clinical data indicates that brainstem, or possibly a specific portion of the brainstem, is more radiosensitive than the parameters in the literature indicate, and that there is very little volume effect; in other words, irradiation of a small fraction of the brainstem yields NTCPs that are nearly as high as those calculated for entire volume irradiation. These new fitting parameters are specific to acoustic neuroma radiosurgery, and the small volume effect that we observe may be an artifact of the fixed relationship of acoustic tumors to specific regions of the brainstem. Applying the model to our patient database, we calculate an average NTCP of 7.2% for patients who had no
Unexpected Detection of Parotid Gland Malignancy during Primary Extracapsular Dissection

OpenAIRE

Mantsopoulos, Konstantinos; Velegrakis, Stylianos; Iro, Heinrich

2015-01-01

Objective To evaluate the oncologic and functional outcome in cases in which a false preoperative working hypothesis “benign parotid tumor” led to a primary extracapsular dissection being performed rather than a traditional, more radical surgical modality. Study Design Case series with chart review. Setting Academic tertiary referral center. Subjects and Methods The records of all patients treated for malignant tumors of the parotid gland between 2006 and 2012 were...
Malignant tumor of the parotid gland with metastasis into the cervical vertebra

International Nuclear Information System (INIS)

Kimura, Jun; Tsuchiya, Keiichi; Utsumi, Takehiko; Furuki, Shin; Asano, Hisashi.

1979-01-01

A patient with malignant tumor of the parotid gland with metastasis into the cervical vertebra was found. Because spinal symptoms were observed at first and the symptoms and the course of the disease were not typical, it was so difficult to diagnose it. For this patient, a parotid gland scintigram with sup(99m)Tc was very useful to diagnose the lesion. The patient was treated with chemotherapy, 60 Co beam therapy and immuno-chemo-therapy and survived about one year and two months more. Cyclo-C (cyclocytidine) was very effective to control the primary lesion in the parotid gland. (Nishio, M.)
Adrenal status assessed by direct radioimmunoassay of cortisol in whole saliva or parotid saliva

International Nuclear Information System (INIS)

Walker, R.F.; Riad-Fahmy, D.; Read, G.F.

1978-01-01

We describe a direct radioimmunoassay for cortisol in 10-μl volumes of parotid saliva or whole saliva. Binding proteins are absent from these fluids, as demonstrated by the excellent correlation between results for samples assayed directly and by a comparison procedure involving extraction with 1,2-dichloroethane. The direct assay is specific, precise, and had a lower limit of sensitivity of 4 pg per assay tube. Comparison of cortisol concentrations in plasma, parotid saliva, and whole saliva in persons undergoing investigations for assessing adrenal function, including stimulation with cosyntropin (Synachthen) and suppression with dexamethasone, indicated that changes in plasma cortisol concentration were accurately and immediately reflected in saliva from either the parotid-gland or whole saliva. A marked circadian rhythm has also been demonstrated for cortisol in parotid-gland saliva and whole saliva. We had to modify the 1,2-dichloroethane extraction procedure for accurate determination of cortisol in parotid saliva and whole saliva of patients undergoing treatment with metyrapone
[Lupus erythematosus panniculitis presenting as palpebral edema and parotiditis].

Science.gov (United States)

Pérez-Pastor, G; Valcuende, F; Tomás, G; Moreno, M

2007-10-01

Lupus erythematosus panniculitis or lupus erythematosus profundus is characterized by inflammation of the deep dermis and subcutaneous tissue. It can occur in isolation or associated with chronic systemic or discoid lupus erythematosus. It usually consists of nodules and hardened subcutaneous plaques on the forehead, cheeks, proximal extremities, and buttocks. Periorbital and parotid involvement are rare and can lead to misdiagnosis. We present the case of a patient with lupus erythematosus panniculitis who presented with palpebral edema and involvement of the periocular fat and parotid gland.
Differential Diagnosis of Parotid Lipoma in a Breast Ca Patient

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Melda Misirlioglu

2017-01-01

Full Text Available Lipomas are common benign tumors usually detected on the torso, neck, upper thighs, and upper arms. However, they are rarely found in the parotid gland region. Because of their rarity at this site, they are not often considered in the differential diagnosis of parotid tumors. This report describes a rare case of a lipoma in the superficial lobe of parotid gland. A 71-year-old female patient admitted to our department complaining about swelling and pain in the posterior area of the left mandibular region since one month. Her medical history included mastectomy after breast CA fifteen years ago. Clinical examination revealed a smooth-surfaced, soft, and painful mass, with well-defined margins in the left mandibular region. Differential diagnosis of metastasis, inflammatory neck swellings, and benign salivary gland tumors were considered for the patient. Advanced imaging methods such as ultrasonography and contrast tomography revealed that the lesion was a lipoma of parotid gland. A surgical intervention under general anesthesia was planned for the removal of the mass; however patient refused the surgical treatment. Patient was placed on six-month periodic recall. This article reviews the radiographic appearance and differential diagnoses of lipoma in this rare location.
[Acute parotiditis after tracheostomy in Intensive Care].

Science.gov (United States)

Serviá Goixart, L; Badía, M; Campi, D; Trujillano, J; Alcega, R; Vilanova, J

2006-01-01

Post-anesthesic parotiditis is a little known entity related with anesthesic procedures but described in any situation that motivates manipulation of the oropharyngeal cavity. Its physiopathological mechanism is not well-defined, although it could have a multifactorial origin. A case of a male who was admitted for post-operative control of brain tumor exeresis and who had preauricular and submaxillary inflammation after a routinely performed tracheostomy is presented. Coincidence with the performing of a tracheostomy required us to propose the differential diagnosis with the complications associated to said surgical act. Post-anesthesic parotiditis, even though it is a rare complication and has no clinical significance, should be kept in mind when there is facial edema after any manipulation of the oropharyngeal cavity.
A case-case study of mobile phone use and acoustic neuroma risk in Japan.

Science.gov (United States)

Sato, Yasuto; Akiba, Suminori; Kubo, Osami; Yamaguchi, Naohito

2011-02-01

Results of case-control studies of mobile phone use and acoustic neuroma have been inconsistent. We conducted a case-case study of mobile phone use and acoustic neuroma using a self-administered postal questionnaire. A total of 1589 cases identified in 22 hospitals throughout Japan were invited to participate, and 787 cases (51%) actually participated. Associations between laterality of mobile phone use prior to the reference dates (1 and 5 years before diagnosis) and tumor location were analyzed. The overall risk ratio was 1.08 (95% confidence interval (CI), 0.93-1.28) for regular mobile phone use until 1 year before diagnosis and 1.14 (95% CI, 0.96-1.40) for regular mobile phone use until 5 years before diagnosis. A significantly increased risk was identified for mobile phone use for >20 min/day on average, with risk ratios of 2.74 at 1 year before diagnosis, and 3.08 at 5 years before diagnosis. Cases with ipsilateral combination of tumor location and more frequently used ear were found to have tumors with smaller diameters, suggesting an effect of detection bias. Furthermore, analysis of the distribution of left and right tumors suggested an effect of tumor-side-related recall bias for recall of mobile phone use at 5 years before diagnosis. The increased risk identified for mobile phone users with average call duration >20 min/day should be interpreted with caution, taking into account the possibilities of detection and recall biases. However, we could not conclude that the increased risk was entirely explicable by these biases, leaving open the possibility that mobile phone use increased the risk of acoustic neuroma. Copyright © 2010 Wiley-Liss, Inc.
Frozen section pathology for decision making in parotid surgery.

Science.gov (United States)

Olsen, Kerry D; Moore, Eric J; Lewis, Jean E

2013-12-01

For parotid lesions, the high accuracy and utility of intraoperative frozen section (FS) pathology, compared with permanent section pathology, facilitates intraoperative decision making about the extent of surgery required. To demonstrate the accuracy and utility of FS pathology of parotid lesions as one factor in intraoperative decision making. Retrospective review of patients undergoing parotidectomy at a tertiary care center. Evaluation of the accuracy of FS pathology for parotid surgery by comparing FS pathology results with those of permanent section. Documented changes from FS to permanent section in 1339 parotidectomy pathology reports conducted from January 1, 2000, through December 31, 2009, included 693 benign and 268 primary and metastatic malignant tumors. Changes in diagnosis were found from benign to malignant (n = 11) and malignant to benign (n = 2). Sensitivity and specificity of a malignant diagnosis were 98.5% and 99.0%, respectively. Other changes were for lymphoma vs inflammation or lymphoma typing (n = 89) and for confirmation of or change in tumor type for benign (n = 36) or malignant (n = 69) tumors. No case changed from low- to high-grade malignant tumor. Only 4 cases that changed from FS to permanent section would have affected intraoperative decision making. Three patients underwent additional surgery 2 to 3 weeks later. Overall, only 1 patient was overtreated (lymphoma initially deemed carcinoma). Frozen section pathology for parotid lesions has high accuracy and utility in intraoperative decision making, facilitating timely complete procedures.
Parotid abscess due to salmonella enteritidis: A case report.

Science.gov (United States)

Reyes, Cesar V; Jensen, JoAnne D

2006-01-01

Salmonella infection of the parotid gland is rare. An instance in a 50-year-old man of Salmonella enteritidis parotiditis initially recognized by microbial culture of a fine needle aspiration cytology material is described. The identified predisposing factor was chronic alcoholic abuse. For the infection source, a carrier state of salmonella parotitis was postulated, which progressed to focal abscess and was subsequently complicated by bacteremia and hematogenous spread to the liver, spleen and lungs. Salmonella should be included in the differential consideration of head and neck abscesses in immunocompromised individuals and treated aggressively.
Postoperative radiotherapy for parotid gland malignancy

Energy Technology Data Exchange (ETDEWEB)

Eom, Keun Yong; Wu, Hong Gyun; Kim, Jae Sung; Park, Charn Il; Kim, Kwang Hyun; Lee, Chae Seo [Seoul National University College of Medicine, Seoul (Korea, Republic of); Kim, In Ah [Bundang Seoul National University Hospital, Seongnam (Korea, Republic of)

2005-09-15

The aim of this study was to evaluate the clinical results of postoperative radiotherapy for parotid gland malignancy, and determine prognostic factors for locoregional control and survival. Between 1980 and 2002, 130 patients with parotid malignancy were registered in the database of the Department of Radiation Oncology, Seoul National University Hospital. The subjects of this analysis were the 72 of these 130 patients who underwent postoperative irradiation. There were 42 males and 30 females, with a median age of 46.5 years. The most common histological type was a mucoepidermoid carcinoma. There were 6, 23, 23 and 20 patients in Stages I, II, III and IV, respectively. The median dose to the tumor bed was 60 Gy, with a median fraction size of 1.8 Gy. The overall 5 and 10 year survival rates were 85 and 76%, respectively. The five-year locoregional control rate was 85%, which reached a plateau phase after 6 years. Sex and histological type were found to be statistically significant for overall survival from a multivariate analysis. No other factors, including age, facial nerve palsy and stage, were related to overall survival. For locoregional control, nodal involvement and positive resection margin were associated with poor local control. Histological type, tumor size, perineural invasion and type of surgery were not significant for locoregional control. A high survival rate of parotid gland malignancies, with surgery and postoperative radiotherapy, was confirmed. Sex and histological type were significant prognostic factors for overall survival. Nodal involvement and a positive resection margin were associated with poor locoregional control.
Treatment of acoustic neuroma: stereotactic radiosurgery vs. microsurgery

International Nuclear Information System (INIS)

Karpinos, Marianna; Teh, Bin S.; Zeck, Otto; Carpenter, L. Steven; Phan, Chris; Mai, W.-Y.; Lu, Hsin H.; Chiu, J. Kam; Butler, E. Brian; Gormley, William B.; Woo, Shiao Y.

2002-01-01

Purpose: Two major treatment options are available for patients with acoustic neuroma, microsurgery and radiosurgery. Our objective was to compare these two treatment modalities with respect to tumor growth control, hearing preservation, development of cranial neuropathies, complications, functional outcome, and patient satisfaction. Methods and Materials: To compare radiosurgery with microsurgery, we analyzed 96 patients with unilateral acoustic neuromas treated with Leksell Gamma Knife or microsurgery at Memorial Hermann Hospital, Houston, Texas, between 1993 and 2000. Radiosurgery technique involved multiple isocenter (1-30 single fraction fixed-frame magnetic resonance imaging) image-based treatment with a mean dose prescription of 14.5 Gy. Microsurgery included translabyrinthine, suboccipital, and middle fossa approaches with intraoperative neurophysiologic monitoring. Preoperative patient characteristics were similar except for tumor size and age. Patients undergoing microsurgery were younger with larger tumors compared to the radiosurgical group. The tumors were divided into small 4.0 cm. Median follow-up of the radiosurgical group was longer than the microsurgical group, 48 months (3-84 months) vs. 24 months (3-72 months). Results: There was no statistical significance in tumor growth control between the two groups, 100% in the microsurgery group vs. 91% in the radiosurgery group (p>0.05). Radiosurgery was more effective than microsurgery in measurable hearing preservation, 57.5% vs. 14.4% (p=0.01). There was no difference in serviceable hearing preservation between the two groups. Microsurgery was associated with a greater rate of facial and trigeminal neuropathy in the immediate postoperative period and at long-term follow-up. The rate of development of facial neuropathy was significantly higher in the microsurgical group than in the radiosurgical group (35% vs. 0%, p<0.01 in the immediate postsurgical period and 35.3% vs. 6.1%, p=0.008, at long
Treatment of acoustic neuroma: stereotactic radiosurgery vs. microsurgery

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Karpinos, Marianna; Teh, Bin S; Zeck, Otto; Carpenter, L Steven; Phan, Chris; Mai, W -Y; Lu, Hsin H; Chiu, J Kam; Butler, E Brian; Gormley, William B; Woo, Shiao Y

2002-12-01

Purpose: Two major treatment options are available for patients with acoustic neuroma, microsurgery and radiosurgery. Our objective was to compare these two treatment modalities with respect to tumor growth control, hearing preservation, development of cranial neuropathies, complications, functional outcome, and patient satisfaction. Methods and Materials: To compare radiosurgery with microsurgery, we analyzed 96 patients with unilateral acoustic neuromas treated with Leksell Gamma Knife or microsurgery at Memorial Hermann Hospital, Houston, Texas, between 1993 and 2000. Radiosurgery technique involved multiple isocenter (1-30 single fraction fixed-frame magnetic resonance imaging) image-based treatment with a mean dose prescription of 14.5 Gy. Microsurgery included translabyrinthine, suboccipital, and middle fossa approaches with intraoperative neurophysiologic monitoring. Preoperative patient characteristics were similar except for tumor size and age. Patients undergoing microsurgery were younger with larger tumors compared to the radiosurgical group. The tumors were divided into small <2.0 cm, medium 2.0-3.9 cm, or large >4.0 cm. Median follow-up of the radiosurgical group was longer than the microsurgical group, 48 months (3-84 months) vs. 24 months (3-72 months). Results: There was no statistical significance in tumor growth control between the two groups, 100% in the microsurgery group vs. 91% in the radiosurgery group (p>0.05). Radiosurgery was more effective than microsurgery in measurable hearing preservation, 57.5% vs. 14.4% (p=0.01). There was no difference in serviceable hearing preservation between the two groups. Microsurgery was associated with a greater rate of facial and trigeminal neuropathy in the immediate postoperative period and at long-term follow-up. The rate of development of facial neuropathy was significantly higher in the microsurgical group than in the radiosurgical group (35% vs. 0%, p<0.01 in the immediate postsurgical period and 35
Parotid lymphomas - clinical and computed tomogrphic imaging ...

African Journals Online (AJOL)

Parotid lymphomas - clinical and computed tomogrphic imaging features. ... South African Journal of Surgery ... Lymphoma has a clinical presentation similar ... CT scanning is a useful adjunctive investigation to determine the site and extent of ...
Prospective longitudinal assessment of parotid gland function using dynamic quantitative pertechnate scintigraphy and estimation of dose–response relationship of parotid-sparing radiotherapy in head-neck cancers

International Nuclear Information System (INIS)

Gupta, Tejpal; Hotwani, Chandni; Kannan, Sadhana; Master, Zubin; Rangarajan, Venkatesh; Murthy, Vedang; Budrukkar, Ashwini; Ghosh-Laskar, Sarbani; Agarwal, Jai Prakash

2015-01-01

To estimate dose–response relationship using dynamic quantitative 99m Tc-pertechnate scintigraphy in head-neck cancer patients treated with parotid-sparing conformal radiotherapy. Dynamic quantitative pertechnate salivary scintigraphy was performed pre-treatment and subsequently periodically after definitive radiotherapy. Reduction in salivary function following radiotherapy was quantified by salivary excretion fraction (SEF) ratios. Dose–response curves were modeled using standardized methodology to calculate tolerance dose 50 (TD50) for parotid glands. Salivary gland function was significantly affected by radiotherapy with maximal decrease in SEF ratios at 3-months, with moderate functional recovery over time. There was significant inverse correlation between SEF ratios and mean parotid doses at 3-months (r = −0.589, p < 0.001); 12-months (r = −0.554, p < 0.001); 24-months (r = −0.371, p = 0.002); and 36-months (r = −0.350, p = 0.005) respectively. Using a post-treatment SEF ratio <45% as the scintigraphic criteria to define severe salivary toxicity, the estimated TD50 value with its 95% confidence interval (95% CI) for the parotid gland was 35.1Gy (23.6-42.6Gy), 41.3Gy (34.6-48.8Gy), 55.9Gy (47.4-70.0Gy) and 64.3Gy (55.8-70.0Gy) at 3, 12, 24, and 36-months respectively. There is consistent decline in parotid function even after conformal radiotherapy with moderate recovery over time. Dynamic quantitative pertechnate scintigraphy is a simple, reproducible, and minimally invasive test of major salivary gland function. The online version of this article (doi:10.1186/s13014-015-0371-2) contains supplementary material, which is available to authorized users
Parotid metastasis--an independent prognostic factor for head and neck cutaneous squamous cell carcinoma.

Science.gov (United States)

Ch'ng, S; Maitra, A; Lea, R; Brasch, H; Tan, S T

2006-01-01

Metastatic parotid cutaneous squamous cell carcinoma (SCC) is the most common parotid gland malignancy in New Zealand and Australia. The current AJCC TNM staging system does not account for the extent of nodal metastasis. A staging system that separates parotid (P stage) from neck disease (N stage) has been proposed recently. To review the outcome of patients with metastatic head and neck cutaneous SCC treated at our multidisciplinary Head and Neck Service using the proposed staging system. Consecutive patients were culled from our Head and Neck/Skull Base Database, 1990-2004. These patients were restaged according to the proposed staging system: P stage: P0 = no disease in the parotid (i.e., neck disease only); P1 = metastatic node P2=metastatic node > 3 cm and 6 cm, or disease involving the facial nerve or skull base. N stage: N0=no disease in the neck (i.e., parotid disease only); N1 = single ipsilateral metastatic node 3 cm, or contralateral neck involvement. Loco-regional recurrence and disease-specific survival were calculated using the Kaplan-Meier method and comparison of graphs made with the log-rank test. Multivariate analysis using the Cox regression model was carried out to assess the impact of various parameters. Sixty-seven patients with metastatic head and neck cutaneous SCC were identified. Thirty-seven patients had parotid metastasis (of whom 13 also had neck disease) while 21 had neck metastasis alone. Nine patients had dermal or soft tissue metastasis. These nine patients were excluded from this series, and data analysis was carried out on the remaining 58 (46 men, 12 women, mean age 71 years) patients. Sixty-seven percent of the patients underwent post-operative adjuvant radiotherapy. The five-year disease-specific survival rate was 54%. Among 56 patients followed up to disease recurrence or for a minimum period of 18 months, the loco-regional recurrence rate was 52%. The presence of parotid disease was an independent prognostic factor on
Effects of methotrexate on rat parotid and submandibular glands and their secretions

International Nuclear Information System (INIS)

McBride, R.K.

1986-01-01

Experimental animals were injected intraperitoneally with methotrexate for 3 days. Parotid and submandibular main ducts were cannulated and saliva flow was evoked by either intravenous infusion of acetylcholine or an intravenous injection of benthanechol. Methotrexate was found to reduce significantly mean food consumption, body weight, and parotid gland wet weights. Experimental animal salivary total gland DNA levels were not different, but total parotid gland RNA, protein, amylase and water content, and submandibular gland RNA were significantly lower compared to control. Acetylcholine, but not bethanechol, evoked parotid protein and amylase outputs and submandibular protein output from experimental animals were significantly higher than the control groups'. The increased outputs were apparently linked to β-adrenergic receptor activation, since hexamethonium or propranolol eliminated the significant increases while phenoxybenzamine did not. Plasma catecholamine levels were significantly higher in the methotrexate treated animals and probably played a role in the salivary gland β-adrenergic activation. Methotrexate treatment significantly increased the submandibular gland β-adrenergic receptor concentration as determined by [ 3 H]-dihydroalprenolol receptor binding assays. Muscarinic receptor concentrations determined with [ 3 H]-quinuclidninyl benzilate were not changed
SU-E-T-14: A Comparative Study Between Forward and Inverse Planning in Gamma Knife Radiosurgery for Acoustic Neuroma Tumours

Energy Technology Data Exchange (ETDEWEB)

Gopishankar, N; Agarwal, Priyanka; Bisht, Raj Kishor; Kale, S S; Rath, G K; Chander, S; Sharma, B S [All India Institute of Medical Sciences, New Delhi (India)

2015-06-15

Purpose: To evaluate forward and inverse planning methods for acoustic neuroma cases treated in Gamma Knife Perfexion. Methods: Five patients with acoustic neuroma tumour abutting brainstem were planned twice in LGP TPS (Version 10.1) using TMR10 algorithm. First plan was entirely based on forward planning (FP) in which each shot was chosen manually. Second plan was generated using inverse planning (IP) for which planning parameters like coverage, selectivity, gradient index (GI) and beam-on time threshold were set. Number of shots in IP was automatically selected by objective function using iterative process. In both planning methods MRI MPRAGE sequence images were used for tumour localization and planning. A planning dose of 12Gy at 50% isodose level was chosen. Results and Discussion: Number of shots used in FP was greater than IP and beam-on time in FP was in average 1.4 times more than IP. One advantage of FP was that the brainstem volume subjected to 6Gy dose (25% isodose) was less in FP than IP. Our results showed use of more number of shots as in FP results in GI less than or equal to 2.55 which is close to its lower limit. Dose homogeneity index (DHI) analysis of FP and IP showed average values of 0.59 and 0.67 respectively. General trend in GK for planning in acoustic neuroma cases is to use small collimator shots to avoid dose to adjacent critical structures. More number of shots and prolonged treatment time causes inconvenience to the patients. Similarly overuse of automatic shot shaping as in IP results in increased scatter dose. A compromise is required in shot selection for these cases. Conclusion: IP method could be used in acoustic neuroma cases to decrease treatment time provided the source sector openings near brainstem are shielded or adjusted appropriately to reduce brainstem dose.

MR imaging of the parotid gland following sialography

International Nuclear Information System (INIS)

Nakano, Y.; Nishimura, K.; Togashi, K.; Itoh, K.; Fujisawa, I.; Itoh, H.; Abe, M.; Torizuka, K.; Naito, Y.

1986-01-01

MR imaging was performed after sialography (using 76% Renografin) in eight patients with parotid tumor. MR imaging was performed at 1.5 T and using 16-cm-diameter surface coil and a pulse sequence of 600/25 msec. The ductal system and periductal interstitial space consistently appeared as a linear low-intensity band. MR images of two rabbits that had received parotid gland injections of 76% Renografin confirmed that the low-intensity signal arose from the edema fluid in the periductal interstitial space of the gland. Since the facial nerve follows a course immediately lateral to the major duct, an appreciation of the course of the facial nerve may allow more precise presurgical planning
Lymphoepithelial Carcinoma of Parotid Gland- A Case Report

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Sachin A. Badge

2014-07-01

Full Text Available Lymphoepithelial carcinoma (LEC is most commonly seen in the nasopharynx. Very rarely it is found in the salivary gland, preferably in parotid gland followed by submandibular gland where it accounts for 0.4% of all malignant salivary gland tumours. Most commonly it is seen in fifth decade with female predominance. Significant correlation has been reported between this tumour and the Epstein Barr virus (EBV.It has a racial predilection for Inuits,Chinese and Japanese. Very rarely it is found In Indians. So we present a case of LEC of parotid gland in a 23 year old male Indian patient. As this is a very radiosensitive tumour, surgery followed by radiotherapy remains the treatment of choice.
Acoustic neuromas: single dose vs fractionated therapy

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Fuss, M; Debus, J; Lohr, F; Engenhart-Cabillic, R; Wannenmacher, M

1997-07-01

Purpose: Radiosurgical treatment (RS) of acoustic neuromas is a well established treatment. However, few data are available concerning conformal fractionated radiotherapy (FT) of this tumor entity. We evaluated treatment outcome and toxicity for both treatment modalities in 41 patients treated at our institution between 1984 and 1997. Material and Methods: All treatments were performed using a specially adapted linear accelerator and circular collimators for convergent beam RS or multi-leaf collimators (leaf thickness 1 or 3mm) for multi-field RS or fractionated treatment. 22 patients (7 male, 15 female, median age 60 years, range 20-83 years) were treated radiosurgically with single doses between 7 and 28 Gray (median 15 Gy) prescribed to the 80% isodose line. Tumor volumes ranged from 0.7 to 10.5 ccm with a median volume of 3.4 ccm. The median number of isocenters was 2 (1-4 isocenters). One patient was treated by a multi-field technique (14 isocentric irregularly shaped noncoplanar fields). 19 patients (5 male, 14 female, median age 55 years, range 20-81 years) were treated with stereotactic conformal radiotherapy. Median dose was 60 Gray with a median daily fraction size of 2 Gy and a median of 3 (1-4) irregularly shaped isocentric fields. Tumor volumes ranged from 0.7 to 32.4 ccm (median 15 ccm). Median follow-up was 30 months (7-149 months) for radiosurgical and 30 months (2-88 months) for fractionated treatment. Seven patients who underwent fractionated treatment had previously undergone neurosurgical resection on the contralateral side. One had undergone radiosurgery on the opposite side before. Results: All tumors were locally controlled. A volume reduction of more than 20% was seen in 16% after RS and 18% following FT. Typical posttherapeutic central reduction of contrast media enhancement was found in 73% following RS after a median of 8 (3-12) months and in 63% following FT after a median of 6 (1-12) months. Temporary brainstem edema was diagnosed in 4
Carcinoma ex mixed tumor arising in the parotid gland

International Nuclear Information System (INIS)

Choi, Y. S.; Hwang, E. H.; Lee, S. R.

2000-01-01

Carcinoma ex mixed tumor is a mixed tumor in which a second neoplasm develops from the epithelial component that fulfills the criteria for malignancy. This tumor occurs frequently in the parotid glands. Individuals in whom carcinoma ex mixed tumor have a past history of benign mixed tumor. These lesions contain both a benign mixed tumor as well as a malignant neoplasm. We report a case of carcinoma ex mixed tumor which occurred in the parotid gland. A 67-year-old woman presented with movable right mass. She complained pain and facial paralysis. The clinical presentation, several diagnostic images, and histopathologic findings are presented.
Metastatic Parotid Myoepithelial Carcinoma in a 7-Year-Old Boy

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Issam Saliba

2012-01-01

Full Text Available Myoepithelial carcinoma is a rare malignancy of the parotid gland that is usually seen in adults. We report the first case in children of myoepithelial carcinoma of the parotid gland with massive invasion of the facial nerve and metastasis to cervical lymph nodes. Due to its rarity, the treatment and the clinical course of this tumor are not well defined yet. We performed a total parotidectomy, a modified neck dissection, and a postoperative radiotherapy in 7-year-old boy. Sparing of the facial nerve was impossible; it was sacrificed and grafted with a sural nerve. Histopathology confirmed the diagnosis of a parotid gland carcinoma and immunohistochemical markers showed that the tumor cells express cytokeratin, epithelial membrane antigen, cytokeratin 7, smooth muscle actin, P63, CEA, and S100. This pattern of immunostaining is consistent with the diagnosis of myoepithelial carcinoma. On the postoperative tenth month he presented with a pulmonary and lumbar vertebra metastasis.
Evaluation of ultrasound in the diagnosis of parotid gland masses

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Parotid gland

1999-08-01

Full Text Available In order to evaluate accuracy and usefulness of sonography and choose it as preliminary investigation method in pathologic processes of parotid gland, 50 patients were studied in duration of 16 months. The lesions were evaluated with ultrasound and sonographic images were obtained before surgery and then were compared with pathologic results after surgery. All lesions were detected with sonography. This method could differentiate intraglandular from extraglandular lesions with accuracy of 100%. Except one case of lipomatosis which was hyperechoic, all other lesions of parotid gland were hypoechoic. All lesions with sharp and well-defined borders were benign whereas malignant processes had ill-defined borders. The results obtained show that sonography is a reliable diagnostic method to differentiate benign from malignant lesions and it has a high diagnostic value to detect warthin's tumor, plemorphic adenoma, Sjogren's syndrome and lipomatosis. Presence of calcification in a parotid mass of young patient with high probabye is related to cavernous hemangioma.
Structural differences between alcoholic and diabetic parotid sialosis.

Science.gov (United States)

Carda, Carmen; Carranza, Miriam; Arriaga, Adriana; Díaz, Anselmo; Peydró, Amando; Gomez de Ferraris, Maria Elsa

2005-01-01

Between the sialosis' etiologic agents, we can find the chronic alcoholism and diabetes. Both nosologic entities are described using a similar histopathologic pattern. The purpose of this work has been analyzing and comparing the histopathological differences between the diabetic and alcoholic sialosis. We studied 7 parotid glands samples of diabetic patients and 4 samples of normal glands obtained from surgical material were used as a control. For the comparative study, we used 12 parotid glands from chronic alcoholic patients with clinical diagnosis of cirrhosis and 6 autopsies on individuals who had died from alcoholic hepatic cirrhosis. This material was fixed in formaline, processed for embedding in paraffin, standard coloration techniques and immunotechnique for cytokeratin EA/1 y EA/3. In the cases of diabetics, the parotid gland was characterised by the presence of small acini, a bigger number of lipid intracytoplasmic droplets in the acinar and ductal cells, as well as an abundant adipose infiltration in the stroma when compared to the alcoholics. We observed that the cytokeratins' expression was heterogeneous at the acinar level, and very positive in the hyperplasic ducts, compared to the alcoholic and control groups. These qualitative valorations indicate the differences between the histopathologic pattern of sialosis with different origins.
[Acute neonatal suppurative parotiditis: about three clinical cases and review of the literature].

Science.gov (United States)

Isfaoun, Zineb; Radouani, Mohammed Amine; Azzaoui, Sihame; Knouni, Houria; Aguenaou, Hassan; Barkat, Amina

2016-01-01

The following case study reports three cases of neonatal bacterial parotiditis observed over a period of seven months. Diagnosis is often based on patient's clinical features: they typically include hyperthermia, swelling, erythema, warmth as well as local tenderness and purulent discharge at Stensen duct during the massage of the parotid. The clinical diagnosis is confirmed by ultrasound and by culture of parotid purulent secretion. They are mainly of nosocomial origin and are generally caused by prematurity and dehydration. Early treatment improves patient outcome. Risk factors such as age should lead clinicians to start empiric antibiotic therapy first and then antibiotic therapy based on direct examination of pus extracted from Stensen duct. Staphylococcus aureus, Streptococcus Viridans and anaerobic germs are most commonly isolated. Acute parotiditis are extremely rare in the neonatal period: less than 50 cases have been reported in the literature. We here report three rather peculiar cases. The diagnosis was suspected on the basis of signs of local inflammation.
Can sparing of the superficial contralateral parotid lobe reduce xerostomia following radiotherapy for head and neck cancer?

Science.gov (United States)

Nevens, Daan; Nuyts, Sandra

2017-12-01

The purpose of this study is to see whether sparing the superficial contralateral parotid lobe can help limiting xerostomia following radiotherapy for head and neck cancer. 88 patients that were included in two prospective randomized studies were analysed in the current study. Using the dosimetry of both the parotid glands, we divided our patients in four groups. Group 1 includes patients where we were able to reduce the radiation dose below the threshold in order to spare both the ipsilateral and contralateral parotid glands, Group 2 consists of patients where only the contralateral parotid gland could be spared. Group 3 consists of patients where only the contralateral superficial parotid lobe could be spared, while in Group 4 not even the contralateral superficial lobe could be spared. When we compared Group 1 and Group 2, we did not observe a significant difference between both groups in terms of xerostomia scores at 6 or 12 months. When we compared these groups with Group 3, we observed significant differences with more xerostomia in Group 3 where only the contralateral superficial lobe was spared. A significant difference was also observed between Group 3 and Group 4 with more xerostomia in Group 4. Sparing of just one superficial parotid lobe results in less xerostomia when compared to not sparing any lobe of both parotid glands. Advances in knowledge: When sparing of the whole contralateral parotid gland is not possible, delineating both the superficial parotid glands and trying to spare at least one of them can mean a way forward in limiting xerostomia in head and neck cancer patients treated with radiotherapy.
Radiosurgery supported in the lineal accelerator for the acoustic neuroma treatment

International Nuclear Information System (INIS)

Santos Ortega, M.; Gutierrez Diaz, J.; Rodriguez Villaba, S.; Garcia Berrocal, I.; Samblas Garcia, J.; Bustos Perez de Salcedo, J.C.; Ortiz de Urbina, D.; Donckaster Clavero, G.; Delgado Rodriguez, J.M.; Sansivirini Valle, F.

1996-01-01

Radiosurgery becomes in a great interest technique in acoustic neuroma treatments. We present preliminary results over 74 neurinomas patients in our Unit. From August 1991 to August 1994, 74 consecutive patients with acoustic neuromas, median age 50 yrs. has been treated in our Unit. A SRS 200 radiosurgery system was employed using a 6 MV photon beam Linear Accelerator as radiation source. In every case treatment dose was lesser than 18 gy (14-16 Gy). Before treatment all patients were evaluated with MRI and neurological examination, acoustic test included. This screening was repeated each six months during the follow up. Tumoral control was defined both, as no changes or diminishing in tumoral size, observed in sequential MRI studies with gadolinium and comparable techniques. The median fallow up is 18 months. Tumor control is 88,5%. In 30 patients control means dismissing in tumoral size. In 10 patients tumoral progression was evident, in a half of their a neurofibromatosis type II was previously diagnosed. The neurological function during the follow up shown improve or estabilitation in symptoms, for 85% VII pair patients, 83% in VII pair patients, 86% in V pair patients and 83% in cerebellar disfunction patients. Although preliminaries, this dates showing the efficacy of radiosurgery in tumoral control of patients with neurinomas with doses laser than 18 Gy. This dose are safe with toxicities around 15%, mainly in transitory presentations. (Auhtor) 67 refs
The study of parotid function with radionuclide imaging after radiation therapy in nasopharyngeal cancer

International Nuclear Information System (INIS)

Li Huanbin; Zhang Qi; Wang Ling; Wu Shixiu; Xie Congying

2006-01-01

Objective: To study the uptake and excretion function of parotid by radionuclide imaging after simultaneous modulated accelerated radiation therapy (SMART) in nasopharyngeal cancer. Methods: Forty-eight nasopharyngeal cancer cases, 38 of them were treated by SMART with 2.5 Gy/fraction at tumor and enlarged lymph node to a total dose of 70 Gy, and 2.0 Gy/fraction at subclinical foci and prophy laxtic area volume to a total dose of 56 Gy in 38 d. The other 10 cases were treated by traditional radiation therapy (RT). After treatment, all patients performed parotid imaging and both uptake index (UI) and excretion index (EI) after acid stimulation were calculated. Clinical manifestation such as grade of mouth dryness was also analyzed. Results: Average UI and EI in SMART group decreased 21.9% and 37.3% respectively, with 12 cases moderate and severe mouth dryness, whereas in traditional RT group, mean UI and El decreased 56.1% and 96.1% respectively, with 9 cases moderate and severe mouth dryness. There was significant difference between them (P<0.05). Conclusion: Parotid imaging is sensitive for monitoring parotid function, and it is also reliable to evaluate the safety of SMART to parotid.. (authors)
Intraparotid facial nerve schwannoma: Report of two cases

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Seyyed Basir Hashemi

2008-07-01

Full Text Available Introduction: Intra parotid facial nerve schowannoma is a rare tumor. Case report: In this article we presented two cases of intra parotid facial nerve schowannoma. In two cases tumor presented with asymptomatic parotid mass that mimic pleomorphic adenoma. No preoperative facial nerve dysfunction in cases is detected. Diagnostic result and surgical management are discussed in this paper.
[Descending hypoglossal branch-facial nerve anastomosis in treating unilateral facial palsy after acoustic neuroma resection].

Science.gov (United States)

Liang, Jiantao; Li, Mingchu; Chen, Ge; Guo, Hongchuan; Zhang, Qiuhang; Bao, Yuhai

2015-12-15

To evaluate the efficiency of the descending hypoglossal branch-facial nerve anastomosis for the severe facial palsy after acoustic neuroma resection. The clinical data of 14 patients (6 males, 8 females, average age 45. 6 years old) underwent descending hypoglossal branch-facial nerve anastomosis for treatment of unilateral facial palsy was analyzed retrospectively. All patients previously had undergone resection of a large acoustic neuroma. House-Brackmann (H-B) grading system was used to evaluate the pre-, post-operative and follow up facial nerve function status. 12 cases (85.7%) had long follow up, with an average follow-up period of 24. 6 months. 6 patients had good outcome (H-B 2 - 3 grade); 5 patients had fair outcome (H-B 3 - 4 grade) and 1 patient had poor outcome (H-B 5 grade) Only 1 patient suffered hemitongue myoparalysis owing to the operation. Descending hypoglossal branch-facial nerve anastomosis is effective for facial reanimation, and it has little impact on the function of chewing, swallowing and pronunciation of the patients compared with the traditional hypoglossal-facial nerve anastomosis.
Fractionated stereotactic radiation therapy and single high-dose radiosurgery for acoustic neuroma: early results of a prospective clinical study

International Nuclear Information System (INIS)

Meijer, O.W.M.; Wolbers, J.G.; Baayen, J.C.; Slotman, B.J.

2000-01-01

Purpose: To prospectively assess the local control and toxicity rate in acoustic neuroma patients treated with linear accelerator-based radiosurgery and fractionated stereotactic radiation therapy. Methods and Materials: We evaluated 37 consecutive patients treated with stereotactic radiation therapy for acoustic neuroma. All patients had progressive tumors, progressive symptoms, or both. Mean tumor diameter was 2.3 cm (range 0.8-3.3) on magnetic resonance (MR) scan. Dentate patients were given a dose of 5 x 4 Gy or 5 x 5 Gy and edentate patients were given a dose of 1 x 10 Gy or 1 x 12.50 Gy prescribed to the 80% isodose. All patients were treated with a single isocenter. Results: With a mean follow-up period of 25 months (range 12-61), the actuarial local control rate at 5 years was 91% (only 1 patient failed). The actuarial rate of hearing preservation at 5 years was 66% in previously-hearing patients. The actuarial rate of freedom from trigeminal nerve toxicity was 97% at 5 years. No patient developed facial nerve toxicity or other complications. Conclusion: In this unselected series, fractionated stereotactic radiation therapy and linear accelerator-based radiosurgery give excellent local control in acoustic neuroma. It combines a high rate of preservation of hearing with a very low rate of other toxicity, although follow-up is relatively short
Effect of Cisplatin on Parotid Gland Function in Concomitant Radiochemotherapy

International Nuclear Information System (INIS)

Hey, Jeremias; Setz, Juergen; Gerlach, Reinhard; Vordermark, Dirk; Gernhardt, Christian R.; Kuhnt, Thomas

2009-01-01

Purpose: To determine the influence of concomitant radiochemotherapy with cisplatin on parotid gland tissue complication probability. Methods and Materials: Patients treated with either radiotherapy (n = 61) or concomitant radiochemotherapy with cisplatin (n = 36) for head-and-neck cancer were prospectively evaluated. The dose and volume distributions of the parotid glands were noted in dose-volume histograms. Stimulated salivary flow rates were measured before, during the 2nd and 6th weeks and at 4 weeks and 6 months after the treatment. The data were fit using the normal tissue complication probability model of Lyman. Complication was defined as a reduction of the salivary flow rate to less than 25% of the pretreatment flow rate. Results: The normal tissue complication probability model parameter TD 50 (the dose leading to a complication probability of 50%) was found to be 32.2 Gy at 4 weeks and 32.1 Gy at 6 months for concomitant radiochemotherapy and 41.1 Gy at 4 weeks and 39.6 Gy at 6 months for radiotherapy. The tolerated dose for concomitant radiochemotherapy was at least 7 to 8 Gy lower than for radiotherapy alone at TD 50 . Conclusions: In this study, the concomitant radiochemotherapy tended to cause a higher probability of parotid gland tissue damage. Advanced radiotherapy planning approaches such as intensity-modulated radiotherapy may be partiticularly important for parotid sparing in radiochemotherapy because of cisplatin-related increased radiosensitivity of glands.
Effects of methotrexate on rat parotid and submandibular glands and their secretions

Energy Technology Data Exchange (ETDEWEB)

McBride, R.K.

1986-01-01

Experimental animals were injected intraperitoneally with methotrexate for 3 days. Parotid and submandibular main ducts were cannulated and saliva flow was evoked by either intravenous infusion of acetylcholine or an intravenous injection of benthanechol. Methotrexate was found to reduce significantly mean food consumption, body weight, and parotid gland wet weights. Experimental animal salivary total gland DNA levels were not different, but total parotid gland RNA, protein, amylase and water content, and submandibular gland RNA were significantly lower compared to control. Acetylcholine, but not bethanechol, evoked parotid protein and amylase outputs and submandibular protein output from experimental animals were significantly higher than the control groups'. The increased outputs were apparently linked to ..beta..-adrenergic receptor activation, since hexamethonium or propranolol eliminated the significant increases while phenoxybenzamine did not. Plasma catecholamine levels were significantly higher in the methotrexate treated animals and probably played a role in the salivary gland ..beta..-adrenergic activation. Methotrexate treatment significantly increased the submandibular gland ..beta..-adrenergic receptor concentration as determined by (/sup 3/H)-dihydroalprenolol receptor binding assays. Muscarinic receptor concentrations determined with (/sup 3/H)-quinuclidninyl benzilate were not changed.
Primary hydatid disease of the infratemporal fossa and the parotid gland

International Nuclear Information System (INIS)

Kalovidouris, A.; Gouliamos, A.; Andreou, I.; Levett, J.; Vlahos, I.; Papavasiliou, C.; Ioannovits, I.

1985-01-01

Hydatid disease should be considered in the differential diagnosis of lesions causing swelling of the parotid area or exophthalmos in patients originating from countries where the incidence of the disease is high. An unusual case of hydatid disease located in the infratemporal fossa and the anterior parotid region is presented. Computed Tomography is a valuable tool for establishment of the diagnosis, before any surgical approach to the lesion is initiated and for postoperative follow-up and evaluation. (orig.) [de
Primary hydatid disease of the infratemporal fossa and the parotid gland

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Kalovidouris, A.; Gouliamos, A.; Andreou, I.; Levett, J.; Vlahos, I.; Papavasiliou, C.; Ioannovits, I.

1985-05-01

Hydatid disease should be considered in the differential diagnosis of lesions causing swelling of the parotid area or exophthalmos in patients originating from countries where the incidence of the disease is high. An unusual case of hydatid disease located in the infratemporal fossa and the anterior parotid region is presented. Computed Tomography is a valuable tool for establishment of the diagnosis, before any surgical approach to the lesion is initiated and for postoperative follow-up and evaluation.
Cell phone use is associated with an inflammatory cytokine profile of parotid gland saliva.

Science.gov (United States)

Siqueira, Elisa Carvalho; de Souza, Fabrício Tinôco Alvim; Ferreira, Efigênia; Souza, Renan Pedra; Macedo, Samuel Costa; Friedman, Eitan; Gomez, Marcus Vinícius; Gomes, Carolina Cavaliéri; Gomez, Ricardo Santiago

2016-10-01

There is controversy on the effects of the non-ionizing radiation emitted by cell phones on cellular processes and the impact of such radiation exposure on health. The purpose of this study was to investigate whether cell phone use alters cytokine expression in the saliva produced by the parotid glands. Cytokine expression profile was determined by enzyme linked immuno sorbent assay (ELISA) in the saliva produced by the parotid glands in healthy volunteers, and correlated with self-reported cell phone use and laterality. The following parameters were determined, in 83 Brazilian individuals in saliva produced by the parotid glands comparing the saliva from the gland exposed to cell phone radiation (ipsilateral) to that from the contralateral parotid: salivary flow, total protein concentration, interleukin 1 β (IL-1 β), interleukin 6 (IL-6), interleukin 10 (IL-10), interferon γ (IFN-γ), and tumor necrosis factor α (TNF-α) salivary levels by ELISA. After multiple testing correction, decreased IL-10 and increased IL-1β salivary levels in the ipsilateral side compared with the contralateral side (P cell phones for more than 10 years presented higher differences between IL-10 levels in ipsilateral versus contralateral parotids (P = 0.0012). No difference was observed in any of the tested parameters in correlation with cell phone monthly usage in minutes. The exposure of parotid glands to cell phones can alter salivary IL-10 and IL-1β levels, consistent with a pro-inflammatory microenvironment that may be related to heat production. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Xerostomia after radiotherapy. What matters - mean total dose or dose to each parotid gland?

International Nuclear Information System (INIS)

Tribius, S.; Sommer, J.; Prosch, C.; Bajrovic, A.; Kruell, A.; Petersen, C.; Muenscher, A.; Blessmann, M.; Todorovic, M.; Tennstedt, P.

2013-01-01

Purpose: Xerostomia is a debilitating side effect of radiotherapy in patients with head and neck cancer. We undertook a prospective study of the effect on xerostomia and outcomes of sparing one or both parotid glands during radiotherapy for patients with squamous cell carcinoma of the head and neck. Methods and materials: Patients with locally advanced squamous cell carcinoma of the head and neck received definitive (70 Gy in 2 Gy fractions) or adjuvant (60-66 Gy in 2 Gy fractions) curative-intent radiotherapy using helical tomotherapy with concurrent chemotherapy if appropriate. Group A received < 26 Gy to the left and right parotids and group B received < 26 Gy to either parotid. Results: The study included 126 patients; 114 (55 in group A and 59 in group B) had follow-up data. There were no statistically significant differences between groups in disease stage. Xerostomia was significantly reduced in group A vs. group B (p = 0.0381). Patients in group A also had significantly less dysphagia. Relapse-free and overall survival were not compromised in group A: 2-year relapse-free survival was 86% vs. 72% in group B (p = 0.361); 2-year overall survival was 88% and 76%, respectively (p = 0.251). Conclusion: This analysis suggests that reducing radiotherapy doses to both parotid glands to < 26 Gy can reduce xerostomia and dysphagia significantly without compromising survival. Sparing both parotids while maintaining target volume coverage and clinical outcome should be the treatment goal and reporting radiotherapy doses delivered to the individual parotids should be standard practice. (orig.)

Xerostomia after radiotherapy. What matters - mean total dose or dose to each parotid gland?

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Tribius, S.; Sommer, J.; Prosch, C.; Bajrovic, A.; Kruell, A.; Petersen, C. [University Medical Center Hamburg-Eppendorf, Hamburg (Germany). Dept. of Radiation Oncology; Muenscher, A. [University Medical Center Hamburg-Eppendorf, Hamburg (Germany). Dept. of Otorhinolaryngology and Head and Neck Surgery; Blessmann, M. [University Medical Center Hamburg-Eppendorf, Hamburg (Germany). Dept. of Oral and Maxillofacial Surgery; Todorovic, M. [University Medical Center Hamburg-Eppendorf, Hamburg (Germany). Dept. of Medical Physics; Tennstedt, P. [University Medical Center Hamburg-Eppendorf, Hamburg (Germany). Martini-Clinic, Prostate Cancer Center

2013-03-15

Purpose: Xerostomia is a debilitating side effect of radiotherapy in patients with head and neck cancer. We undertook a prospective study of the effect on xerostomia and outcomes of sparing one or both parotid glands during radiotherapy for patients with squamous cell carcinoma of the head and neck. Methods and materials: Patients with locally advanced squamous cell carcinoma of the head and neck received definitive (70 Gy in 2 Gy fractions) or adjuvant (60-66 Gy in 2 Gy fractions) curative-intent radiotherapy using helical tomotherapy with concurrent chemotherapy if appropriate. Group A received < 26 Gy to the left and right parotids and group B received < 26 Gy to either parotid. Results: The study included 126 patients; 114 (55 in group A and 59 in group B) had follow-up data. There were no statistically significant differences between groups in disease stage. Xerostomia was significantly reduced in group A vs. group B (p = 0.0381). Patients in group A also had significantly less dysphagia. Relapse-free and overall survival were not compromised in group A: 2-year relapse-free survival was 86% vs. 72% in group B (p = 0.361); 2-year overall survival was 88% and 76%, respectively (p = 0.251). Conclusion: This analysis suggests that reducing radiotherapy doses to both parotid glands to < 26 Gy can reduce xerostomia and dysphagia significantly without compromising survival. Sparing both parotids while maintaining target volume coverage and clinical outcome should be the treatment goal and reporting radiotherapy doses delivered to the individual parotids should be standard practice. (orig.)
Parotid gland mean dose as a xerostomia predictor in low-dose domains.

Science.gov (United States)

Gabryś, Hubert Szymon; Buettner, Florian; Sterzing, Florian; Hauswald, Henrik; Bangert, Mark

2017-09-01

Xerostomia is a common side effect of radiotherapy resulting from excessive irradiation of salivary glands. Typically, xerostomia is modeled by the mean dose-response characteristic of parotid glands and prevented by mean dose constraints to either contralateral or both parotid glands. The aim of this study was to investigate whether normal tissue complication probability (NTCP) models based on the mean radiation dose to parotid glands are suitable for the prediction of xerostomia in a highly conformal low-dose regime of modern intensity-modulated radiotherapy (IMRT) techniques. We present a retrospective analysis of 153 head and neck cancer patients treated with radiotherapy. The Lyman Kutcher Burman (LKB) model was used to evaluate predictive power of the parotid gland mean dose with respect to xerostomia at 6 and 12 months after the treatment. The predictive performance of the model was evaluated by receiver operating characteristic (ROC) curves and precision-recall (PR) curves. Average mean doses to ipsilateral and contralateral parotid glands were 25.4 Gy and 18.7 Gy, respectively. QUANTEC constraints were met in 74% of patients. Mild to severe (G1+) xerostomia prevalence at both 6 and 12 months was 67%. Moderate to severe (G2+) xerostomia prevalence at 6 and 12 months was 20% and 15%, respectively. G1 + xerostomia was predicted reasonably well with area under the ROC curve ranging from 0.69 to 0.76. The LKB model failed to provide reliable G2 + xerostomia predictions at both time points. Reduction of the mean dose to parotid glands below QUANTEC guidelines resulted in low G2 + xerostomia rates. In this dose domain, the mean dose models predicted G1 + xerostomia fairly well, however, failed to recognize patients at risk of G2 + xerostomia. There is a need for the development of more flexible models able to capture complexity of dose response in this dose regime.
Quantitative dose-volume response analysis of changes in parotid gland function after radiotherapy in the head-and-neck region

International Nuclear Information System (INIS)

Roesink, Judith M.; Moerland, Marinus A.; Battermann, Jan J.; Hordijk, Gerrit Jan; Terhaard, Chris H.J.

2001-01-01

Purpose: To study the radiation tolerance of the parotid glands as a function of dose and volume irradiated. Methods and Materials: One hundred eight patients treated with primary or postoperative radiotherapy for various malignancies in the head-and-neck region were prospectively evaluated. Stimulated parotid flow rate was measured before radiotherapy and 6 weeks, 6 months, and 1 year after radiotherapy. Parotid gland dose-volume histograms were derived from CT-based treatment planning. The normal tissue complication probability model proposed by Lyman was fit to the data. A complication was defined as stimulated parotid flow rate 50 (the dose to the whole organ leading to a complication probability of 50%) was found to be 31, 35, and 39 Gy at 6 weeks, 6 months, and 1 year postradiotherapy, respectively. The volume dependency parameter n was around 1, which means that the mean parotid dose correlates best with the observed complications. There was no steep dose-response curve (m=0.45 at 1 year postradiotherapy). Conclusions: This study on dose/volume/parotid gland function relationships revealed a linear correlation between postradiotherapy flow ratio and parotid gland dose and a strong volume dependency. No threshold dose was found. Recovery of parotid gland function was shown at 6 months and 1 year after radiotherapy. In radiation planning, attempts should be made to achieve a mean parotid gland dose at least below 39 Gy (leading to a complication probability of 50%)
Paraganglioma with unusual presentation in parotid gland: A diagnostic dilemma in fine needle aspiration

Directory of Open Access Journals (Sweden)

Anagh A Vora

2012-01-01

Full Text Available Paragangliomas (PGLs are uncommon tumors. Although PGLs are known to occur in the head and neck region, especially the carotid body, middle ear, and larynx, involvement of the parotid glands has not been reported. In this article, we report the fine needle aspiration features of tumor in an unusual location, presenting as a parotid gland mass, submitted to pathology for initial diagnosis. The clinical presentation, cytomorphology, and the immunohistochemical features for the diagnosis are described. To our knowledge, this is the first case of paraganglioma of the parotid gland reported in the literature.
A type II first branchial cleft cyst masquerading as an infected parotid Warthin's tumor.

Science.gov (United States)

Chen, Meng-Feng; Ueng, Shir-Hwa; Jung, Shih-Ming; Chen, Yao-Liang; Chang, Kai-Ping

2006-01-01

The diagnosis of a parotid mass usually depends on thorough history taking and physical examination. Diagnostic modalities, including ultrasonographic examinations, computed tomography and magnetic resonance images, may also provide substantial information but their accuracy for diagnosis is sometimes questionable, especially in differentiating some rare neoplasms. First branchial cleft cysts (FBCCs) are rare causes of parotid swelling and comprise less than 1% of all branchial anomalies. They are frequently misdiagnosed due to their rarity and unfamiliar clinical signs and symptoms. We present a case of type II FBCC masquerading as an infected parotid Warthin's tumor. We also review the clinical signs and symptoms of FBCCs in order to remind clinicians that this rare branchial anomaly can mimic an infected Warthin's tumor and may be seated in the deep lobe of the parotid gland. By making an accurate pre-operative diagnosis of type II FBCC, we can minimize surgical morbidity and avoid incomplete resection and possible recurrence.
Iodine-131 therapy for parotid oncocytoma

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Kosuda, S.; Ishikawa, M.; Tamura, K.; Mukai, M.; Kubo, A.; Hashimoto, S.

1988-06-01

We present a rare case of a patient with coexisting parotid oncocytoma and chronic thyroiditis who received two therapeutic doses of (/sup 131/I)iodide for a recurrent oncocytoma (oxyphilic granular cell adenoma), resulting in a definite reduction in tumor volume. We suggest that radioiodine therapy for a recurrent oncocytoma is an effective form of tumor therapy.
Quantitative gammagraphie and sialometry of the parotid in patients irradiated in the cervico-facial area

International Nuclear Information System (INIS)

Gaztelu, R.; Rodriguez, R.; Fernandez Garcia, M.C.; Cobo Plana, J.

1988-01-01

Changes in parotid function in patients presenting with tumors of the cervico-facial area, in whom the whole of the parotid gland was within the irradiation field were assesse by means of saliva secretion determinations and quantitative gammagrams of the parotid. The following aims were pursued: a) To evaluate and to compare the sensitivity of both methods. b) To compare the radiotracer agent uptake in normal parotid glands, as well as the variations that occur in relation to the number of received, and with the time duration of irradiation. The conclusions were as follows: -Both methods are sensitive, but the gammagraphic method has the advantages of being non-invasive, easily performed and not causing discomfort to the patient. -The quantification of the parotied uptake in a control group of patients, as compared with the variations occuring in relation to the number of rads racived, show that at the end of the treatment with 5.000 rads, uptake reaches 15% of that of the control group. One year later, function is very little restored, not reaching 20% of that of the control group. -Decrease of both parotid secretion and uptake is directly proportional to the dose received. (Author)
Induction of parotitis by fine-needle aspiration in parotid Warthin's tumor.

Science.gov (United States)

Suzuki, Kensuke; Iwai, Hiroshi; Kaneko, Toshihiko; Sakaguchi, Mariko; Hoshino, Shoichi; Inaba, Muneo

2009-08-01

To estimate parotitis caused by fine-needle aspiration (FNA) in parotid Warthin tumor. Case series with chart review. Hospital records were reviewed for 104 parotid tumors (103 patients) including 35 Warthin tumors, which underwent FNA within our department. Three patients with four Warthin tumors among them noticed parotid pain, swelling, and abscess formation as a consequence of acute parotitis after FNA. Examinations of the materials obtained from tumor puncture or drainage before the start of antibiotic therapy showed no bacterial association in any patient. Two of the patients with Warthin tumor underwent parotidectomy, and the surgical specimens indicated histopathological changes with necrosis, abscess, granuloma, and the infiltration of inflammatory cells including Langhans-type multinucleated giant cells. It is conceivable that Warthin tumor bears the characteristics of inflammation induced by the FNA procedure without any relation to infection. Therefore, it may be better to avoid routine FNA and give priority to diagnostic imagings over FNA in the diagnosis of tumors strongly suspected as Warthin tumor.
Vestibular Schwannoma or acoustic neuroma

Directory of Open Access Journals (Sweden)

Hekmatara M

1997-04-01

Full Text Available Vestibular schwannoma is the most common tumor of the posterior fossa of the skull. Patients referred with the primary otologic symptoms such as hearing loss, tinnitus, vertigo, imbalance, and the cranial nerve palsy. Thirty-three patients were operated and treated by a team of otolaryngologist and neurosurgeon, anudiometrist, and internist. Patients'chiefcomplaint was due to 94% hearing loss and 27% tinnitus. They scarcely complain of vertigo. If a patient refers with the palsy or paralysis of facial nerve preoperation, we must think of the facial nerve schwannoma or hemangioma or congential cholestoma or malignant metastases rather than acoustic neuroma. The best way for preoperative diagnosis is audiometry, ABR (Auditory Brain Response, and SDS (speech discrimination score with 90% success, but computer Tomography (CT scan and MRI (Magnetic Resonance Image are the valuable anatomic diagnostic radiographic devices. The best method of operation is translabirynthine approach (TLA, since it has the advantages such as an easy access to nerve paths and being the nearest path to CPA (Cerebellopontine Angle. Physicians ought to talk to patients about the importance of the microscopic surgery, surgical methods, and their probable diverse effects such as hearing loss, facial nerve palsy, and intracranial problems.
Parotid radiosensitivity changes: a temporal relation to glandular circadian rhythms

International Nuclear Information System (INIS)

El-Mofty, S.K.; Hovenga, T.L.; Russell, J.E.; Simmons, D.J.

1982-01-01

The radiosensitivity of the rat parotid gland to X-radiation increased considerably towards the end of the daily light span (0800-2000 hours) and to a lesser extent before the onset of that period. The major sensitivity peak occurred at 1600 hours and coincides with a diurnal nadir in the rates of protein and RNA synthesis. The minor peak occurred at 0400 hours and was temporally related to a daily period of maximal secretory activity. It is suggested that suboptimal repair and secretion-linked cellular perturbations might contribute to the pathogenesis of the circadian increases in radiosensitivity of parotid cells. (author)
MR of acoustic neuromas; Relationship to cranial nerves

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Suzuki, Masayuki; Takashima, Tsutomu; Kadoya, Masumi; Takahashi, Shiroh; Miyayama, Shiroh; Taira, Sakae; Kashihara, Kengo; Yamashima, Tetsumori; Itoh, Haruhide [Kanazawa Univ. (Japan). School of Medicine

1989-08-01

In this report, the relationship of acoustic neuromas to the adjacent cranial nerves is discussed. On T{sub 1}-weighted images, the trigeminal nerve was detected in all 13 cases. Mild to marked compression of these nerves by the tumors was observed in eight cases. The extent of compression did not always correspond to the clinical symptoms. In four cases with a maximum tumor diameter of 2 cm or less, the 7th and 8th cranial nerves were identified. There was no facial palsy in these patients. Two patients with a tumor diameter of more than 2 cm also had no facial palsy. All patients, including those with small tumors, complained of hearing loss and/or tinnitus. While MR imaging has some limitations, it is an effective imaging modality for showing the relationship between tumors and nerves. (author).
Prognostic factors for hearing preservation following observation-only versus stereotactic irradiation (STI) in patients with acoustic neuroma

International Nuclear Information System (INIS)

Sakamoto, Tooru

1998-01-01

Prognostic factors for hearing preservation following observation-only versus STI were compared in patients with acoustic neuroma. There were 48 patients with acoustic neuroma treated by fractionated STI. Between 1991 and 1997, patients were given 36 Gy in 20 fractions over 5 weeks (36 Gy/20 Fr/5 wks) to 44 Gy/22 Fr/6 wks followed by a 4 Gy boost. A linear accelerator was used for irradiation. Twenty-three patients with acoustic neuroma who were followed without any treatment (observation-only group) were selected as matched controls. The largest hearing loss was observed at the frequency of 2 kHz in the observation-only group and at 1-2 kHz in the STI group. Hearing loss at lkHz was more frequent in the STI group (p<0.01). There were no significant prognostic factors which predicted hearing preservation in the observation-only group. Stereotactic irradiation has been suggested to damage to cochlear nerve function in patients whose cochlear nerve had been impaired already. Tumor control rate of STI appeared to be as good as single fraction radiosurgery rates in the literature and better than in the observation-only group. Hearing preservation rate in the STI group was as good as in the observation-only group and appeared to be better than single fraction radiosurgery. In conclusion, because there were no factors predictive of hearing preservation in the observation-only group, it is difficult to select patients for observation only. Fractionated STI is potentially the treatment of choice, resulting in the same hearing preservation rate as achieved with observation only, although longer follow-up periods are needed. (author)
Parotid gland sparing effect by computed tomography-based modified lower field margin in whole brain radiotherapy

International Nuclear Information System (INIS)

Cho, Oyeon; Chun, Mi Son; Oh, Young Taek; Kim, Mi Hwa; Park, Hae Jin; Nam, Sang Soo; Heo, Jae Sung; Noh, O Kyu; Park, Sung Ho

2013-01-01

Parotid gland can be considered as a risk organ in whole brain radiotherapy (WBRT). The purpose of this study is to evaluate the parotid gland sparing effect of computed tomography (CT)-based WBRT compared to 2-dimensional plan with conventional field margin. From January 2008 to April 2011, 53 patients underwent WBRT using CT-based simulation. Bilateral two-field arrangement was used and the prescribed dose was 30 Gy in 10 fractions. We compared the parotid dose between 2 radiotherapy plans using different lower field margins: conventional field to the lower level of the atlas (CF) and modified field fitted to the brain tissue (MF). Averages of mean parotid dose of the 2 protocols with CF and MF were 17.4 Gy and 8.7 Gy, respectively (p 98% of prescribed dose were 99.7% for CF and 99.5% for MF. Compared to WBRT with CF, CT-based lower field margin modification is a simple and effective technique for sparing the parotid gland, while providing similar dose coverage of the whole brain.
Functional imaging of parotid glands: Diffusion-weighted echo-planar MRI before and after stimulation

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Habermann, C.R.; Cramer, M.C.; Gossrau, P.; Adam, G. [University Hospital Hamburg-Eppendorf (Germany). Department of Diagnostic and Interventional Radiology; Graessner, J. [Siemens AG, Hamburg (Germany). Medical Solutions; Reitmeier, F.; Jaehne, M. [University Hospital Hamburg-Eppendorf (Germany). Department of Oto-, Rhino-, Laryngology; Fiehler, J. [University Hospital Hamburg-Eppendorf (Germany). Department of Neuroradiology; Schoder, V. [University Hospital Hamburg-Eppendorf (Germany). Institute for Medical Biometry and Epidemiology

2004-10-01

Purpose: To investigate the feasibility of diffusion-weighted (DW) echo-planar imaging (EPI) for measuring different functional conditions of the parotid gland and to compare different measurement approaches. Materials and Methods: Parotid glands of 27 healthy volunteers were examined with a DW EPI sequence (TR 1,500 msec, TE 77 msec, field-of-view 250 x 250 mm, pixel size 2.10 x 1.95 mm, section thickness 5 mm) before and after oral stimulation with commercially available lemon juice. The b factors used were 0, 500, and 1,000 sec/mm{sup 2}. Apparent diffusion coefficient (ADC) maps were digitally transferred to MRIcro (Chris Rorden, University of Nottingham, Great Britain) and evaluated with a manually placed circular region of interest (ROI) containing 100-200 pixel. Additional ROIs including the entire parotid gland were placed on either side. The results of both measurements were compared, using the Student's t test based on the median ADC values for each person. A two-tailed p-value of less than.05 was determined to indicate statistical significance. To compare both measurement approaches, the Pearson's correlation coefficient (r) was calculated. Results: Diffusion-weighted echo-planar MR imaging successfully visualized the parotid gland of all volunteers. In a first step, the median ADC value per person was computed. Using ROIs of 100-200 pixels, the mean was calculated to be 1.08 x 10{sup -3} mm{sup 2}/sec{+-}0.12 x 10{sup -3} mm{sup 2}/sec for both parotid glands prior to simulation. After stimulation, the mean ADC was measured at 1.15 x 10{sup -3} mm{sup 2}/sec{+-}0.11 x 10{sup -3} mm{sup 2}/sec for both parotid glands. Evaluating the entire parotid gland, the ADC was 1.12 x 10{sup -3} mm{sup 2}/sec{+-}0.08 x 10{sup -3} mm{sup 2}/sec prior to simulation, whereas the ADC increased to 1.18 x 10{sup -3} mm{sup 2}/sec{+-}0.09 x 10{sup -3} mm{sup 2}/sec after simulation with lemon juice. For both types of measurements, the increase in ADC after
Adenocarcinoma of the parotid gland with calcification

Energy Technology Data Exchange (ETDEWEB)

Song, Haeng Eun; Koh, Kwang Joon [School of Dentistry, Chonbuk National University, Chonju (Korea, Republic of)

2002-03-15

A 78-year-old woman was referred to Chonbuk National University Dental Hospital complaining of facial palsy and palpable mass on the right parotid gland area. Clinical examination showed non-specific findings of the intraoral region, but showed asymmetrical facial appearance. Panoramic view showed a large amorphous calcified mass on the posterior to the mandibular ramus and thin cortical plate of the posterior ramus. Sialogram showed constriction of the main duct and no further filling of striated, intercalated ducts and parenchymal areas. CT scans demonstrated an irregular, infiltrating mass with slight enhancement in the right parotid gland. The mass showed necrotic areas and calcifications. Bone scan showed marked accumulation of {sup 99m}Tc-MDP on the right posterior maxilla. Microscopic findings demonstrated the minimal morphologic alterations and rare mitotic figures within tumor cells, and diagnosed as adenocarcinoma (NOS, Grade II). This report could be aid in the diagnosis of calcified lesions of the salivary gland.
Adenocarcinoma of the parotid gland with calcification

International Nuclear Information System (INIS)

Song, Haeng Eun; Koh, Kwang Joon

2002-01-01

A 78-year-old woman was referred to Chonbuk National University Dental Hospital complaining of facial palsy and palpable mass on the right parotid gland area. Clinical examination showed non-specific findings of the intraoral region, but showed asymmetrical facial appearance. Panoramic view showed a large amorphous calcified mass on the posterior to the mandibular ramus and thin cortical plate of the posterior ramus. Sialogram showed constriction of the main duct and no further filling of striated, intercalated ducts and parenchymal areas. CT scans demonstrated an irregular, infiltrating mass with slight enhancement in the right parotid gland. The mass showed necrotic areas and calcifications. Bone scan showed marked accumulation of 99m Tc-MDP on the right posterior maxilla. Microscopic findings demonstrated the minimal morphologic alterations and rare mitotic figures within tumor cells, and diagnosed as adenocarcinoma (NOS, Grade II). This report could be aid in the diagnosis of calcified lesions of the salivary gland.
Primary clear cell carcinoma of parotid gland: Case report and review of literature.

Science.gov (United States)

Rodríguez, Marta Saldaña; Reija, Maria Fe García; Rodilla, Irene González

2013-01-01

Clear cell carcinoma (CCC) is a rare low-grade carcinoma that represents only 1% to 2% of all salivary glands tumors. The finding of a clear cell tumor in a parotid gland involves the necessity of differential diagnosis between primary clear cell parotid tumors and metastases, mainly from kidney. The biological behavior is not very aggressive and development, which is very slow, is usually asymptomatic and indeed, the tumor often reaches considerable dimensions before being diagnosed. The treatment of choice is the surgical excision. There are rare cases of local recurrence and distant metastases. The aim of this article is to report a primary CCC in the parotid gland that microscopically closely resembled a metastatic CCC of renal origin, making microscopic differentiation difficult.
Perfusion characteristics of late radiation injury of parotid glands: quantitative evaluation with dynamic contrast-enhanced MRI

International Nuclear Information System (INIS)

Juan, Chun-Jung; Chen, Cheng-Yu.; Hsueh, Chun-Jen; Huang, Guo-Shu; Jen, Yee-Min; Liu, Hua-Shan; Wang, Chao-Ying; Chung, Hsiao-Wen; Liu, Yi-Jui; Chou, Yu-Ching; Chai, Yao-Te

2009-01-01

We aimed to quantitatively investigate the alteration of parotid perfusion after irradiation using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) based on a two-compartment tracer kinetic model. This study enrolled 19 patients (53.2±14.9 years) treated by head and neck radiotherapy and 19 age-relevant and sex-matched subjects as a control group. Perfusion parameters (K el , k 21 and A) of parotid glands were analyzed based on the Brix model from T1-weighted DCE-MRI. Suitability of the Brix model was evaluated via Monte Carlo simulation for the goodness-of-fit. Analysis of nonlinear goodness-of-fit showed that the Brix model is appropriate in evaluating the parotid perfusion (R 2 = 0.938±0.050). The irradiated parotid glands showed significantly lower K el (P 21 (P < 0.05) and consequently significantly higher value of peak enhancement (P<0.0005) and time-to-peak (P<0.0005) compared with non-irradiated ones, suggestive of gradual and prolonged accumulation and delayed wash-out of contrast agent due to increased extracellular extravascular space and decreased vascular permeability in the irradiated glands. Linear regression analysis showed dose-dependent perfusion changes of the irradiated parotid glands. We conclude that quantitative DCE-MRI is a potential tool in investigating parotid gland perfusion changes after radiotherapy. (orig.)
Density variation of parotid glands during IMRT for head–neck cancer: Correlation with treatment and anatomical parameters

International Nuclear Information System (INIS)

Fiorino, Claudio; Rizzo, Giovanna; Scalco, Elisa; Broggi, Sara; Belli, Maria Luisa; Dell’Oca, Italo; Dinapoli, Nicola; Ricchetti, Francesco; Rodriguez, Aldo Mejia; Di Muzio, Nadia; Calandrino, Riccardo; Sanguineti, Giuseppe; Valentini, Vincenzo; Cattaneo, Giovanni Mauro

2012-01-01

Purpose: Measuring parotid density changes in patients treated with IMRT for head–neck cancer (HNC) and assessing correlation with treatment-related parameters. Patients and materials: Data of 84 patients treated with IMRT for different HNC were pooled from three institutions. Parotid deformation and average Hounsfield number changes (ΔHU) were evaluated through MVCT (with Helical Tomotherapy) or diagnostic kVCT images taken at the treatment start/end. Parotids were delineated in the first image and propagated to the last using a previously validated algorithm based on elastic registration. The correlation between ΔHU and several treatment-related parameters was tested; then, logistic uni- and multi-variate analyses taking “large” ΔHU as end-point were carried out. Due to the better image quality, analyses were repeated considering only kVCT data. Results: ΔHU was negative in 116/168 parotids (69%; for kVCT patients: 72/92, 78%). The average ΔHU was significantly different from zero (−7.3, 0.20–0.25 HU/fraction, p m ean), and with neck thickness variation; these correlations were much stronger for kVCT data. Logistic analyses considering ΔHU m ean < 0.68) and initial neck thickness to be the most predictive variables (p < 0.0005, AUC = 0.683; AUC = 0.776 for kVCT); the odd ratio of large vs moderate/small parotid deformation was 3.8 and 8.0 for the whole and the kVCT population respectively. Conclusions: Parotid density reduced in most patients during IMRT and this phenomenon was highly correlated with parotid deformation. The individual assessment of density changes was highly reliable just with diagnostic KvCT. Density changes should be considered as an additional objective measurement of early parotid radiation-induced modifications; further research is warranted.
Early evaluation of radiation-induced parotid damage in patients with nasopharyngeal carcinoma by T2 mapping and mDIXON Quant imaging: initial findings.

Science.gov (United States)

Zhou, Nan; Chu, Chen; Dou, Xin; Chen, Weibo; He, Jian; Yan, Jing; Zhou, Zhengyang; Yang, Xiaofeng

2018-02-08

Radiation-induced parotid damage is a common complication in patients with nasopharyngeal carcinoma (NPC) treated with radiotherapy to head and neck region, which severely reduce the life quality of those patients. The aim of this study was to early evaluate the changes of irradiated parotid glands with T2 mapping and mDIXON Quant imaging. Forty-one patients with NPC underwent conventional magnetic resonance imaging for nasopharynx and neck, and T2 mapping and mDIXON Quant imaging for bilateral parotid glands within 2 weeks before radiotherapy (pre-RT), 5 weeks after the beginning of radiotherapy (mid-RT), and 4 weeks after radiotherapy (post-RT). Parotid volume, T2 values, fat fraction (FF) values, and mean radiation dose were recorded and analyzed. From pre-RT to mid-RT, parotid volume decreased (atrophy rate, 27.0 ± 11.5%), while parotid T2 and FF values increased (change rate, 6.0 ± 6.2% for T2 value and 9.1 ± 9.9% for FF value) significantly. From mid-RT to post-RT, parotid T2 value continuously increased (change rate, 4.6 ± 7.7%), but parotid FF value decreased (change rate, - 9.9 ± 18.2%) significantly. Change rate of parotid T2 value significantly correlated with parotid atrophy rate from pre-RT to post-RT (r = 0.313, P = 0.027). Multiple linear regression analysis showed that parotid T2 value (standardized coefficient [SC] = - 0.259, P = 0.001) and FF value (SC = - 0.320, P = 0.014) negatively correlated with parotid volume, while parotid T2 value positively correlated with MR scan time point (SC = 0.476, P = 0.001) significantly. Parotid T2 and FF values showed excellent reproducibility (intraclass correlation coefficient, 0.935-0.992). T2 mapping and mDIXON Quant imaging is useful for noninvasive evaluation of radiation-induced parotid damage.

Introducing the Jacobian-volume-histogram of deforming organs: application to parotid shrinkage evaluation

International Nuclear Information System (INIS)

Fiorino, Claudio; Maggiulli, Eleonora; Broggi, Sara; Cattaneo, Giovanni Mauro; Calandrino, Riccardo; Liberini, Simone; Faggiano, Elena; Rizzo, Giovanna; Dell'Oca, Italo; Di Muzio, Nadia

2011-01-01

The Jacobian of the deformation field of elastic registration between images taken during radiotherapy is a measure of inter-fraction local deformation. The histogram of the Jacobian values (Jac) within an organ was introduced (JVH-Jacobian-volume-histogram) and first applied in quantifying parotid shrinkage. MVCTs of 32 patients previously treated with helical tomotherapy for head-neck cancers were collected. Parotid deformation was evaluated through elastic registration between MVCTs taken at the first and last fractions. Jac was calculated for each voxel of all parotids, and integral JVHs were calculated for each parotid; the correlation between the JVH and the planning dose-volume histogram (DVH) was investigated. On average, 82% (±17%) of the voxels shrinks (Jac 50% (Jac < 0.5). The best correlation between the DVH and the JVH was found between V10 and V15, and Jac < 0.4-0.6 (p < 0.01). The best constraint predicting a higher number of largely compressing voxels (Jac0.5<7.5%, median value) was V15 ≥ 75% (OR: 7.6, p = 0.002). Jac and the JVH are promising tools for scoring/modelling toxicity and for evaluating organ/contour variations with potential applications in adaptive radiotherapy.
Visualizing form and function in organotypic slices of the adult mouse parotid gland.

Science.gov (United States)

Warner, Jennifer D; Peters, Christian G; Saunders, Rudel; Won, Jong Hak; Betzenhauser, Matthew J; Gunning, William T; Yule, David I; Giovannucci, David R

2008-09-01

An organotypic slice preparation of the adult mouse parotid salivary gland amenable to a variety of optical assessments of fluid and protein secretion dynamics is described. The semi-intact preparation rendered without the use of enzymatic treatment permitted live-cell imaging and multiphoton analysis of cellular and supracellular signals. Toward this end we demonstrated that the parotid slice is a significant addition to the repertoire of tools available to investigators to probe exocrine structure and function since there is currently no cell culture system that fully recapitulates parotid acinar cell biology. Importantly, we show that a subpopulation of the acinar cells of parotid slices can be maintained in short-term culture and retain their morphology and function for up to 2 days. This in vitro model system is a significant step forward compared with enzymatically dispersed acini that rapidly lose their morphological and functional characteristics over several hours, and it was shown to be long enough for the expression and trafficking of exogenous protein following adenoviral infection. This system is compatible with a variety of genetic and physiological approaches used to study secretory function.
High-resolution magnetic resonance of the extracranial facial nerve and parotid duct: demonstration of the branches of the intraparotid facial nerve and its relation to parotid tumours by MRI with a surface coil

International Nuclear Information System (INIS)

Takahashi, N.; Okamoto, K.; Ohkubo, M.; Kawana, M.

2005-01-01

AIM: To investigate the usefulness of high-resolution MR imaging in the evaluation of the extracranial facial nerve, compared with surgical findings. MATERIALS AND METHODS: Thirteen patients with benign parotid tumours were studied on a 1.5-T MR system with a 3 in circular surface coil. High-resolution T1-weighted spin-echo, T2-weighted fast spin-echo, and three-dimensional gradient-recalled acquisition in the steady state (GRASS) images were obtained in the axial planes. Oblique reformatted images were generated. Tumours, parotid ducts and facial nerves were identified on these images. The relationship of the tumours to the facial nerves was confirmed at surgery. RESULTS: Facial nerves appeared as linear structures of low intensity on all pulse sequences. The main trunks and cervicofacial and temporofacial divisions of the facial nerves were identified in 100%, 84.1% and 53.8% of GRASS images, respectively. Parotid ducts appeared as structures of low intensity on T1-weighted (66.6%) and GRASS images (81.8%), and as structures of very high intensity on T2-weighted images (91.7%). The relationships of the tumours to the facial nerves were correctly diagnosed in 11 (91.7%) of 12 cases. CONCLUSION: High-resolution MR imaging depicts the extracranial facial nerve and the parotid duct, and is useful for preoperative evaluation of parotid gland tumours
High-resolution magnetic resonance of the extracranial facial nerve and parotid duct: demonstration of the branches of the intraparotid facial nerve and its relation to parotid tumours by MRI with a surface coil

Energy Technology Data Exchange (ETDEWEB)

Takahashi, N. [Department of Radiology, Niigata University Faculty of Medicine, Niigata (Japan) and Department of Radiology, Niigata City General Hospital, Niigata (Japan)]. E-mail: nandtr@hosp.niigata.niigata.jp; Okamoto, K. [Department of Radiology, Niigata University Faculty of Medicine, Niigata (Japan); Ohkubo, M. [Department of Radiotechnology, Niigata University Faculty of Medicine, Niigata (Japan); Kawana, M. [Department of Otorhinolaryngology, Niigata University Faculty of Medicine, Niigata (Japan)

2005-03-01

AIM: To investigate the usefulness of high-resolution MR imaging in the evaluation of the extracranial facial nerve, compared with surgical findings. MATERIALS AND METHODS: Thirteen patients with benign parotid tumours were studied on a 1.5-T MR system with a 3 in circular surface coil. High-resolution T1-weighted spin-echo, T2-weighted fast spin-echo, and three-dimensional gradient-recalled acquisition in the steady state (GRASS) images were obtained in the axial planes. Oblique reformatted images were generated. Tumours, parotid ducts and facial nerves were identified on these images. The relationship of the tumours to the facial nerves was confirmed at surgery. RESULTS: Facial nerves appeared as linear structures of low intensity on all pulse sequences. The main trunks and cervicofacial and temporofacial divisions of the facial nerves were identified in 100%, 84.1% and 53.8% of GRASS images, respectively. Parotid ducts appeared as structures of low intensity on T1-weighted (66.6%) and GRASS images (81.8%), and as structures of very high intensity on T2-weighted images (91.7%). The relationships of the tumours to the facial nerves were correctly diagnosed in 11 (91.7%) of 12 cases. CONCLUSION: High-resolution MR imaging depicts the extracranial facial nerve and the parotid duct, and is useful for preoperative evaluation of parotid gland tumours.
Incidental focal FDG uptake in the parotid glands on PET/CT in patients with head and neck malignancy

Energy Technology Data Exchange (ETDEWEB)

Seo, Young Lan; Yoon, Dae Young; Lim, Kyoung Ja; Yun, Eun Joo; Cho, Young Kwon [Hallym University College of Medicine, Department of Radiology, Kangdong Seong-Sim Hospital, Seoul (Korea, Republic of); Baek, Sora [Hallym University College of Medicine, Department of Nuclear Medicine, Kangdong Seong-Sim Hospital, Seoul (Korea, Republic of); Bae, Woo Jin; Chung, Eun Jae; Kwon, Kee Hwan [Hallym University College of Medicine, Department of Otorhinolaryngology, Ilsong Memorial Institute of Head and Neck Cancer, Kangdong Seong-Sim Hospital, Seoul (Korea, Republic of)

2015-01-15

To evaluate the prevalence and clinical significance of focal parotid lesions identified by {sup 18} F- FDG PET/CT in patients with nonparotid head and neck malignancies. From 3,638 PET/CT examinations using {sup 18} F-FDG conducted on 1,342 patients with nonparotid head and neck malignancies, we retrospectively identified patients showing incidental focal FDG uptake in the parotid glands. The diagnosis of parotid lesions was confirmed histopathologically or on imaging follow-up. Patient demographics, clinical features, maximum standardized uptake value (SUV{sub max}) on PET images, size and attenuation on corresponding contrast-enhanced CT images were assessed and correlated with the final diagnosis. The prevalence of incidental focal parotid FDG uptake on PET/CT was 2.1 % (95 % CI 1.4 - 3.0 %). Among 21 patients with focal parotid lesions confirmed histologically or on imaging follow-up, 7 (33.3 %) had malignant lesions (all metastases) and 14 (66.7 %) had benign lesions (four pleomorphic adenomas, two Warthin's tumours, one benign lymph node, one granulomatous lesion, six lesions without histopathological confirmation). There were no significant differences in age, sex, SUV{sub max} or CT findings between patients with benign and those with malignant lesions. Focal parotid FDG uptake on PET/CT in patients with head and neck malignancy warrants further investigations to ensure adequate therapy for incidental parotid lesions. (orig.)
Quantitative MR imaging of intra-orbital structures: Tissue-specific measurements and age dependency compared to extra-orbital structures using multispectral quantitative MR imaging.

Science.gov (United States)

Watanabe, Memi; Buch, Karen; Fujita, Akifumi; Jara, Hernán; Qureshi, Muhammad Mustafa; Sakai, Osamu

2017-08-01

The orbit can be affected by unique pathologic conditions and often requires MRI evaluation. The purpose of this study was to investigate the age-related changes in multiple intra-orbital structures using quantitative MRI (qMRI). Thirty-eight subjects (20 males, 18 females; ages 0.5-87 years) underwent MRI with a mixed turbo spin echo sequence. T1 and T2 measurements were obtained within ROI in 6 intra-orbital structures (medial and lateral rectus muscles, medial and lateral retrobulbar fat, lacrimal gland, and optic nerve), and compared with those of corresponding extra-orbital structures (masseter muscle, subcutaneous cheek fat, buccal fat, parotid gland, and frontal white matter). Statistical analyses were performed using Pearson's correlation coefficients. T1 and T2 values of the extra-ocular muscles increased with age, with higher T1 and T2 values compared to the masseter muscles. Retrobulbar fat showed significant age-associated increases in T1 values in the lateral side and in T2 values in both sides. T1 and T2 values in the lacrimal gland increased with age, while the parotid gland showed an age-associated increase in T2 values and decrease in T1 values. Optic nerves demonstrated age-related changes, similar to that of frontal white matter; rapid decreases with age in T1 and T2 times in early stages of life, and slight increases in T1 and T2 times later in life. Intra-orbital structures demonstrated specific qMRI measurements and aging patterns, which were different from extra-orbital structures. Location-specific age-related changes of intra-orbital structures should be considered in the qMRI assessment of the orbital pathology.
Congenital tri-cavernous hemangiomas of the right buccal region, right accessory parotid gland, and masseter muscle region.

Science.gov (United States)

Yang, Tao; Gu, Yongchun; Zhang, Li; Hua, Zequan

2014-03-01

We report a rare case of congenital tri-cavernous hemangiomas of the right buccal region, right accessory parotid gland, and masseter muscle region in an adult. The patient, a 25-year-old woman, complained of 3 masses in her right midcheek. Ultrasonographic and computed tomographic findings showed an irregular-shaped mass (multiple calcifications) with a well-defined margin in the masseter muscle region, an ellipse-shaped mass (multiple calcifications) with a well-defined margin in the right buccal region, and a comma-shaped mass (no calcifications) with a well-defined margin separate from the parotid gland in the right accessory parotid gland region. These iconographic findings suggested that the masses were all hemangiomas separately originating from the parotid gland, accessory parotid gland, and masseter muscle. The masses were completely removed through a standard parotid incision without postoperative facial palsy, skin deformity, and difficulty in secreting saliva. Findings from histologic examination of the tumor revealed multiple, thin-walled, and dilated blood vessels, confirming the diagnosis of cavernous hemangiomas. Ultrasonographic and computed tomographic findings were extremely useful in diagnosing the mass/masses as hemangioma before surgery, clarifying relationships between the mass and adjacent structures, and determining the surgical approach to the mass/masses.
Sonographic Assessment of Parotid and Submandibular Glands in Patients Undergoing 3D Conformal Radiotherapy

Directory of Open Access Journals (Sweden)

Johari M

2016-06-01

Full Text Available The aim of this study was to evaluate sonographic changes in parotid and submandibular salivary glands in patients undergoing radiotherapy for head and neck malignancies. In addition, salivary changes subsequent to radiotherapy were evaluated objectively and subjectively. Twenty patients(13males and 7females with head and neck malignancies, who had been referred to the Radiotherapy/Oncology Department of the Shahid Madani Hospital in Tabriz, Iran, were included in the study. Length, width, echotexture, echogenicity and margins of parotid and submandibular glands were evaluated before and after radiotherapy using sonography. Peak-systolic velocity(PSV,end-diastolic velocity(EDV and resistive index(RI were also assessed by Doppler sonography. Xerostomia subsequent to radiotherapy was evaluated with the use of two techniques: patients’ self-reported scoring and objective measurement of resting saliva. There was a significant decrease in the width of the parotid gland after radiotherapy compared to baseline(P=0.005.Although the length of the parotid gland and the dimensions of submandibular gland decrease, the differences were not significant. In addition, the echogenicity, echotexture and the margin of the glands change to hypoechoic, heterogenic and irregular, respectively, subsequent to radiotherapy. The Doppler technique showed decrease in PSV and RI and an increase in EDV; however, only the decrease in RI in the submandibular gland was statistically significant(P=0.002.The results showed a significant decrease in salivary flow after radiotherapy(P<0.001.In addition, based on the patients reports, the severity of xerostomia increased significantly after radiotherapy(P<0.001. Songraphic changes of parotid and submandibular glands after radiotherapy should be considered in ultrasound examinations. The damages to the parotid and submandibular glands had significant influence in patient post 3D-CRT.
Parotid lymphomas – clinical and computed tomographic imaging ...

African Journals Online (AJOL)

mass in the parotid region.3-5 Many centres complement this approach with ancillary investigations ... radiotherapy, alone or in combination.2 Surgical intervention for lymphoma is limited to a purely diagnostic role.9 It is therefore desirable to ...
Congenital agenesis of unilateral parotid gland with ipsilateral type I first branchial cleft anomaly: A rare presentation

OpenAIRE

Tripti Maithani; Apoorva Pandey; Seema Acharya

2014-01-01

Aim: To report a rare case of unilateral parotid agenesis with ipsilateral type I first branchial cleft anomaly. Material and methods: A case study with special emphasis on the embryology, outlining the complex developmental process of parotid and branchial arches and highlighting the probable reason for development of such anomalies. Results: The literature states that unilateral parotid agenesis is a rare entity with few reported cases occurring solely or in conjunction with other hea...
la tumeur de warthin de la parotide : a propos de 11 cas

African Journals Online (AJOL)

9 mai 2013 ... Nodule de densité tissulaire à contours nets du pôle infé- rieur de la glande parotide gauche avec prise de contraste hétérogène. L'iRM réalisée pour 3 autres patients a posé le diagnos- tic de tumeur bénigne de la parotide dans tous les cas en montrant des tumeurs aux contours réguliers et biens définis.
Comparison of semi-quantitative parotid scintigraphy with biopsy of labial gland in the patiens with Sjogren's syndrome

International Nuclear Information System (INIS)

Huang Jingxiong; He Xiaojiang; Yu Hao; Wu Hua; Chen Guibing

2009-01-01

Objective: Labial gland biopsy is one of major diagnostic methods for Sjogren's syndrome (SS). Meanwhile, 99 Tc m O 4 - parotid scintigraphy has been proven useful for the clinical evaluation of SS. This study was performed to investigate the correlation between the two examinations and evaluate the semi-quantitative parotid scintigraphy in the early diagnosis and staging for SS patients.Methods: There were 135 SS patients and 30 normal subjects as control group in this study. They all underwent 99 Tc m O 4 - parotid scintigraphy. Semi-quantitative analyses of parotid scintigraphy were conducted with parameters including maximum accumulation ratio (MAR), maximum secretion ratio (MSR), time interval from stimulation to minimum count (t parotid ), prestimulatory oral activity index (PRI) and poststimulatory oral activity index (POI). For comparison, the biopsy of labial gland was performed in each patient and the pathological se-verity was classified into grade 0, 1, 2, 3, 4 (also defined as subgroups). One-way ANOVA and q-teat were applied for the correlation analyses between the two examinations. Results: There was significant difference between pathological subgroup 3 or subgroup 4 and the control in all the semi-quantitative parameters (q=6.79-38.64, P parotid (r=0.364, P 99 Tc m aO 4 - parotid scintigraphy may be well correlated with the pathological severity of labial gland biopsy in SS patients. Further, the semi-quantitative indices especially PRI and POI may be helpful for the early diagnosis and staging of SS patients. (authors)
High-risk factors of parotid lymph node metastasis in nasopharyngeal carcinoma: a case-control study

International Nuclear Information System (INIS)

Wang, Hong-zhi; Cao, Cai-neng; Luo, Jing-wei; Yi, Jun-lin; Huang, Xiao-dong; Zhang, Shi-ping; Wang, Kai; Qu, Yuan; Xiao, Jian-ping; Li, Su-yan; Gao, Li; Xu, Guo-zhen

2016-01-01

Although parotid-sparing IMRT decreased the dose distribution of parotid, parotid region recurrence has been reported. Prophylactic irradiation in parotid area would be necessary in patients with high risk of parotid lymph node metastasis (PLNM). This study was to detect the high-risk factors of PLNM in nasopharyngeal carcinoma. This was a 1:2 case-control study. All patients in this study were newly diagnosed NPC with N2-3 classification from January 2005 to December 2012. Cases were 22 sides with ipsilateral PLNM. Controls were 44 patients who were randomly selected from N2-3 disease in database. 20/1096 (1.82 %) NPC patients were found PLNM. Sum of the longest diameter for multiple lymph nodes (SLD) in level II was larger in case group than that in control group (6.0 cm vs. 3.6 cm, p = 0.003). Level II lymph node necrosis, level Va/b involvement, and rare neck areas involvement were more common in case group (p = 0.016, p = 0.034, and p < 0.001, respectively). RPN, level III, and level IV metastases showed no significant difference between the two groups. Multivariate analysis in logistic regression showed that only SLD ≥5 cm in II area (OR = 4.11, p = 0.030) and rare neck areas involvement (OR = 3.95, p = 0.045) were associated with PLNM in NPC patients. PLNM was an uncommon event in NPC patients. SLD ≥5 cm in level II and involvement in rare-neck areas may be potentially high-risk factors for PLNM. Sparing parotid in IMRT was not recommended for NPC patients with high risks of PLNM
Parotid gland function following accelerated and conventionally fractionated radiotherapy

International Nuclear Information System (INIS)

Leslie, M.D.; Dische, S.

1991-01-01

The function of parotid glands in patients treated by 3 different schedules of radiotherapy was studied 9 months or more after its conclusion. All had received radiotherapy for a malignancy confined to 1 side of the head and neck region and only the gland on the side of the lesion was in the treatment volume; the contralateral gland acted as an internal control. Saliva was selectively collected from the parotid glands and the stimulated flow rate and pH of the saliva determined. Flow rates were expressed in each case as a percentage of that of the contralateral ('untreated') gland. Twelve glands that had received conventionally fractionated radiotherapy to a dose of 60-66 Gy showed a mean percentage flow of 20 percent and a significant fall in the pH of the saliva produced. Six glands that had received CHART (Continuous Hyperfractionated Accelerated RadioTherapy) and 8 conventionally fractionated radiotherapy to a dose of 35-40 Gy showed mean percentage flows of 57 and 65 percent respectively, with only slight and non-significant falls in saliva pH. The results show that in the treatment of squamous cell carcinoma in the head and neck the use of CHART can lead to considerable less late change in the function of the parotid gland. (author). 26 refs.; 5 figs.; 2 tabs
Organising haematoma mimicking tumour on MRI following resection of acoustic neuroma

International Nuclear Information System (INIS)

Higgins, J.N.P.; Pigeon, C.N.; Moseley, I.F.

1995-01-01

We describe a 26-year-old woman in whom an enhancing, intradural extramedullary mass was found at the craniocervical junction on MRI 3 years after resection of a large acoustic neuroma. The radiological appearances suggested a new tumour, raising the possibility of neurofibromatosis 2, provoking a review of family members in an attempt to confirm the diagnosis, as well as further surgery. Histology of the lesion revealed an organising haematoma, with no evidence of malignancy. The imaging features can be explained by the process by which blood clot in the subarachnoid space is resorbed. Caution is advised in interpreting CT or MRI after neurosurgery. (orig.)
Environmental risk factors for sporadic acoustic neuroma (Interphone Study Group, Germany)

DEFF Research Database (Denmark)

Schlehofer, B; Schlaefer, K; Blettner, M

2007-01-01

The only known risk factor for sporadic acoustic neuroma is high-dose ionising radiation. Environmental exposures, such as radiofrequency electromagnetic fields and noise are under discussion, as well as an association with allergic diseases. We performed a population-based case-control study.......31; 95% CI 1.15-4.66), and for hay fever (OR=2.20; 95% CI 1.09-4.45), but not for ionising radiation (OR=0.91; 95 % CI 0.51-1.61) or regular mobile phone use (OR=0.67; 95% CI 0.38-1.19). The study confirms results of recently published studies, although the pathogenetic mechanisms are still unknown....
Mucoepidermoid carcinoma of parotid gland: A case report

Directory of Open Access Journals (Sweden)

Jeetendra Purohit

2015-01-01

Full Text Available Mucoepidermoid carcinoma (MEC is the most common malignant neoplasm of the major salivary glands, accounting for 15.5% of all cases, benign and malignant. The aim of this article is to report a case of MEC in a 73-years-old male patient who presented with a painless firm fluctuant swelling in left preauricular area. The lesion was thoroughly examined preoperatively, and investigations were carried out. Fine-needle aspiration cytology was done for the lesion and report suggested tumor of the parotid gland. Superficial parotidectomy procedure was done, taking care not to injure the lower division of the facial nerve. Post recovery was uneventful with no defect of facial nerve functions. The histologic picture confirmed that the tumor was MEC of parotid gland. Through the literature reviews of MEC the discussions on prevalence, origin, diagnosis, histological finding, investigation and the modes of treatment are made.
An experimental study of the irradiation effects on rat parotid gland

International Nuclear Information System (INIS)

Lee, Kyu Chan; Lee, Sang Rae

1986-01-01

This study was designed to investigate the irradiation effects on the rat parotid gland, applied to the head and neck region. For this experiment, twenty-four rat, feeded under the even condition, were used as experimental animals. Twenty rat were used for experimental group and the rest were assigned to the control group. The experimental group was singly irradiated with 10 Gray through Cobalt-60 radiotherapy device, Pickre model 4M 60 (Field size; 12x5 cm, SSD; 50 cm, Depth; 1 cm). The experimental animals of both group were sacrificed each four animals in 2 days, 1 week, 2 weeks, 3 weeks and 4 weeks after irradiation. The specimens were examined through the light microscope using the H-E stain and H stain by routine procedure. The other specimens were observed under the fluorescence microscope using the B-O dichroic mirror and Y 45 5 barrier filter after PA-ACH stain. The results of this study were obtained as follows: 1. The parotid acini were severely degenerated and intraacinar space were widened. Within the acini, retained secretory granules and increased fibrosis were observed. Also the shape and the size of the acini showed very irregular atrophic degeneration. 2. The nuclei showed severe pyknosis, displacement and irregular aggregated appearance. 3. The tissue changes of the parotid acini were initiated after 2 days of irradiation and most severely appeared at the second week of irradiation, but almost returned to normal. 4. The salivary ducts of the parotid gland were severely atrophied, discontinued but initiated to regenerated after 3 weeks of irradiation.
Effect of transcutaneous electrical nerve stimulation induced parotid stimulation on salivary flow

Directory of Open Access Journals (Sweden)

Sreenivasulu Pattipati

2013-01-01

Full Text Available Aims and Objectives: The main objective of this study was to evaluate the duration of stimulation over the parotid salivary flow following the use of transcutaneous electric nerve stimulation (TENS in different age groups. Materials and Methods: The study was carried out in three different age groups. Under group A individuals from 21 to 35 years of age, group B 36-50 years and group C above 51 years were considered. In each group 30 subjects were taken of whom 15 were males and 15 were females. The placement of pads was approximated bilaterally over the parotid glands. The working parameters of TENS unit were fixed at 50 Hz and the unit was in normal mode. Results: Subjects belonging to group B were showing statistically significant increases in the duration of stimulated parotid salivary flow following the use of TENS. Conclusion: TENS can be considered as a non-pharmacological alternative to improve salivation for longer period in xerostomia patients.
Clinical predictors of facial nerve outcome after translabyrinthine resection of acoustic neuromas.

Science.gov (United States)

Shamji, Mohammed F; Schramm, David R; Benoit, Brien G

2007-01-01

The translabyrinthine approach to acoustic neuroma resection offers excellent exposure for facial nerve dissection with 95% preservation of anatomic continuity. Acceptable outcome in facial asymptomatic patients is reported at 64-90%, but transient postoperative deterioration often occurs. The objective of this study was to identify preoperative clinical presentation and intraoperative surgical findings that predispose patients to facial nerve dysfunction after acoustic neuroma surgery. The charts of 128 consecutive translabyrinthine patients were examined retrospectively to identify new clinical and intraoperative predictors of facial nerve outcome. Postoperative evaluation of patients to normal function or mild asymmetry upon close inspection (House-Brackmann grades of I or II) was defined as an acceptable outcome, with obvious asymmetry to no movement (grades III to VI) defined as unacceptable. Intraoperative nerve stimulation was performed in all cases, and clinical grading was performed by a single neurosurgeon in all cases. Among patients with no preoperative facial nerve deficit, 87% had an acceptable result. Small size (P mA (P< 0.01) were reaffirmed as predictive of functional nerve preservation. Additionally, preoperative tinnitus (P = 0.03), short duration of hearing loss (P< 0. 01), and lack of subjective tumour adherence to the facial nerve (P = 0.02) were independently correlated with positive outcome. Our experience with the translabyrinthine approach reveals the previously unestablished associations of facial nerve outcome to include presence of tinnitus and duration of hypoacusis. Independent predictors of tumour size and nerve stimulation thresholds were reaffirmed, and the subjective description of tumour adherence to the facial nerve making dissection more difficult appears to be important.

Squamous cell carcinoma originating in the parotid gland: MRI features with histopathological correlation

International Nuclear Information System (INIS)

Takahashi, H.; Kashiwagi, N.; Chikugo, T.; Nakanishi, K.; Tomita, Y.; Murakami, T.

2014-01-01

Aim: To report the magnetic resonance imaging (MRI) and corresponding histopathological features of squamous cell carcinoma (SCC) originating in the parotid gland. Materials and methods: The MRI images of seven patients with histopathologically proven SCC originating in the parotid gland were reviewed retrospectively, with an emphasis on tumour size, shape, contour definition, extraparotid infiltration, signal characteristics, and the presence of central necrosis. These were correlated with the microscopic findings of the surgical specimens. Results: The tumours ranged in size from 3.9–7 cm (mean 4.7 cm). All tumours had an ill-defined margin with extraparotid infiltration, which seemed to reflect the invasive growth of the tumour cells on histopathological examination. The solid portions of the tumours showed predominantly low to intermediate signal intensities on T2-weighted images, which seemed to reflect the high cellularity, intercellular bridges, and/or keratin pearl formation observed at histopathological examination. Five of the seven tumours had central necrosis. Conclusion: A relatively large tumour with central necrosis is a useful imaging feature of SCCs originating in the parotid gland, in addition to the well-recognized indicators of parotid malignancy, such as an ill-defined margin, extraparotid infiltration, and low to intermediate signal intensity on T2-weighted images
Parotidectomy for benign parotid tumors: An aesthetic approach

International Nuclear Information System (INIS)

Amin, A.; Mostafa, A.; Rifaat, M.; Shallan, M.; Rabie, A.; Elzohairy, M.; Nabawi, A.

2011-01-01

The sternocleidomastoid (SCM) partial thickness muscle flap is among the various methods described to correct parotidectomy defects, but its indications and limitations are not clearly demonstrated in several reports. This study was done to test the aesthetic outcome of this method, its indications and limitations. The technique was combined with a face lift incision to further improve the outcome. Patients and methods: At the National Cancer Institute, Cairo University, Egypt, 23 patients presenting with benign tumors underwent parotidectomy, 19 had superficial parotidectomy and four had total parotidectomy done. The superiorly based (SCM) muscle flap was used to correct the contour deformity. The aesthetic result was evaluated by assessing arid scoring the overall appearance of the scar, the degree of symmetry of the reconstructed parotid region and the site of the donor muscle to their contralateral normal sides. The overall aesthetic appearance was then calculated by the summation of the scores of the latter three parameters. Patients' satisfaction was assessed by patients' questionnaire. Result: The overall aesthetic appearance was good in 17 patients, and moderate in six patients. 16/23 patients had an overall deep satisfaction with the result. The residual hollowness of the parotid following reconstruction of the total parotidectomy defect and the poor quality of scars were the main reasons affecting the aesthetic outcome. Conclusion: Superficial parotidectomy through facelift incision with immediate reconstruction with superiorly based partial thickness SCM flap allows adequate resection of most benign parotid tumors with a satisfactory aesthetic outcome and minimal donor site morbidity
Parotid gland-recovery after radiotherapy in the head and neck region - 36 months follow-up of a prospective clinical study

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2011-01-01

Background The aim of the present study was to evaluate the recovery potential of the parotid glands after using either 3D-conformal-radiotherapy (3D-CRT) or intensity-modulated radiotherapy (IMRT) by sparing one single parotid gland. Methods Between 06/2002 and 10/2008, 117 patients with head and neck cancer were included in this prospective, non-randomised clinical study. All patients were treated with curative intent. Salivary gland function was assessed by measuring stimulated salivary flow at the beginning, during and at the end of radiotherapy as well as 1, 6, 12, 24, and 36 months after treatment. Measurements were converted to flow rates and normalized relative to rates before treatment. Mean doses (Dmean) were calculated from dose-volume histograms based on computed tomographies of the parotid glands. Results Patients were grouped according to the Dmean of the spared parotid gland having the lowest radiation exposure: Group I - Dmean 40 Gy (n = 36). 15/117 (13%) patients received IMRT. By using IMRT as compared to 3D-CRT the Dmean of the spared parotid gland could be significantly reduced (Dmean IMRT vs. 3D-CRT: 21.7 vs. 34.4 Gy, p < 0.001). The relative salivary flow rates (RFSR) as a function of the mean parotid dose after 24 and 36 months was in group I 66% and 74%, in group II 56% and 49%, and in group III 31% and 24%, respectively. Multiple linear regression analyses revealed that the parotid gland dose and the tumor site were the independent determinants 12 and 36 months after the end of RT. Patients of group I and II parotid gland function did recover at 12, 24, and 36 months after the end of RT. Conclusions If a Dmean < 26 Gy for at least one parotid gland can be achieved then this is sufficient to reach complete recovery of pre-RT salivary flow rates. The radiation volume which depends on tumor site did significantly impact on the Dmean of the parotids, and thus on the saliva flow and recovery of parotid gland. PMID:21951317
Parotid gland-recovery after radiotherapy in the head and neck region - 36 months follow-up of a prospective clinical study

International Nuclear Information System (INIS)

Hey, Jeremias; Setz, Juergen; Gerlach, Reinhard; Janich, Martin; Hildebrandt, Guido; Vordermark, Dirk; Gernhardt, Christian R; Kuhnt, Thomas

2011-01-01

The aim of the present study was to evaluate the recovery potential of the parotid glands after using either 3D-conformal-radiotherapy (3D-CRT) or intensity-modulated radiotherapy (IMRT) by sparing one single parotid gland. Between 06/2002 and 10/2008, 117 patients with head and neck cancer were included in this prospective, non-randomised clinical study. All patients were treated with curative intent. Salivary gland function was assessed by measuring stimulated salivary flow at the beginning, during and at the end of radiotherapy as well as 1, 6, 12, 24, and 36 months after treatment. Measurements were converted to flow rates and normalized relative to rates before treatment. Mean doses (D mean ) were calculated from dose-volume histograms based on computed tomographies of the parotid glands. Patients were grouped according to the D mean of the spared parotid gland having the lowest radiation exposure: Group I - D mean < 26 Gy (n = 36), group II - D mean 26-40 Gy (n = 45), and group III - D mean > 40 Gy (n = 36). 15/117 (13%) patients received IMRT. By using IMRT as compared to 3D-CRT the D mean of the spared parotid gland could be significantly reduced (D mean IMRT vs. 3D-CRT: 21.7 vs. 34.4 Gy, p < 0.001). The relative salivary flow rates (RFSR) as a function of the mean parotid dose after 24 and 36 months was in group I 66% and 74%, in group II 56% and 49%, and in group III 31% and 24%, respectively. Multiple linear regression analyses revealed that the parotid gland dose and the tumor site were the independent determinants 12 and 36 months after the end of RT. Patients of group I and II parotid gland function did recover at 12, 24, and 36 months after the end of RT. If a D mean < 26 Gy for at least one parotid gland can be achieved then this is sufficient to reach complete recovery of pre-RT salivary flow rates. The radiation volume which depends on tumor site did significantly impact on the D mean of the parotids, and thus on the saliva flow and recovery of
Automated Segmentation of the Parotid Gland Based on Atlas Registration and Machine Learning: A Longitudinal MRI Study in Head-and-Neck Radiation Therapy

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Yang, Xiaofeng [Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Wu, Ning; Cheng, Guanghui [Radiation Oncology, Jilin University, Chuangchun, Jilin (China); Zhou, Zhengyang [Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing (China); Yu, David S.; Beitler, Jonathan J.; Curran, Walter J. [Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Liu, Tian, E-mail: tliu34@emory.edu [Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia (United States)

2014-12-01

Purpose: To develop an automated magnetic resonance imaging (MRI) parotid segmentation method to monitor radiation-induced parotid gland changes in patients after head and neck radiation therapy (RT). Methods and Materials: The proposed method combines the atlas registration method, which captures the global variation of anatomy, with a machine learning technology, which captures the local statistical features, to automatically segment the parotid glands from the MRIs. The segmentation method consists of 3 major steps. First, an atlas (pre-RT MRI and manually contoured parotid gland mask) is built for each patient. A hybrid deformable image registration is used to map the pre-RT MRI to the post-RT MRI, and the transformation is applied to the pre-RT parotid volume. Second, the kernel support vector machine (SVM) is trained with the subject-specific atlas pair consisting of multiple features (intensity, gradient, and others) from the aligned pre-RT MRI and the transformed parotid volume. Third, the well-trained kernel SVM is used to differentiate the parotid from surrounding tissues in the post-RT MRIs by statistically matching multiple texture features. A longitudinal study of 15 patients undergoing head and neck RT was conducted: baseline MRI was acquired prior to RT, and the post-RT MRIs were acquired at 3-, 6-, and 12-month follow-up examinations. The resulting segmentations were compared with the physicians' manual contours. Results: Successful parotid segmentation was achieved for all 15 patients (42 post-RT MRIs). The average percentage of volume differences between the automated segmentations and those of the physicians' manual contours were 7.98% for the left parotid and 8.12% for the right parotid. The average volume overlap was 91.1% ± 1.6% for the left parotid and 90.5% ± 2.4% for the right parotid. The parotid gland volume reduction at follow-up was 25% at 3 months, 27% at 6 months, and 16% at 12 months. Conclusions: We have validated
Longitudinal assessment of parotid function in patients receiving tomotherapy for head-and-neck cancer

International Nuclear Information System (INIS)

Voordeckers, M.; Tournel, K.; Verellen, D.; Esch, G. van; Storme, G.; Everaert, H.; Vanhove, C.; Baron, I.

2008-01-01

Background and purpose: conventional radiotherapy is associated with high doses to the salivary glands which causes xerostomia and adverse effects on quality of life. The study aims to investigate the potential of helical tomotherapy (Hi-Art Tomotherapy registered ) to preserve parotid function in head-and-neck cancer patients. Patients and methods: seven consecutive patients treated with helical tomotherapy at the UZ Brussel, Belgium, were included. During planning, priority was attributed to planning target volume (PTV) coverage: ≥ 95% of the dose must be delivered to ≥ 95% of the PTV. Elective nodal regions received 54 Gy (1.8 Gy/fraction). A dose of 70.5 Gy (2.35 Gy/fraction) was prescribed to the primary tumor and pathologic lymph nodes = simultaneous integrated boost scheme. If possible, the mean parotid dose was kept below 26 Gy. Salivary gland function was assessed by technetium scintigraphy. Results: there was a significant dose-response relationship between mean parotid dose and functional recuperation. If the mean dose was kept 26 %). In order to preserve 75% of SE, 46% of the parotid volume should receive a dose 26 Gy can be reduced. (orig.)
CT findings of parotid gland tumors: benign versus malignant tumors

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Lee, Moon Ok; Han, Chun Hwan; Kim, Mie Young; Yi, Jeong Geun; Park, Kyung Joo; Lee, Joo Hyuk; Bae, Sang Hoon; Kim, Jeung Sook

1994-01-01

The purpose of this study is to evaluate the characteristics of parotid gland tumors to help in the differentiation between benign and malignant lesions. The CT findings of 22 patients with surgically proven parotid gland tumors were reviewed. Analysis was focused on the density and margin characteristics of the tumors, and the relationship between the tumor and surrounding structures. Those tumors were pleomorphic adenoma (n = 8), Warthin's tumor (n = 5), basal cell adenoma (n = 1), lipoma (n = 1), dermoid cyst (n = 1), adenoid cystic carcinoma (n = 2), mucoepidermoid carcinoma (n 1), epidermoid carcinoma (n = 1), and carcinoma in pleomorphic adenoma (n 1). Most of benign and malignant tumors were heterogeneous in density on contrast enhanced CT scans. In 5 of 6 malignant cases, the tumors had irregular or ill-defined margin and a tendancy to involve or cross the superficial layer of deep cervical fascia with obliteration of subcutaneous fat. Two malignant tumors invaded surrounding structures. Although the heterogeneous density of tumor is not a specific finding for malignancy at CT, following findings, such as, irregular or blurred margin of the lesion, the involvement of fascial plane, and the infiltration of surrounding structures may suggest the possibility of malignant parotid tumor
Manual therapy in the management of a patient with a symptomatic Morton's Neuroma: A case report.

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Sault, Josiah D; Morris, Matthew V; Jayaseelan, Dhinu J; Emerson-Kavchak, Alicia J

2016-02-01

Patients with Morton's neuroma are rarely referred to physical therapy. This case reports the resolution of pain, increase in local pressure pain thresholds, and improvement of scores on the Lower Extremity Functional Scale and Foot and Ankle Ability Measure following a course of joint based manual therapy for a patient who had failed standard conservative medical treatment. Copyright © 2015 Elsevier Ltd. All rights reserved.
Outcome, general, and symptom-specific quality of life after various types of parotid resection.

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Ciuman, Raphael Richard; Oels, Wolfgang; Jaussi, Rolf; Dost, Philipp

2012-06-01

To document the outcome and impact on general and symptom-specific quality of life (QOL) after various types of parotid resection. General and symptom-specific QOL assessment at least 1 year after performed surgery. Retrospective data and outcome analysis of patients. Between 2004 and 2010, 353 parotid resections in 337 patients were conducted at the Department of Otorhinolaryngology, University Teaching Hospital, St. Mary's Hospital Gelsenkirchen, Gelsenkirchen, Germany. A total of 196 patients fit the inclusion criteria and were available for postoperative evaluation. The general QOL assessment was based on both the global health status and global QOL scales of the European Organisation for Research and Treatment of Cancer (EORTC) Quality-of-Life Questionnaire in 34 patients. Symptom-specific QOL was assessed with the Parotidectomy Outcome Inventory-8 (POI-8). In addition, aesthetic outcome was evaluated with an ordinal scale. Outcome of parotidectomies in benign disease has little impact on general QOL and global health status. However, hypoesthesia or dysesthesia, Frey's syndrome, and cosmetic discontent are quite common and may affect symptom-specific and general QOL. Correlation with extent of surgery and statistically significant differences of patient evaluation for aesthetic outcome, sensory impairment, and Frey's syndrome between various types of limited parotid surgery (enucleation, extracapsular dissection, partial superficial parotidectomy) and superficial parotidectomy could be shown. An adequate parotid resection technique must be chosen to achieve the least disturbing outcome. In addition, in our patient collective, there was no increased recurrence rate found after limited parotid resection for pleomorphic adenoma or cystadenolymphoma. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
The effect of concomitant chemotherapy on parotid gland function following head and neck IMRT

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Miah, Aisha B.; Gulliford, Sarah L.; Bhide, Shreerang A.; Zaidi, Shane H.; Newbold, Kate L.; Harrington, Kevin J.; Nutting, Christopher M.

2013-01-01

Purpose: To determine whether concomitant chemotherapy increases the incidence of high grade xerostomia following parotid-sparing intensity-modulated radiotherapy (IMRT) in patients with locally advanced head and neck squamous cell cancer. Materials and methods: The incidence of high grade (⩾G2) acute (CTCAEv3.0) and late (LENTSOMA and RTOG) xerostomia was compared between patients treated with either IMRT or concomitant chemo-IMRT (c-IMRT) in 2 prospective studies. Parotid gland mean tolerance doses (D 50 ) were reported using non-linear logistic regression analysis. Results: Thirty-six patients received IMRT alone and 60 patients received c-IMRT. Patients received 65 Gy in 30 daily fractions to the primary site and involved nodal groups and 54 Gy in 30 fractions to elective nodal groups, mean doses to the parotid glands were comparable. Concomitant cisplatin 100 mg/m 2 was administered on days 1 and 29 of IMRT. The incidence of ⩾G2 subjective xerostomia was similar in both groups; acute-64.7% (IMRT) versus 60.3% (c-IMRT), p = 0.83; late-43% (IMRT) versus 34% (c-IMRT), p = 0.51. Recovery of parotid salivary flow at 1 year was higher with IMRT (64% vs 50%), but not statistically significant (p = 0.15). D 50 for absence of parotid saliva flow at 1 year was 23.2 Gy (95% CI: 17.7–28.7) for IMRT and 21.1 Gy (11.8–30.3) for c-IMRT. Conclusion: Concomitant c-IMRT does not increase the incidence of acute or late xerostomia relative to IMRT alone
The effect of concomitant chemotherapy on parotid gland function following head and neck IMRT.

Science.gov (United States)

Miah, Aisha B; Gulliford, Sarah L; Bhide, Shreerang A; Zaidi, Shane H; Newbold, Kate L; Harrington, Kevin J; Nutting, Christopher M

2013-03-01

To determine whether concomitant chemotherapy increases the incidence of high grade xerostomia following parotid-sparing intensity-modulated radiotherapy (IMRT) in patients with locally advanced head and neck squamous cell cancer. The incidence of high grade (≥G2) acute (CTCAEv3.0) and late (LENTSOMA and RTOG) xerostomia was compared between patients treated with either IMRT or concomitant chemo-IMRT (c-IMRT) in 2 prospective studies. Parotid gland mean tolerance doses (D₅₀) were reported using non-linear logistic regression analysis. Thirty-six patients received IMRT alone and 60 patients received c-IMRT. Patients received 65 Gy in 30 daily fractions to the primary site and involved nodal groups and 54 Gy in 30 fractions to elective nodal groups, mean doses to the parotid glands were comparable. Concomitant cisplatin 100mg/m(2) was administered on days 1 and 29 of IMRT. The incidence of ≥G2 subjective xerostomia was similar in both groups; acute-64.7% (IMRT) versus 60.3% (c-IMRT), p=0.83; late-43% (IMRT) versus 34% (c-IMRT), p=0.51. Recovery of parotid salivary flow at 1 year was higher with IMRT (64% vs 50%), but not statistically significant (p=0.15). D₅₀ for absence of parotid saliva flow at 1 year was 23.2 Gy (95% CI: 17.7-28.7) for IMRT and 21.1 Gy (11.8-30.3) for c-IMRT. Concomitant c-IMRT does not increase the incidence of acute or late xerostomia relative to IMRT alone. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Treatment of primary parotid non-Hodgkin's lymphoma: an analysis of 29 patients

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Gu Wendong; Feng Yan

2003-01-01

Objective: To analyze the clinical characteristics, treatment and prognosis of primary parotid non-Hodgkin's lymphoma. Methods: From March 1988 to February 2001, twenty-nine patients with primary parotid non-Hodgkin's lymphoma treated in our hospital were retrospectively analyzed. The data were analyzed according to the following factors: sex, age, stage, pathologic classification, chemotherapy given or not, cycles of chemotherapy, radiotherapy given or not, and the dose at the parotid. Kaplan-Meier method and Log-rank method were used in the statistic analysis. Results: The overall 5-year and 10-year survival rates were 73.3% and 51.0%. Stage and pathologic classification were prognostic factors in our statistic analysis. The 5-year survival rates were 81.6% and 25.0% for early stage (I E + II E) and advanced stage (III E + IV E) patients, with the difference significant (P<0.01). The 5-year survival rate for patients with the pathologic classification of mucosa associated lymphoid tissue (MALT) was 100% as compared to 42.2% for patients with diffused large B cell lymphoma, with the difference also significant (P<0.05). Conclusions: The prognosis of primary parotid non-Hodgkin's lymphoma is satisfactory. Surgery should only be used as a diagnostic method. Radiotherapy should be the first choice for patients with MALT lymphoma and stage I E and II E follicular lymphoma, but comprehensive treatment including chemotherapy is necessary to the diffuse large B cell lymphoma
Effect of ionizing radiation on rat parotid gland

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Boraks, George; Tampelini, Flavio Silva; Pereira, Kleber Fernando; Chopard, Renato Paulo [University of Sao Paulo (USP), SP (Brazil). Inst. of Biomedical Sciences. Dept. of Anatomy]. E-mail: rchopard@usp.br

2008-01-15

A common side effect of radiotherapy used in the treatment of oral cancer is the occurrence of structural and physiological alterations of the salivary glands due to exposure to ionizing radiation, as demonstrated by conditions such as decreased salivary flow. The present study evaluated ultrastructural alterations in the parotid glands of rats receiving a fractionated dose (1,500-cGy) of radiation emitted by a Cesium-137 source and rats that were not subjected to ionizing radiation. After sacrifice, the parotid glands were removed and examined by transmission electron microscopy. Damage such as cytoplasmic vacuolisation, dilatation of the endoplasmic reticulum and destruction of mitochondria, as well as damage to the cellular membrane of acinar cells, were observed. These findings lead to the conclusion that ionizing radiation promotes alterations in the glandular parenchyma, and that these alterations are directly related to the dose level of absorbed radiation. Certain phenomena that appear in the cytoplasm and nuclear material indicate that ionizing radiation causes acinar cell death (apoptosis). (author)
Capsule of parotid gland tumor: evaluation by 3.0 T magnetic resonance imaging using surface coils

International Nuclear Information System (INIS)

Ishibashi, Mana; Fujii, Shinya; Nishihara, Keisuke; Matsusue, Eiji; Kodani, Kazuhiko; Kaminou, Toshio; Ogawa, Toshihide; Kawamoto, Katsuyuki

2010-01-01

Background: Magnetic resonance (MR) imaging of parotid gland tumors has been widely reported, although few reports have evaluated the capsule of parotid gland tumors in detail. Purpose: To evaluate the diagnostic usefulness of 3.0 T MR imaging with surface coils for detection of the parotid gland tumor capsule, and to clarify the characteristics of the capsules. Material and Methods: Seventy-eight patients with parotid gland tumors (63 benign and 15 malignant) were evaluated. Axial and coronal T2-weighted and contrast-enhanced T1-weighted images were obtained using a 3.0 T MR scanner with 70 mm surface coils. It was retrospectively assessed whether each parotid gland tumor was completely surrounded by a capsule. The capsule was classified as regular or irregular in terms of capsular thickness, and as none, mildly, or strongly enhancing in terms of contrast enhancement. Visual interpretations were compared with histopathological findings to evaluate the diagnostic ability of MR imaging to detect parotid gland tumor capsules. Statistical evaluation was conducted concerning the presence of capsules, capsular irregularity, and the difference in contrast enhancement between benign and malignant tumors, and that between pleomorphic adenomas and Warthin's tumors. Results: Capsules completely surrounding the tumor on MR imaging yielded a sensitivity of 87.7% (50/57), specificity of 90.5% (19/21), and accuracy of 88.5% (69/78). Benign tumors had a capsule completely surrounding the tumor significantly more often than malignant tumors (P = 0.009). Concerning capsular irregularity, malignant tumors tended to have more irregular capsules than benign tumors, although there were no significant differences. The capsules of malignant tumors enhanced significantly more strongly than those of benign tumors (P = 0.018). Conclusion: 3.0 T MR imaging using surface coils could correctly depict parotid gland tumor capsules in most cases. Most benign and some malignant tumors had capsules
Occurrence of lymph node metastasis in early-stage parotid gland cancer.

Science.gov (United States)

Stenner, Markus; Molls, Christoph; Luers, Jan C; Beutner, Dirk; Klussmann, Jens P; Huettenbrink, Karl-Bernd

2012-02-01

Lymph node metastasis is one of the most important factors in therapy and prognosis for patients with parotid gland cancer. Nevertheless, the extent of the primary tumor resection and the necessity of a neck dissection still is a common issue. Since little is known about lymph node metastasis in early-stage parotid gland cancer, the purpose of the present study was to evaluate the occurrence of lymph node metastases in T1 and T2 carcinomas and its impact on local control and survival. We retrospectively analyzed 70 patients with early-stage (T1 and T2) primary parotid gland cancer. All patients were treated with parotidectomy and an ipsilateral neck dissection from 1987 to 2009. Clinicopathological and survival parameters were calculated. The median follow-up time was 51.7 months. A positive pathological lymph node stage (pN+) was found in 21.4% of patients with a significant correlation to the clinical lymph node stage (cN) (p = 0.061). There were no differences in the clinical and histopathological data between pN- and pN+ patients. In 73.3% of pN+ patients, the metastases were located intraparotideal. The incidence of occult metastases (pN+/cN-) was 17.2%. Of all patients with occult metastases, 30.0% had extraparotideal lymphatic spread. A positive lymph node stage significantly indicated a poorer 5-year overall as well as 5-year disease-free survival rate compared to pN- patients (p = 0.048; p = 0.011). We propose total parotidectomy in combination with at least a level II-III selective neck dissection in any case of early-stage parotid gland cancer.
Apparent diffusion coefficient histogram analysis can evaluate radiation-induced parotid damage and predict late xerostomia degree in nasopharyngeal carcinoma.

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Zhou, Nan; Guo, Tingting; Zheng, Huanhuan; Pan, Xia; Chu, Chen; Dou, Xin; Li, Ming; Liu, Song; Zhu, Lijing; Liu, Baorui; Chen, Weibo; He, Jian; Yan, Jing; Zhou, Zhengyang; Yang, Xiaofeng

2017-09-19

We investigated apparent diffusion coefficient (ADC) histogram analysis to evaluate radiation-induced parotid damage and predict xerostomia degrees in nasopharyngeal carcinoma (NPC) patients receiving radiotherapy. The imaging of bilateral parotid glands in NPC patients was conducted 2 weeks before radiotherapy (time point 1), one month after radiotherapy (time point 2), and four months after radiotherapy (time point 3). From time point 1 to 2, parotid volume, skewness, and kurtosis decreased ( P histogram parameters increased (all P histogram parameters. Early mean change rates for bilateral parotid SD and ADC max could predict late xerostomia degrees at seven months after radiotherapy (three months after time point 3) with AUC of 0.781 and 0.818 ( P = 0.014, 0.005, respectively). ADC histogram parameters were reproducible (intraclass correlation coefficient, 0.830 - 0.999). ADC histogram analysis could be used to evaluate radiation-induced parotid damage noninvasively, and predict late xerostomia degrees of NPC patients treated with radiotherapy.
Actual Dose Variation of Parotid Glands and Spinal Cord for Nasopharyngeal Cancer Patients During Radiotherapy

International Nuclear Information System (INIS)

Han Chunhui; Chen Yijen; Liu An; Schultheiss, Timothy E.; Wong, Jeffrey Y.C.

2008-01-01

Purpose: For intensity-modulated radiotherapy of nasopharyngeal cancer, accurate dose delivery is crucial to the success of treatment. This study aimed to evaluate the significance of daily image-guided patient setup corrections and to quantify the parotid gland volume and dose variations for nasopharyngeal cancer patients using helical tomotherapy megavoltage computed tomography (CT). Methods and Materials: Five nasopharyngeal cancer patients who underwent helical tomotherapy were selected retrospectively. Each patient had received 70 Gy in 35 fractions. Daily megavoltage CT scans were registered with the planning CT images to correct the patient setup errors. Contours of the spinal cord and parotid glands were drawn on the megavoltage CT images at fixed treatment intervals. The actual doses delivered to the critical structures were calculated using the helical tomotherapy Planned Adaptive application. Results: The maximal dose to the spinal cord showed a significant increase and greater variation without daily setup corrections. The significant decrease in the parotid gland volume led to a greater median dose in the later phase of treatment. The average parotid gland volume had decreased from 20.5 to 13.2 cm 3 by the end of treatment. On average, the median dose to the parotid glands was 83 cGy and 145 cGy for the first and the last treatment fractions, respectively. Conclusions: Daily image-guided setup corrections can eliminate significant dose variations to critical structures. Constant monitoring of patient anatomic changes and selective replanning should be used during radiotherapy to avoid critical structure complications
Histomorphologic study of the parotide glands of young rats exposed of ionizing radiation

International Nuclear Information System (INIS)

Roslindo, E.B.; Utrilla, L.S.; Roslindo, N.C.; Onofre, M.A.

1989-01-01

A study was performed on rats to verify the effects of ionizing radiation on the structure of the parotid glands of young rats. Thirty twenty five-day old rats (Holtzman) were equally distributed into two experimental groups: Group 1 - irradiated; Group II - control. Using a conventional X-ray apparatus, the region of the parotid glands was irradiated with a dose of 300 R, this procedure was repeated every 48 hours up to an exposition of 1200 R. After periods of 3, 8, 13, 18, and 28 days, the animals belonging to both groups were sacrificed and the parotid glands removed and fixed in 10% formalin and Bouin liquid for 24 hours. The sections were stained by hematoxylin and eosin and Mallory's Thricromic, allowing analysis through the usual optical microscope. The following conclusions may be drawn through the methodology used: the Group 1 - rats gained body weight uniformly after the 13 sup(th) day, although this was not equivalent to the control group; the critical phase of glandular disorganization determined by irradiation corresponded to the experimental period of 8 days, decreasing in the subsequent days; the serous acini and the striated ducts showed to be more radium sensitive even under the use of low fractionated doses; the parotid glands showed indications of gradual morphological recovery after the last exposition to X-rays. (author)
Parotid gland-recovery after radiotherapy in the head and neck region - 36 months follow-up of a prospective clinical study

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Vordermark Dirk

2011-09-01

Full Text Available Abstract Background The aim of the present study was to evaluate the recovery potential of the parotid glands after using either 3D-conformal-radiotherapy (3D-CRT or intensity-modulated radiotherapy (IMRT by sparing one single parotid gland. Methods Between 06/2002 and 10/2008, 117 patients with head and neck cancer were included in this prospective, non-randomised clinical study. All patients were treated with curative intent. Salivary gland function was assessed by measuring stimulated salivary flow at the beginning, during and at the end of radiotherapy as well as 1, 6, 12, 24, and 36 months after treatment. Measurements were converted to flow rates and normalized relative to rates before treatment. Mean doses (Dmean were calculated from dose-volume histograms based on computed tomographies of the parotid glands. Results Patients were grouped according to the Dmean of the spared parotid gland having the lowest radiation exposure: Group I - Dmean mean 26-40 Gy (n = 45, and group III - Dmean > 40 Gy (n = 36. 15/117 (13% patients received IMRT. By using IMRT as compared to 3D-CRT the Dmean of the spared parotid gland could be significantly reduced (Dmean IMRT vs. 3D-CRT: 21.7 vs. 34.4 Gy, p Conclusions If a Dmean mean of the parotids, and thus on the saliva flow and recovery of parotid gland.
Postoperative treatment of malignant tumors of the parotid gland: radiotherapy, concomitant chemotherapy and radiation therapy; Tumeurs malignes de la parotide: prise en charge multidisciplinaire, role de la radiotherapie

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Bouyon, A.; Durdux, C.; Housset, M. [Hopital Europeen Georges-Pompidou, Service d' Oncoradiotherapie, 75 - Paris (France); Hans, S. [Hopital Europeen Georges-Pompidou, Service d' ORL et de Chirurgie de la Face et du Cou, 75 - Paris (France)

2007-12-15

The low incidence, the wide histological spectrum and the natural, sometimes slow, evolution of malignant parotid gland tumours do not allow to easily establish the impact of their treatments. At present, clinical data come from retrospective cohort analysis, whereas randomized phase II-III trials are confidential. Moreover conclusions from these studies are controversial. We present here the therapeutic highlights of parotid cancers: surgery, with the particular concern of facial nerve preservation; and adjuvant treatment essentially based on radiotherapy. This review focused on adjuvant care explores the indications and the technical aspects of radiation, as well as the role of concurrent chemotherapy. (authors)

Chemoradioprotection of the rat parotid gland by the beta-sympathomimetic agonist, terbutaline

International Nuclear Information System (INIS)

Sinesi, M.S.

1981-01-01

The present study demonstrates the effectiveness of the beta-adrenergic stimulator known as terbutaline in providing increased radioresistance to the normal, (i.e. nonmalignant) rat parotid salivary gland. Radiation damage was assessed by gland weight and microscopic examination of saline-treated and terbutaline-treated groups during days 1 to 10 and at 60 days post-irradiation. Terbutaline-treated groups exhibited both a sparing of gland weight loss as well as better preservation of glandular microstructure at all periods examined post-irradiation. Radioprotection of human parotid glands would provide relief from the xerostomia and its severe sequelae which often follow radiotherapy to the head and neck region in cancer patients. Terbutaline, with its preferential affinity for the beta-2 adrenergic receptor may provide a therapeutic advantage without the cardiac effects which normally accompany less specific (beta-1 + beta-2) adrenergic stimulation. In addition to providing a model for clinical protection of the salivary glands, this demonstration of protection of the rat parotid may also serve as a model for investigation of the mechanisms of action of terbutaline and other radioprotective compounds
Risk of a second cancer from scattered radiation in acoustic neuroma treatment

Science.gov (United States)

Yoon, Myonggeun; Lee, Hyunho; Sung, Jiwon; Shin, Dongoh; Park, Sungho; Chung, Weon Kuu; Jahng, Geon-Ho; Kim, Dong Wook

2014-06-01

The present study aimed to compare the risk of a secondary cancer from scattered and leakage doses in patients receiving intensity-modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT), and stereotactic radiosurgery (SRS). Four acoustic neuroma patients were treated with IMRT, VMAT, or SRS. Their excess relative risk (ERR), excess absolute risk (EAR), and lifetime attributable risk (LAR) of a secondary cancer were estimated using the corresponding secondary doses measured at various organs by using radio-photoluminescence glass dosimeters (RPLGD) placed inside a humanoid phantom. When a prescription dose was delivered in the planning target volume of the 4 patients, the average organ equivalent doses (OED) at the thyroid, lung, liver, bowel, bladder, prostate (or ovary), and rectum were 14.6, 1.7, 0.9, 0.8, 0.6, 0.6, and 0.6 cGy, respectively, for IMRT whereas they were 19.1, 1.8, 2.0, 0.6, 0.4, 0.4, and 0.4 cGy, respectively, for VMAT, and 22.8, 4.6, 1.4, 0.7, 0.5, 0.5, and 0.5 cGy, respectively, for SRS. The OED decreased as the distance from the primary beam increased. The thyroid received the highest OED compared to other organs. A lifetime attributable risk evaluation estimated that more than 0.03% of acoustic neuroma (AN) patients would get radiation-induced cancer within 20 years of receiving radiation therapy. The organ with the highest radiation-induced cancer risk after radiation treatment for AN was the thyroid. We found that the LAR could be increased by the transmitted dose from the primary beam. No modality-specific difference in radiation-induced cancer risk was observed in our study.
Risk of a second cancer from scattered radiation in acoustic neuroma treatment

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Yoon, Myonggeun; Lee, Hyunho; Sung, Jiwon [Korea University, Seoul (Korea, Republic of); Shin, Dongoh [Kyung Hee University Medical Center, Seoul (Korea, Republic of); Park, Sungho [Ulsan University Hospital, Ulsan (Korea, Republic of); Chung, Weonkuu; Jahng, Geonho; Kim, Dongwook [Kyung Hee University Hospital at Gangdong, Seoul (Korea, Republic of)

2014-06-15

The present study aimed to compare the risk of a secondary cancer from scattered and leakage doses in patients receiving intensity-modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT), and stereotactic radiosurgery (SRS). Four acoustic neuroma patients were treated with IMRT, VMAT, or SRS. Their excess relative risk (ERR), excess absolute risk (EAR), and lifetime attributable risk (LAR) of a secondary cancer were estimated using the corresponding secondary doses measured at various organs by using radio-photoluminescence glass dosimeters (RPLGD) placed inside a humanoid phantom. When a prescription dose was delivered in the planning target volume of the 4 patients, the average organ equivalent doses (OED) at the thyroid, lung, liver, bowel, bladder, prostate (or ovary), and rectum were 14.6, 1.7, 0.9, 0.8, 0.6, 0.6, and 0.6 cGy, respectively, for IMRT whereas they were 19.1, 1.8, 2.0, 0.6, 0.4, 0.4, and 0.4 cGy, respectively, for VMAT, and 22.8, 4.6, 1.4, 0.7, 0.5, 0.5, and 0.5 cGy, respectively, for SRS. The OED decreased as the distance from the primary beam increased. The thyroid received the highest OED compared to other organs. A lifetime attributable risk evaluation estimated that more than 0.03% of acoustic neuroma (AN) patients would get radiation-induced cancer within 20 years of receiving radiation therapy. The organ with the highest radiation-induced cancer risk after radiation treatment for AN was the thyroid. We found that the LAR could be increased by the transmitted dose from the primary beam. No modality-specific difference in radiation-induced cancer risk was observed in our study.
Role of the Accessory Parotid Gland in the Etiology of Parotitis: Statistical Analysis of Sialographic Features.

Science.gov (United States)

Zhu, Wangyong; Hu, Fengchun; Liu, Xingguang; Guo, Songcan; Tao, Qian

2016-01-01

This retrospective study aimed to identify if the existence of the accessory parotid gland correlated with the etiology of parotitis. This may aid the development of better treatment strategies in the future. Sialographic features of cases with parotitis and healthy subjects were reviewed. The chi-square test was used to compare the incidence of accessory parotid gland between the groups. The Student's t test was used to compare the length of Stensen's duct, the length from the orifice to the confluence of the accessory duct, and the angle between the accessory duct and Stensen's duct between the groups. The incidence of accessory parotid gland in patients with parotitis was 71.8% (28/39), which was significantly higher than that in healthy subjects (P = 0.005). Patients with parotitis had a longer Stensen's duct than healthy subjects (P = 0.003). There was no significant difference in the length from the orifice to the confluence of the accessory duct or the angle between the accessory duct and Stensen's duct (P = 0.136 and 0.511, respectively) between the groups. The accessory parotid gland might play a role in the pathogenesis of parotitis. The existence of an accessory parotid gland is likely to interfere with salivary flow. Computational fluid dynamics analysis of salivary flow in the ductal system would be useful in future etiologic studies on parotitis.
SU-E-J-109: Evaluation of Deformable Accumulated Parotid Doses Using Different Registration Algorithms in Adaptive Head and Neck Radiotherapy

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Xu, S [Key Laboratory of Particle & Radiation Imaging (Tsinghua University), Ministry of Education, Beijing, 100084 China (China); Chinese PLA General Hospital, Beijing, 100853 China (China); Liu, B [Image processing center, Beihang University, Beijing, 100191 China (China)

2015-06-15

Purpose: Three deformable image registration (DIR) algorithms are utilized to perform deformable dose accumulation for head and neck tomotherapy treatment, and the differences of the accumulated doses are evaluated. Methods: Daily MVCT data for 10 patients with pathologically proven nasopharyngeal cancers were analyzed. The data were acquired using tomotherapy (TomoTherapy, Accuray) at the PLA General Hospital. The prescription dose to the primary target was 70Gy in 33 fractions.Three DIR methods (B-spline, Diffeomorphic Demons and MIMvista) were used to propagate parotid structures from planning CTs to the daily CTs and accumulate fractionated dose on the planning CTs. The mean accumulated doses of parotids were quantitatively compared and the uncertainties of the propagated parotid contours were evaluated using Dice similarity index (DSI). Results: The planned mean dose of the ipsilateral parotids (32.42±3.13Gy) was slightly higher than those of the contralateral parotids (31.38±3.19Gy)in 10 patients. The difference between the accumulated mean doses of the ipsilateral parotids in the B-spline, Demons and MIMvista deformation algorithms (36.40±5.78Gy, 34.08±6.72Gy and 33.72±2.63Gy ) were statistically significant (B-spline vs Demons, P<0.0001, B-spline vs MIMvista, p =0.002). And The difference between those of the contralateral parotids in the B-spline, Demons and MIMvista deformation algorithms (34.08±4.82Gy, 32.42±4.80Gy and 33.92±4.65Gy ) were also significant (B-spline vs Demons, p =0.009, B-spline vs MIMvista, p =0.074). For the DSI analysis, the scores of B-spline, Demons and MIMvista DIRs were 0.90, 0.89 and 0.76. Conclusion: Shrinkage of parotid volumes results in the dose increase to the parotid glands in adaptive head and neck radiotherapy. The accumulated doses of parotids show significant difference using the different DIR algorithms between kVCT and MVCT. Therefore, the volume-based criterion (i.e. DSI) as a quantitative evaluation of
Function protection of the parotid gland after intensity modulated radiotherapy for thirty-six patients of nasopharyngeal carcinoma

International Nuclear Information System (INIS)

Xiao Zemin; Liao Yuping; Jiang Wuzhong; Wu Tao

2008-01-01

Objective: To study the parotid gland function protection of intensity modulated radiotherapy (IMRT) for patients with nasopharyngeal carcinoma (NPC) Methods: Thirty-six NPC patients were divided into IMRT group (therapy group) and conventional fraction (CF) group (control group) by random balanced design. Each group had 18 patients. The planning gross tumor volume (pGTV) of nasopharyngeal was treated with a total dose of 72.0 in therapy group, with a total dose of 70.0 Gy in control group (with daily 2.0 Gy/fraction and 5 times/week). Before treatment and at 3, 6, and 9 months, 1 and 2 years after therapy, all patients performed parotid imaging and both uptake index (UI) and excretion index (EI) after acid stimulation were calculated. The dose-volume histogram (DVH) was used to analyse the dose of parotid. Results: The values of UI were 77.6% and 96.2% at the end of therapy and after tow years in therapy group and 56.8% and 7.0% in contrast group. The values of EI were 64.1% and 95.3% at the end of therapy and after tow years in therapy group and 19.4% and 0 in control group. The mean doses of normal side and the trouble side of parotid gland were 20.0 Gy and 31.0 Gy in therapy group and 61.0 Gy and 68.2 Gy in control group. Conclusions: IMRT can reduce radiation dose of parotid glands compared with CF distinctly and thus protect parotid function effectively. (authors)
VESTIBULAR SCHWANNOMA (ACOUSTIC NEUROMA) MIMICKING TEMPOROMANDIBULAR DISORDERS: A CASE REPORT

Science.gov (United States)

Bisi, Maurício A.; Selaimen, Caio M. P.; Chaves, Karen D.; Bisi, Melissa C.; Grossi, Márcio L.

2006-01-01

Approximately 6 to 16% of patients with trigeminal neuralgia symptoms present intracranial tumors, the most common being the vestibular schwannoma (acoustic neuroma). Some symptoms reported by patients include hearing loss, tinnitus, headaches, vertigo and trigeminal disturbances. An increased muscle response in the surrounding head and neck musculature may also be observed, which mimics signs and symptoms of temporomandibular disorders. In these cases, magnetic resonance imaging (MRI) has proved to be a useful tool in tumor diagnosis. The differential diagnosis between myofascial and neuralgic pain is important, as both may present similar characteristics, while being of different origin, and demanding special treatment approaches. The purpose of this paper is to demonstrate the relationship among trigeminal neuralgia symptoms, intracranial tumors and temporomandibular dysfunction by presenting a clinical case. PMID:19089251
Giant lipoma arising from deep lobe of the parotid gland

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Hsu Ying-Che

2006-06-01

Full Text Available Abstract Background Lipomas are common benign soft tissue neoplasms but they are found very rarely in the deep lobe of parotid gland. Surgical intervention in these tumors is challenging because of the proximity of the facial nerve, and thus knowledge of the anatomy and meticulous surgical technique are essential. Case presentation A 71-year-old female presented with a large asymptomatic mass, which had occupied the left facial area for over the past fifteen years, and she requested surgical excision for a cosmetically better facial appearance. The computed tomography (CT scan showed a well-defined giant lipoma arising from the left deep parotid gland. The lipoma was successfully enucleated after full exposure and mobilization of the overlying facial nerve branches. The surgical specimen measured 9 × 6 cm in size, and histopathology revealed fibrolipoma. The patient experienced an uneventful recovery, with a satisfying facial contour and intact facial nerve function. Conclusion Giant lipomas involving the deep parotid lobe are extremely rare. The high-resolution CT scan provides an accurate and cost-effective preoperative investigative method. Surgical management of deep lobe lipoma should be performed by experienced surgeons due to the need for meticulous dissection of the facial nerve branches. Superficial parotidectomy before deep lobe lipoma removal may be unnecessary in selected cases because preservation of the superficial lobe may contribute to a better aesthetic and functional result.
Warthin's Tumor of the Parotid Gland: CT and MR Features

International Nuclear Information System (INIS)

Lee, Yun Hee; Yu, In Kyu; Lee, Byung Hee; Kim, Min Sun; Han, Moon Hee; Song, Chang Joon

2009-01-01

In this study, we have evaluated the imaging features of Warthin's tumor of the parotid gland with the use of CT and MR imaging. CT (n = 30) and MR (n = 7) images of 26 patients (M:F=23:3; age range, 38-76 years; mean age, 58 years) with surgically-proven Warthin's tumor (n = 37) were reviewed with a focus on bilaterality, multiplicity, location, size, demarcation, margin, enhancement pattern and MR signal intensity. Lesions were bilateral in seven patients (27%), multiple in nine patients (35%) and unilateral multiple in four patients (15%). Tumors were located in the superficial lobe (65%), deep lobe (24%) and both lobes (11%) of the parotid gland. Most tumors had a clear (95%) and smooth margin (95%) with a round or oval shape. Tumors mainly showed a solid and cystic composition (n = 24, 65%) and all solid stroma showed poor or weak enhancement on both CT and MR images. Papillary projections from the peripheral wall were clearly seen (n = 6, 86%). Warthin's tumor is frequently seen in the parotid superficial lobe of older males with a higher bilateral and multiple tendency. Warthin's tumor shows cystic portions with papillary projections at the wall on CT images and focal high signal intensity (SI) on T1-weighted images with dense nodular enhancement on MR images
Peptide-evoked release of amylase from isolated acini of the rat parotid gland

DEFF Research Database (Denmark)

Goll, R; Poulsen, J H; Schmidt, P

1994-01-01

on isolated acini of the rat parotid gland. Furthermore, the occurrence and location of the peptides in the gland was studied. Finally, binding of 125I-BH-SP to isolated acini were studied in order to characterize their tachykinin receptor(s) and their binding kinetics. Only SP, NKA, NPK and VIP stimulated...... of NK1-receptors. Thus, the results of the present study support previous suggestions that the tachykinins and VIP are likely to be involved in amylase secretion in the rat parotid gland....
Validation of the facial dysfunction domain of the Penn Acoustic Neuroma Quality-of-Life (PANQOL) Scale.

Science.gov (United States)

Lodder, Wouter L; Adan, Guleed H; Chean, Chung S; Lesser, Tristram H; Leong, Samuel C

2017-06-01

The objective of this study is to evaluate the strength of content validity within the facial dysfunction domain of the Penn Acoustic Neuroma Quality-of-Life (PANQOL) Scale and to compare how it correlates with a facial dysfunction-specific QOL instrument (Facial Clinimetric Evaluation, FaCE). The study design is online questionnaire survey. Members of the British Acoustic Neuroma Association received both PANQOL questionnaires and the FaCE scale. 158 respondents with self-identified facial paralysis or dysfunction had completed PANQOL and FaCE data sets for analysis. The mean composite PANQOL score was 53.5 (range 19.2-93.5), whilst the mean total FaCE score was 50.9 (range 10-95). The total scores of the PANQOL and FaCE correlated moderate (r = 0.48). Strong correlation (r = 0.63) was observed between the PANQOL's facial dysfunction domain and the FaCE total score. Of all the FaCE domains, social function was strongly correlated with the PANQOL facial dysfunction domain (r = 0.66), whilst there was very weak-to-moderate correlation (range 0.01-0.43) to the other FaCE domains. The current study has demonstrated a strong correlation between the facial dysfunction domains of PANQOL with a facial paralysis-specific QOL instrument.
Influence of Parotid from Various Dose Rate in Intensity Modulated Radiation Therapy Planning for Head and Neck Cancer

International Nuclear Information System (INIS)

Hong, Joo Wan; Jeong, Yun Ju; Won, Hui Su; Chang, Nam Jun; Choi, Ji Hun; Seok, Jin Yong

2010-01-01

There are various beam parameter in intensity modulated radiation therapy (IMRT). The aim of this study is to investigate how various dose rate affect the parotid in treatment plan of IMRT. Materials and Methods: The study was performed on 10 nasopharyngeal carcinoma patients who have undergone IMRT. CT images were scanned 3 mm of thickness in the same condition and the treatment plan was performed by Eclipse (Ver.7.1, Varian, Palo Alto, USA). The parameters for planning used 6 MV energy and 8 beams under the same dose volume constraint. The variation of dose rates were used 300, 400, 500 MU/min. The mean dose of both parotid was accessed from the calculated planning among the 10 patients. The mean dose of parotid was verificated by 2D diode array (Mapcheck from Sun Nuclear Corporation, Melbourne, Florida). Also, Total monitor unit (MU) and beam-on time was analysed. Results: According to the dose rate, the mean dose of parotid was increased by 0.8%, 2.0% each, when dose rate was changed from 300 MU/min to 400, 500 MU/min, moreover Total MU was increased by 5.4% and 10.6% each. There was also a dose upward trend in the dose measurement of parotid by 2D diode array. However, beam - on time difference of 1-2 minutes was no significant in the dose rate increases. From this study, when the dose rates increase, there was a significant increase of Total MU and the parotid dose accordingly, however the shortened treatment time was not significant. Hence, it is considered that there is a significant decrease of late side effect in parotid radiation therapy, if the precise dose rate in IMRT is used.
Whole brain radiotherapy for brain metastases: The technique of irradiation influences the dose to parotid glands

International Nuclear Information System (INIS)

Loos, G.; Paulon, R.; Verrelle, P.; Lapeyre, M.

2012-01-01

In the treatment of brain metastases, whole brain radiotherapy can be carried out according two distinct methods: one using multi-leaf collimator for field shaping and protection of organs at risk, and a second one is to make a rotation of the field to avoid the eyes. The aim of the study was to compare for 10 patients the dose distributions at organs at risk for each method. Patients received 30 Gy in 10 fractions. Except for parotid glands, the dose received by organs at risk and the planning target volume was the same with each method. For whole brain radiotherapy, excluding the cisterna cerebellomedullaris, the mean parotid dose was 9.63 Gy using the multi-leaf collimator versus 12.32 Gy using the field rotation (P = 0.04). For whole brain radiotherapy including the cisterna cerebellomedullaris, the mean parotid dose was 11.12 Gy using the multi-leaf collimator versus 20.06 Gy using field rotation (P < 0.001). Using the multi-leaf collimator seems recommended for whole brain radiotherapy, to reduce the dose to the parotids. (authors)
X radiation in parotid gland of young rats. Histopathological comparative evaluation

International Nuclear Information System (INIS)

Roslindo, E.B.; Utrilla, L.S.; Lia, R.C.C.; Roslindo, N.C.; Cerri, P.S.; Azoubel, R.

1992-01-01

The effects of X radiation on the structure of the parotid glands of young rats are studied by means of morphologic technique. Seventy male rats (Rattus norvegicus, albinus Holtzman) were distributed in two experimental groups: Group 1- irradiated and Group 2- control. The region of the parroted glands was irradiated with a dose of 300 rads from 48 to 48 hours up to an exposition of 1.200 rads. After predetermined periods the animals belonging to both groups were sacrificed and the parotid glands were removed for histopathologic evaluation. The serous acini showed to be radium sensitive and in the periods closer to the radiation, the glandular structure des organization and degeneration was noted. (M.A.C.)
Parotid gland sparing radiotherapy technique using 3-D conformal radiotherapy for nasopharyngeal carcinoma

International Nuclear Information System (INIS)

Lim, Ji Hoon; Kim, Gwi Eon; Keum, Ki Chang; Suh, Chang Ok; Lee, Sang Wook; Park, Hee Chul; Cho, Jae Ho; Chang, Sei Kyung; Loh, Juhn Kyu

2000-01-01

Although using the high energy photon beam with conventional parallel-opposed beams radio-therapy for nasopgaryngeal carcinoma, radiation-induced xerostomia is a troublesome problem for patients. We conducted this study to explore a new parotid gland sparing technique in 3-D conformal radiotherapy (3-DCRT) in an effort to prevent the radiation-induced xerostomia. We performed three different planning for four clinically node-negative nasopharyngeal cancer patients with different location of tumor(intracranial extension, nasal cavity extension, oropharyngeal extension, parapharyngeal extension), and intercompared the plans. Total prescription dose was 70.2 Gy to the isocenter. For plan-A, 2-D parallel opposing fields, a conventional radiotherapy technique, were employed. For plan-B, 2-D parallel opposing fields were used up until 54 Gy and afterwards 3-D non-coplanar beams were used. For plan-C, the new technique, 54Gy was delivered by 3-D conformal 3-port beams (AP and both lateral ports with wedge compensator, shielding both superficial lobes of parotid glands at the AP beam using BEV) from the beginning of the treatment and early spinal cord block (at 36 Gy) was performed. And bilateral posterior necks were treated with electron after 36 Gy. After 54 Gy, non-coplanar beams were used for cone-down plan. We intercompared dose statistics (Dmax, Dmin, Dmean, D95, D05, V95, V05, Volume receiving 46 Gy) and dose volume histograms (DVH) of tumor and normal tissues and NTCP values of parotid glands for the above three plans. For all patients, the new technique (plan-C) was comparable or superior to the other plans in target volume isodose distribution and dose statistics and it has more homogenous target volume coverage. The new technique was most superior to the other plans in parotid glands sparing (volume receiving 46 Gy: 100, 98, 69% for each plan-A, B and C). And it showed the lowest NTCP value of parotid glands in all patients (range of NTCP; 96-100%, 79-99%, 51
Paediatric parotid neoplasms: a 10 year retrospective imaging and pathology review of these rare tumours

International Nuclear Information System (INIS)

Mamlouk, M.D.; Rosbe, K.W.; Glastonbury, C.M.

2015-01-01

Aim: To determine the relative incidence of benign and malignant paediatric parotid gland tumours and whether particular presenting symptoms or imaging characteristics were more likely to predict malignancy. Materials and methods: Hospital records were reviewed for all patients <18 years with histopathology-proven parotid neoplasms over the 10 year period from 2003–2013. Infantile haemangiomas and patients with neurofibromatosis type I were excluded. The presenting clinical symptoms for each patient were recorded. All available CT and MRI examinations for these patients were evaluated for tumour imaging characteristics. Results: Seventeen patients (nine boys, eight girls; age range 2–17 years) were identified with neoplastic parotid masses; 11 tumours were malignant (65%) and six were benign (35%). The malignant tumours consisted of three acinic cell carcinomas, two mucoepidermoid carcinomas, one alveolar rhabdomyosarcoma, one poorly differentiated carcinoma, one low-grade adenocarcinoma, and three metastases (two melanoma, one orbital medulloepithelioma). The benign tumours consisted of five pleomorphic adenomas and one schwannoma. Presenting clinical symptoms were similar between benign and malignant tumours. Twelve MRI and six CT examinations were available for review with five patients undergoing both techniques. MRI features commonly identified with malignant tumours included: hypointense T2 signal, restricted diffusion, ill-defined borders, and focal necrosis. Only four of the six tumours imaged at CT were visualized, and of those, the margins were indeterminate in three patients. Conclusion: Paediatric parotid masses are more likely to be malignant than benign. Presenting clinical symptoms and CT are not helpful for distinguishing benign and malignant disease. MRI features such as T2 hypointensity, restricted diffusion, ill-defined borders, and focal necrosis, although not specific, should raise concern for malignancy. - Highlights: • Pediatric parotid
Scintigraphic assessment of salivary function after intensity-modulated radiotherapy for head and neck cancer: correlations with parotid dose and quality of life.

Science.gov (United States)

Chen, Wen-Cheng; Lai, Chia-Hsuan; Lee, Tsair-Fwu; Hung, Chao-Hsiung; Liu, Kuo-Chi; Tsai, Ming-Fong; Wang, Wen-Hung; Chen, Hungcheng; Fang, Fu-Ming; Chen, Miao-Fen

2013-01-01

We investigated salivary function using quantitative scintigraphy and sought to identify functional correlations between parotid dose and quality of life (QoL) for head and neck cancer (HNC) patients receiving intensity-modulated radiotherapy (IMRT). Between August, 2007 and June, 2008, 31 patients treated IMRT for HNC were enrolled in this prospective study. Salivary excretion function (SEF) was previously measured by salivary scintigraphy at annual intervals for 2 years after IMRT. A dose-volume histogram of each parotid gland was calculated, and the normal tissue complication probability (NTCP) was used to determine the tolerance dose. QoL was longitudinally assessed by the EORTC QLQ-C30 and H&N35 questionnaires prior to RT, and at one, three, 12 and 24 months after RT. A significant correlation was found between the reduction of SEF and the mean parotid dose measured at 1 year (correlation coefficient, R(2)=0.651) and 2 years (R(2)=0.310) after IMRT (pwestern countries. We further found that contralateral parotid and submandibular gland function preservation was correlated with reduced sticky saliva and a better QoL compared to the functional preservation of both parotid glands, as determined by the EORTC QLQ-H&N35 questionnaire. A significant correlation was found between the reduction of SEF and the mean parotid dose. Preservation of contralateral parotid and submandibular gland function predicts a better QoL compared to preservation of the function of both parotid glands. Copyright © 2012 Elsevier Ltd. All rights reserved.
Radioprotective effect of vitamin E in parotid glands: a morphometric analysis in rats

International Nuclear Information System (INIS)

Gomes, Carolina Cintra; Boscolo, Frab Norberto; Almeida, Solange Maria de; Ramos-Perez, Flavia Maria de Moraes; Perez, Danyel Elias da Cruz; Novaes, Pedro Duarte

2013-01-01

The aim of this study was to evaluate the radioprotective effect of vitamin E on rat parotid glands by morphometric analysis. Sixty male rats were divided into 5 groups (n=6): control, in which animals received olive oil solution; olive oil/irradiated, in which animals received olive oil and were irradiated with a dose of 15 Gy of gamma radiation; irradiated, in which animals were irradiated with a dose of 15 Gy gamma radiation; vitamin E, which received α-tocopherol acetate solution; vitamin E/irradiated, which received α-tocopherol acetate solution before irradiation with a dose of 15 Gy gamma rays. Half of the animals were euthanized at 8 h, and the remaining at 30 days after irradiation. Both parotid glands were surgically removed and morphometric analysis of acinar cells was performed. Data were subjected to two-way ANOVA and Tukey's test (α=0.05). Morphometric analysis showed a significant reduction in the number of parotid acinar cells at 30 days in olive oil/irradiated and irradiated groups. In groups evaluated over time a significant reduction was shown at 30 days in olive oil/irradiated and irradiated groups, indicating that ionizing radiation caused tissue damage. The vitamin E/irradiated group presented more acinar cells than the irradiated group, but no statistically significant difference was observed (p>0.05). In conclusion, vitamin E seems to have failed as a radioprotective agent on acinar cells in rat parotid glands. (author)
Radioprotective effect of vitamin E in parotid glands: a morphometric analysis in rats

Energy Technology Data Exchange (ETDEWEB)

Gomes, Carolina Cintra; Boscolo, Frab Norberto; Almeida, Solange Maria de [Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP (Brazil). Dept. de Diagnostico Oral; Ramos-Perez, Flavia Maria de Moraes; Perez, Danyel Elias da Cruz, E-mail: flavia.ramosperez@ufpe.br [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil). Dept. de Clinica e Odontologia Preventiva; Novaes, Pedro Duarte [Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP (Brazil). Escola de Odontologia. Dept. de Morfologia

2013-11-01

The aim of this study was to evaluate the radioprotective effect of vitamin E on rat parotid glands by morphometric analysis. Sixty male rats were divided into 5 groups (n=6): control, in which animals received olive oil solution; olive oil/irradiated, in which animals received olive oil and were irradiated with a dose of 15 Gy of gamma radiation; irradiated, in which animals were irradiated with a dose of 15 Gy gamma radiation; vitamin E, which received {alpha}-tocopherol acetate solution; vitamin E/irradiated, which received {alpha}-tocopherol acetate solution before irradiation with a dose of 15 Gy gamma rays. Half of the animals were euthanized at 8 h, and the remaining at 30 days after irradiation. Both parotid glands were surgically removed and morphometric analysis of acinar cells was performed. Data were subjected to two-way ANOVA and Tukey's test ({alpha}=0.05). Morphometric analysis showed a significant reduction in the number of parotid acinar cells at 30 days in olive oil/irradiated and irradiated groups. In groups evaluated over time a significant reduction was shown at 30 days in olive oil/irradiated and irradiated groups, indicating that ionizing radiation caused tissue damage. The vitamin E/irradiated group presented more acinar cells than the irradiated group, but no statistically significant difference was observed (p>0.05). In conclusion, vitamin E seems to have failed as a radioprotective agent on acinar cells in rat parotid glands. (author)
Importance of the initial volume of parotid glands in xerostomia for patients with head and neck cancers treated with IMRT

International Nuclear Information System (INIS)

Nishimura, Yasumasa; Nakamatsu, Kiyoshi; Shibata, Toru; Kanamori, Shuichi; Koike, Ryuta; Okumura, Masahiko; Suzuki, Minoru

2005-01-01

Our aim was to evaluate predictors of xerostomia in patients with head and neck cancers treated with intensity-modulated radiation therapy (IMRT). Thirty-three patients with pharyngeal cancer were evaluated for xerostomia after having been treated with IMRT. All patients were treated with whole-neck irradiation of 46-50 Gy by IMRT, followed by boost IMRT to the high-risk clinical target volume to a total dose of 56-70 Gy in 28-35 fractions (median, 68 Gy). For boost IMRT, a second computed tomography (CT-2) scan was done in the third to fourth week of IMRT. Xerostomia was scored 3-4 months after the start of IMRT. The mean doses to the contralateral and ipsilateral parotid glands were 24.0±6.2 and 30.3±6.6 Gy, respectively. Among the 33 patients, xerostomia of grades 0, 1, 2 and 3 was noted in one, 18, 12 and two patients, respectively. Although the mean dose to the parotid glands was not correlated with the grade of xerostomia, the initial volume of the parotid glands was correlated with the grade of xerostomia (P=0.04). Of 17 patients with small parotid glands (≤38.8 ml) on initial CT (CT-1), 11 (65%) showed grade 2 or grade 3 xerostomia, whereas only three (19%) of 16 patients with larger parotid glands showed grade 2 xerostomia (P<0.05). The mean volume of the parotid glands on CT-1 was 43.1±15.2 ml, but decreased significantly to 32.0±11.4 ml (74%) on CT-2 (P<0.0001). Initial volumes of the parotid glands are significantly correlated with the grade of xerostomia in patients treated with IMRT. The volume of the parotid glands decreased significantly during the course of IMRT. (author)

Perfusion characteristics of parotid gland tumors evaluated by contrast-enhanced ultrasound

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Klotz, Laura V., E-mail: Laura.Klotz@med.uni-muenchen.de [Department of Surgery, University of Munich, Munich (Germany); Gürkov, Robert [Department of Otorhinolaryngology, University of Munich, Munich (Germany); Eichhorn, Martin E. [Department of Surgery, University of Munich, Munich (Germany); Siedek, Vanessa; Krause, Eike [Department of Otorhinolaryngology, University of Munich, Munich (Germany); Jauch, Karl-Walter [Department of Surgery, University of Munich, Munich (Germany); Reiser, Maximilian F.; Clevert, Dirk-Andre [Department of Clinical Radiology, University of Munich, Munich (Germany)

2013-12-01

Purpose: Contrast enhanced ultrasound (CE-US) is a promising imaging modality for non-invasive analysis of parotid gland lesions because their vascularisation differs from normal gland tissue. This clinical study should further investigate CE-US as a diagnostic tool for parotid gland tumors. Materials and methods: 39 patients underwent CE-US measurements after intravenous application of a contrast agent (SonoVue, Bracco, Italy) before surgical tumor resection. Time–intensity curves gradients were calculated and parameters of intratumoral microcirculation were analysed. The vascularisation parameters were compared among the different tumor entities as defined per definitive histological diagnosis. Results: Histological analyses revealed 17 pleomorphic adenoma, 15 cystadenolymphoma and 7 malignoma. A significant difference of area below intensity time curve (AUC) and mean transit time (MTT) was measured in the malignant lesions compared to benign tumors (p < 0.05). A significant difference of AUC and maximum of signal increase (ΔSI{sub max}) for pleomorphic adenoma versus cystadenolymphoma was found (p < 0.05). Conclusion: CE-US seems to be a quantitative and independent method for the assessment of malign and benign parotid gland tumors. Further studies and clinical experience will have to validate this method as a reliable diagnostic tool that facilitates preoperative planning.
Ultrasonic Nakagami-parameter characterization of parotid-gland injury following head-and-neck radiotherapy: A feasibility study of late toxicity

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Yang, Xiaofeng; Wu, Ning; Wang, Yuefeng [Radiation Oncology, Emory University, Atlanta, Georgia 30322 (United States); Tridandapani, Srini [Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia 30322 (United States); School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, Georgia 30332 (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia 30322 (United States); Beitler, Jonathan J.; Yu, David S.; Curran, Walter J.; Liu, Tian, E-mail: tliu34@emory.edu [Radiation Oncology, Emory University, Atlanta, Georgia 30322 and Winship Cancer Institute, Emory University, Atlanta, Georgia 30322 (United States); Bruner, Deborah W. [Radiation Oncology, Emory University, Atlanta, Georgia 30322 (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia 30322 (United States); School of Nursing, Emory University, Atlanta, Georgia 30322 (United States)

2014-02-15

Purpose: The study aims to investigate whether Nakagami parameters—estimated from the statistical distribution of the backscattered ultrasound radio-frequency (RF) signals—could provide a means for quantitative characterization of parotid-gland injury resulting from head-and-neck radiotherapy. Methods: A preliminary clinical study was conducted with 12 postradiotherapy patients and 12 healthy volunteers. Each participant underwent one ultrasound study in which ultrasound scans were performed in the longitudinal, i.e., vertical orientation on the bilateral parotids. For the 12 patients, the mean radiation dose to the parotid glands was 37.7 ± 9.5 Gy, and the mean follow-up time was 16.3 ± 4.8 months. All enrolled patients experienced grade 1 or 2 late salivary-gland toxicity (RTOG/EORTC morbidity scale). The normal parotid glands served as the control group. The Nakagami-scaling and Nakagami-shape parameters were computed from the RF data to quantify radiation-induced parotid-gland changes. Results: Significant differences in Nakagami parameters were observed between the normal and postradiotherapy parotid glands. Compared with the control group, the Nakagami-scaling parameter of the postradiotherapy group decreased by 25.8% (p < 0.001), and the Nakagami-shape parameter decreased by 31.3% (p < 0.001). The area under the receiver operating characteristic curve was 0.85 for the Nakagami-scaling parameter and was 0.95 for the Nakagami-shape parameter, which further demonstrated the diagnostic efficiency of the Nakagami parameters. Conclusions: Nakagami parameters could be used to quantitatively measure parotid-gland injury following head-and-neck radiotherapy. Moreover, the clinical feasibility was demonstrated and this study provides meaningful preliminary data for future clinical investigation.
Oncocytic carcinoma of parotid gland: a case report with clinical, immunohistochemical and ultrastructural features

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Giordano Giovanna

2006-08-01

Full Text Available Abstract Background Oncocytic carcinoma is an extremely rare neoplasm of the salivary glands. We report a case of oncocytic carcinoma arising in a parotid gland in a 66-year-old female. Method An excisional biopsy of the parotid tumor was performed. The specimen was submitted for histology and after fixation in formalin solution and inclusion in paraffin, 3–5 μm sections were stained with hematoxylin and eosin for conventional evaluation and Periodic acid Schiff stain. Immunohistochemical studies were performed using antibodies against mitochondrial antigen, keratin, S-100, alpha-actin, vimentin, alpha-1-antichymotrypsin as well as an ultrastructural analysis was performed. Results Frozen sections revealed an infiltrative growth pattern and the diagnosis of a malignant epithelial lesion was made. Permanent sections stained with haematoxylin and eosin revealed a neoplasm that had replaced a wide area of the parotid gland and had invaded subcutaneous adipose tissue. Perineural invasion was evident, but vascular invasion was not found. Neoplastic elements were large, round or polyhedral cells and were arranged in solid sheets, islands and cords. The cytoplasm was abundant, eosinophilic and finely granular. The nuclei were large and located centrally or peripherally. The nucleoli were distinct and large. Periodic acid Schiff stain demonstrated a granular cytoplasm. Immunohistochemistry demonstrated mithochondrial antigen, keratin, and chymotrypsin immunoreactivity in the neoplastic cells. Ultrastructural analysis revealed numerous mitochondria packed into the cytoplasm of the neoplastic cells. Thus, the final diagnosis was that of oncocytic carcinoma of parotid gland. Conclusion This neoplasm shows clinical, microscopical, histological and ultrastructural features of oncocytic carcinoma and this must be considered in the differential diagnosis of other proliferations in the parotid gland with abundant granular cytoplasm and metastatic oncocytic
Polymer coated liposomes for dental drug delivery--interactions with parotid saliva and dental enamel.

Science.gov (United States)

Nguyen, S; Hiorth, M; Rykke, M; Smistad, G

2013-09-27

The interactions between pectin coated liposomes and parotid saliva and dental enamel were studied to investigate their potential to mimic the protective biofilm formed naturally on tooth surfaces. Different pectin coated liposomes with respect to pectin type (LM-, HM- and AM-pectin) and concentration (0.05% and 0.2%) were prepared. Interactions between the pectin coated liposomes and parotid saliva were studied by turbidimetry and imaging by atomic force microscopy. The liposomes were adsorbed to hydroxyapatite (HA) and human dental enamel using phosphate buffer and parotid saliva as adsorption media. A continuous flow was imposed on the enamel surfaces for various time intervals to examine their retention on the dental enamel. The results were compared to uncoated, charged liposomes. No aggregation tendencies for the pectin coated liposomes and parotid saliva were revealed. This makes them promising as drug delivery systems to be used in the oral cavity. In phosphate buffer the adsorption to HA of pectin coated liposomes was significantly lower than the negative liposomes. The difference diminished in parotid saliva. Positive liposomes adsorbed better to the dental enamel than the pectin coated liposomes. However, when subjected to flow for 1h, no significant differences in the retention levels on the enamel were found between the formulations. For all formulations, more than 40% of the liposomes still remained on the enamel surfaces. At time point 20 min the retention of HM-pectin coated and positive liposomes were significantly higher. It was concluded that pectin coated liposomes can adsorb to HA as well as to the dental enamel. Their ability to retain on the enamel surfaces promotes the concept of using them as protective structures for the teeth. Copyright © 2013 Elsevier B.V. All rights reserved.
Irradiation of metastatic carcinoma parotid

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Jack, G.A.

1981-01-01

Acinic cell carcinomas of the parotid should be considered distinct malignancies despite descriptions of low-grade malignant potential and innocuous histologic patterns. Benign-appearing tumors frequently have a clinically malignant course. Blood-borne metastases may oocur early despite gross and microscopic innocence. Indolent growth may be a characteristic of local disease, which may then be approached with less than radical parotidectomy and sacrifice of the facial nerve. These tumors prove to be radiosensitive. More agressive postoperative irradiation and palliative irradiation is recommended. Two cases of successful palliation of spinal metastases are presented as examples of radiosensitivity of this tumor
Hyperacute unilateral contrast-induced parotiditis during cerebral angiography

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Song J. Kim, MD

2018-02-01

Full Text Available An uncommon complication of iodinated contrast administration is the development of bilateral sialadenitis. We report a unique case of hyperacute unilateral parotiditis during diagnostic cerebral angiography of the external carotid artery, which mimicked possible iatrogenic vascular event associated with cerebral endovascular procedures. Discussion includes the differential diagnosis, diagnostic studies, and treatments for this unusual condition.
Pleomorphic adenoma of the parotid gland 1985-2010

DEFF Research Database (Denmark)

Andreasen, Simon; Therkildsen, Marianne H; Bjørndal, Kristine

2016-01-01

-up on these topics. METHODS: The Danish Pathology Data Bank was searched for parotid pleomorphic adenoma and Ca-ex-PA in the period 1985 to 2010 and all pathology descriptions were reviewed. Ca-ex-PA specimens were reviewed by a pathologist. RESULTS: A total of 5.497 patients were identified and 2.86% had at least...
Perfusion imaging of parotid gland tumours: usefulness of arterial spin labeling for differentiating Warthin's tumours

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Kato, Hiroki; Watanabe, Haruo [Gifu University School of Medicine, Department of Radiology, Gifu (Japan); Kanematsu, Masayuki [Gifu University School of Medicine, Department of Radiology, Gifu (Japan); Gifu University Hospital, High-level Imaging Diagnosis Center, Gifu (Japan); Kajita, Kimihiro [Gifu University Hospital, High-level Imaging Diagnosis Center, Gifu (Japan); Mizuta, Keisuke; Aoki, Mitsuhiro [Gifu University School of Medicine, Department of Otolaryngology, Gifu (Japan); Okuaki, Tomoyuki [Philips Healthcare, Tokyo (Japan)

2015-11-15

To assess prospectively the efficacy of arterial spin labelling (ASL) against conventional and diffusion-weighted (DW) MR imaging for differentiating parotid gland tumours. We included 10 pleomorphic adenomas, 12 Warthin's tumours, and nine malignant tumours of the parotid glands. Only tumours larger than 10 mm were included in this study. All parotid gland tumours underwent T1-weighted, T2-weighted, DW, and ASL imaging. Tumour-to-parotid gland signal intensity ratios (SIRs) and apparent diffusion coefficients (ADCs) of solid components were correlated with these pathologies. SIRs on T2-weighted images and ADCs were higher in pleomorphic adenomas than in Warthin's tumours (p <.01) and malignant tumours (p <.01). SIRs on ASL were higher in Warthin's tumours than in pleomorphic adenomas (p <.01) and malignant tumours (p <.05). Az value of SIRs on ASL for differentiating Warthin's tumours from the other pathologies was 0.982. The sensitivity, specificity, and accuracy of SIRs on ASL for the diagnosis of Warthin's tumours at an optimal SIR threshold of over 8.70 were 91.7 %, 94.7 %, and 93.5 %, respectively. ASL with SIR measurements could non-invasively evaluate tumour blood flow of parotid gland tumours and differentiate Warthin's tumours from pleomorphic adenomas and malignant tumours. (orig.)
Effects of 5-fluorouracil on the secretory process of the rat parotid gland

International Nuclear Information System (INIS)

Sandborg, R.R.

1986-01-01

Experimental animals were injected intraperitoneally with 100 mg/kg 5-fluorouracil for three days. The total volume, amylase and protein content of cannulated parotid saliva were determined following stimulation with either 5 mg/kg pilocarpine or 5 mg/kg isoproterenol in experimental, pair-fed , and control animals. Saliva from experimental animals was significantly lower in volume, amylase and protein content than both control groups. 5-fluorouracil treatment reduced the total glandular amylase per unit DNA in both unstimulated and isoproterenol-stimulated parotid glands. Decreased protein synthesis may be the mechanism underlying depleted secretory protein stores since the contents of isolated secretory granules from experimental parotid glands contained less radiolabelled protein than either control group and whole gland homogenates showed marked reductions in the activities of three lysosomal enzymes and total RNA content. Experimental animals contained less labelled protein in their secretory granules than controls, but secreted a greater proportion of their total glandular radiolabelled secretory protein into saliva relative to amylase suggesting that newly synthesized secretory proteins are preferentially secreted
Effects of 5-fluorouracil on the secretory process of the rat parotid gland

Energy Technology Data Exchange (ETDEWEB)

Sandborg, R.R.

1986-01-01

Experimental animals were injected intraperitoneally with 100 mg/kg 5-fluorouracil for three days. The total volume, amylase and protein content of cannulated parotid saliva were determined following stimulation with either 5 mg/kg pilocarpine or 5 mg/kg isoproterenol in experimental, pair-fed , and control animals. Saliva from experimental animals was significantly lower in volume, amylase and protein content than both control groups. 5-fluorouracil treatment reduced the total glandular amylase per unit DNA in both unstimulated and isoproterenol-stimulated parotid glands. Decreased protein synthesis may be the mechanism underlying depleted secretory protein stores since the contents of isolated secretory granules from experimental parotid glands contained less radiolabelled protein than either control group and whole gland homogenates showed marked reductions in the activities of three lysosomal enzymes and total RNA content. Experimental animals contained less labelled protein in their secretory granules than controls, but secreted a greater proportion of their total glandular radiolabelled secretory protein into saliva relative to amylase suggesting that newly synthesized secretory proteins are preferentially secreted.
Pre-operative irradiation of eosinophilic granuloma in the parotid area

International Nuclear Information System (INIS)

Kitahara, Satoshi; Toda, Yukio; Nakajima, Hisami; Takeyama, Isamu; Sodemoto, Yukio; Endo, Masaru

1983-01-01

Eosinophilic granuloma is thought to originate in the reticuloendothelial system and cannot clearly be distinguished from the surrounding tissue during operation. An eosinophilic granuloma in the parotid area was removed after 25 days of irradiation at a dosage of 10.0 Gy per 3 days. A thin capsule of connective tissue was observed after the tumor was cut in half. Then, histopathological studies were performed on this connective tissue to determine the effect of the irradiation. Histopathologically, at the periphery of the tissue, atrophy of lymphocytes and destruction of the lymphoid tissue, which were thought to result in an increase in the connective tissue, were observed. It was concluded that a small dose of pre-operative radiation on eosinophilic granuloma in the parotid area made the tumor small and produced a capsule around the tumor. (author)
The accuracy of fine-needle aspiration cytology for diagnosis of parotid gland masses: a clinicopathological study of 114 patients

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Jens Kristjan GUDMUNDSSON

Full Text Available ABSTRACT Objective Fine-needle aspiration cytology is a valuable method for preoperative assessment of head and neck tumors. However, its accuracy in detection of salivary gland masses is controversial compared with other methods. The aim of this work was to evaluate the effectiveness and accuracy of fine-needle aspiration cytology (FNAC in the diagnosis of parotid gland masses. Material and Methods Over a 10-year period, 126 parotid gland masses were resected. Retrospective chart reviews of 114 patients were performed. The results of FNAC and final histological diagnosis were compared and the accuracy of FNAC was determined. Results Final histological evaluation revealed 11 malignant tumors and 103 benign lesions. Pleomorphic adenoma was the most common neoplasm (63%, followed by Warthin’s tumor (17.5%. The sensitivity of FNAC in detecting malignant tumors was 73% and the specificity was 97%. Positive predictive value (PPV was 73% and negative predictive value (NPV was 97%. The overall accuracy of FNAC in detecting parotid masses was 95%. False-negative diagnosis was found in mucoepidermoid carcinoma, acinic cell carcinoma, and epithelial-myoepithelial carcinoma whereas there was false-positive diagnosis in cases of pleomorphic adenoma and normal parotid gland tissue. Conclusion FNAC is a reliable minimally invasive diagnostic method with a high sensitivity in diagnosis of lesions in parotid glands. The sensitivity of detection of malignant tumors in parotid glands was low due to the biopsy technique used, and depended on tumor location. Postoperative complications decreased after superficial parotidectomy.
Diagnostic value of magnetic resonance imaging and the pathologic basis of parotid Warthin's tumor in 46 cases

International Nuclear Information System (INIS)

Yuan Jianpeng; Huang Suiqiao; Xie Bangkun; Zhong Jinglian; Li Yong

2004-01-01

Objective: To summarize MR manifestations of parotid Warthin's tumor and to investigate their pathological fundament. MR findings of parotid Warthin's tumor including shape, margin, signal intensity on T 1 WI and T 2 WI, homogeneity of the signal, enhancement were analyzed retrospectively in this study. Methods: In total 46 cases (54 lesions) of parotid Warthin's tumor proved by surgery were enrolled. MRI manifestations were comparatively studied with pathological findings. T 1 WI and T 2 WI sequence were used in non-contrast scan, while both non-contrast and enhanced scan were performed in 50 lesions out of 54. Results: The shapes of Warthin's tumor were regular (51/54); the edges were clear (54/54); more than half of the lesions (33/54) presented with low or equal signal intensity on T 2 WI; 50 Warthin's tumors enhanced slightly. The MR features of Warthin's tumors were different from pleomorphic adenoma and other parotid benign tumors. Conclusion: There are certain characteristics of Warthin's tumors on MR images, and these are helpful in determining the histological nature of the tumor
Evaluation of geometric changes of parotid glands during head and neck cancer radiotherapy using daily MVCT and automatic deformable registration

International Nuclear Information System (INIS)

Lee, Choonik; Langen, Katja M.; Lu, Weiguo; Haimerl, Jason; Schnarr, Eric; Ruchala, Kenneth J.; Olivera, Gustavo H.; Meeks, Sanford L.; Kupelian, Patrick A.; Shellenberger, Thomas D.; Manon, Rafael R.

2008-01-01

Background and purpose: To assess and evaluate geometrical changes in parotid glands using deformable image registration and megavoltage CT (MVCT) images. Methods: A deformable registration algorithm was applied to 330 daily MVCT images (10 patients) to create deformed parotid contours. The accuracy and robustness of the algorithm was evaluated through visual review, comparison with manual contours, and precision analysis. Temporal changes in the parotid gland geometry were observed. Results: The deformed parotid contours were qualitatively judged to be acceptable. Compared with manual contours, the uncertainties of automatically deformed contours were similar with regard to geometry and dosimetric endpoint. The day-to-day variations (1 standard deviation of errors) in the center-of-mass distance and volume were 1.61 mm and 4.36%, respectively. The volumes tended to decrease with a median total loss of 21.3% (6.7-31.5%) and a median change rate of 0.7%/day (0.4-1.3%/day). Parotids migrated toward the patient center with a median total distance change of -5.26 mm (0.00 to -16.35 mm) and a median change rate of -0.22 mm/day (0.02 to -0.56 mm/day). Conclusion: The deformable image registration and daily MVCT images provide an efficient and reliable assessment of parotid changes over the course of a radiation therapy
Monitoring Dosimetric Impact of Weight Loss With Kilovoltage (KV) Cone Beam CT (CBCT) During Parotid-Sparing IMRT and Concurrent Chemotherapy

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Ho, Kean Fatt, E-mail: hokeanfatt@hotmail.com [Academic Radiation Oncology, The Christie NHS Foundation Trust, Manchester (United Kingdom); Marchant, Tom; Moore, Chris; Webster, Gareth; Rowbottom, Carl [North Western Medical Physics, The Christie NHS Foundation Trust, Manchester (United Kingdom); Penington, Hazel [Wade Radiotherapy Research Centre, The Christie NHS Foundation Trust, Manchester (United Kingdom); Lee, Lip; Yap, Beng; Sykes, Andrew; Slevin, Nick [Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester (United Kingdom)

2012-03-01

Purpose: Parotid-sparing head-and-neck intensity-modulated radiotherapy (IMRT) can reduce long-term xerostomia. However, patients frequently experience weight loss and tumor shrinkage during treatment. We evaluate the use of kilovoltage (kV) cone beam computed tomography (CBCT) for dose monitoring and examine if the dosimetric impact of such changes on the parotid and critical neural structures warrants replanning during treatment. Methods and materials: Ten patients with locally advanced oropharyngeal cancer were treated with contralateral parotid-sparing IMRT concurrently with platinum-based chemotherapy. Mean doses of 65 Gy and 54 Gy were delivered to clinical target volume (CTV)1 and CTV2, respectively, in 30 daily fractions. CBCT was prospectively acquired weekly. Each CBCT was coregistered with the planned isocenter. The spinal cord, brainstem, parotids, larynx, and oral cavity were outlined on each CBCT. Dose distributions were recalculated on the CBCT after correcting the gray scale to provide accurate Hounsfield calibration, using the original IMRT plan configuration. Results: Planned contralateral parotid mean doses were not significantly different to those delivered during treatment (p > 0.1). Ipsilateral and contralateral parotids showed a mean reduction in volume of 29.7% and 28.4%, respectively. There was no significant difference between planned and delivered maximum dose to the brainstem (p = 0.6) or spinal cord (p = 0.2), mean dose to larynx (p = 0.5) and oral cavity (p = 0.8). End-of-treatment mean weight loss was 7.5 kg (8.8% of baseline weight). Despite a {>=}10% weight loss in 5 patients, there was no significant dosimetric change affecting the contralateral parotid and neural structures. Conclusions: Although patient weight loss and parotid volume shrinkage was observed, overall, there was no significant excess dose to the organs at risk. No replanning was felt necessary for this patient cohort, but a larger patient sample will be investigated
Impact of residual setup error on parotid gland dose in intensity-modulated radiation therapy with or without planning organ-at-risk margin

International Nuclear Information System (INIS)

Delana, Anna; Menegotti, Loris; Valentini, Aldo; Bolner, Andrea; Tomio, Luigi; Vanoni, Valentina; Lohr, Frank

2009-01-01

Purpose: To estimate the dosimetric impact of residual setup errors on parotid sparing in head-and-neck (H and N) intensity-modulated treatments and to evaluate the effect of employing an PRV (planning organ-at-risk volume) margin for the parotid gland. Patients and methods: Ten patients treated for H and N cancer were considered. A nine-beam intensity-modulated radiotherapy (IMRT) was planned for each patient. A second optimization was performed prescribing dose constraint to the PRV of the parotid gland. Systematic setup errors of 2 mm, 3 mm, and 5 mm were simulated. The dose-volume histograms of the shifted and reference plans were compared with regard to mean parotid gland dose (MPD), normal-tissue complication probability (NTCP), and coverage of the clinical target volume (V 95% and equivalent uniform dose [EUD]); the sensitivity of parotid sparing on setup error was evaluated with a probability-based approach. Results: MPD increased by 3.4%/mm and 3.0%/mm for displacements in the craniocaudal and lateral direction and by 0.7%/mm for displacements in the anterior-posterior direction. The probability to irradiate the parotid with a mean dose > 30 Gy was > 50%, for setup errors in cranial and lateral direction and 95% and EUD variations < 1% and < 1 Gy). Conclusion: The parotid gland is more sensitive to craniocaudal and lateral displacements. A setup error of 2 mm guarantees an MPD ≤ 30 Gy in most cases, without adding a PRV margin. If greater displacements are expected/accepted, an adequate PRV margin could be used to meet the clinical parotid gland constraint of 30 Gy, without affecting target volume coverage. (orig.)
Effect of methimazole-induced hypothyroidism on histological characteristics of parotid gland of albino rat

International Nuclear Information System (INIS)

Hayat, N.Q.; Tahir, M.; Sami, W.

2010-01-01

Background: The current study was carried out to investigate the effect of hypothyroidism on the histological structure of parotid salivary gland of the rat. Methods: Twenty male albino rats, weighing between 130-150 grams, were used which were divided into two groups; control group (A) and an experimental group (B), each containing 10 animals. Group B was rendered hypothyroid by giving methimazole (MMI) as 0.02% solution in drinking water daily for 3 weeks. On day 22 parotid and thyroid glands were removed, weighed and processed for light microscopy. Salivary gland was fixed in Bouin's solution, H and E and Toluidine blue stains were used for histological examination. Serum T /sub 3/, T/sub 4/ and TSH levels were determined by enzyme immunoassay. Results: In group A, serum concentration of T/sub 3/, T/sub 4/ and TSH was 12.58+-3.05 mu g/ml, 4.72 +- 1.20 macro g/dl, and 0.25 +- 0.24 macro IU/ml respectively, where as in group B it was 2.14+-1.83 mu g/ml, 1.04 +- 0.44 macro g/dl and 1.44+-0.20 mu U/ml respectively. When differences between T/sub 3/, T/sub 4/ and TSH of the groups were compared, the p-value was <0.000, <0.000, and <0.000 respectively. Mean thyroid weight significantly increased in group B (44.1 0+-1.66 mg) when compared to that in group A (33.70+-1.56 mg). These findings established the occurrence of hypothyroid state in the experimental group. There was a statistically significant reduction in the parotid gland weight in the animals of the experimental group (38.30 +- 1.15 mg) when compared to the control group (39.60 +- 0.84 mg), (p<0.01). With light microscopy, group A showed a normal structure of parotid salivary gland, whereas multiple histological changes were observed in parotrid gland of the experimental group. Number of mast cells in parotid gland was also significantly higher (p<0.017) in group B (3.70 +- 1.11/mm/sup 2/) than in group A (2.25 +- 1.34/mm/sup 2/). Conclusion: The level of T/sub 3/ T/sub 4/ decreased and that of TSH increased
Recurrence in Region of Spared Parotid Gland After Definitive Intensity-Modulated Radiotherapy for Head and Neck Cancer

International Nuclear Information System (INIS)

Cannon, Donald M.; Lee, Nancy Y.

2008-01-01

Purpose: To discuss the implications of three examples of periparotid recurrence after definitive intensity-modulated radiotherapy (IMRT) for head and neck cancer (HNC). Methods and Materials: We present 3 patients with HNC who underwent definitive IMRT with concurrent chemotherapy and later had treatment failure in or near a spared parotid gland. Two patients had bilateral multilevel nodal disease, and all had Level II nodal disease ipsilateral to the site of recurrence. The patients were treated using dose-painting IMRT with a dose of 70 Gy to the gross tumor volume and 59.4 Gy or 54 Gy to the high-risk or low-risk clinical tumor volume, respectively. The parotid glands were spared bilaterally. The patients had not undergone any surgical treatment for HNC before radiotherapy. Results: All patients had treatment failure in the region of a spared parotid gland. Failure in the 2 patients with bilateral multilevel nodal involvement occurred in the periparotid lymph nodes. The third patient developed a dermal metastasis near the tail of a spared parotid gland. On pretreatment imaging, the 2 patients with nodal failure had small nonspecific periparotid nodules that showed no hypermetabolic activity on positron emission tomography. Conclusion: For HNC patients receiving definitive IMRT, nonspecific positron emission tomography-negative periparotid nodules on pretreatment imaging should raise the index of suspicion for subclinical disease in the presence of multilevel or Level II nodal metastases. Additional evaluation of such nodules might be indicated before sparing the ipsilateral parotid gland
Lipomatosisof the parotid gland in children

International Nuclear Information System (INIS)

Al-Arfaj, Abdullatif A.; Arora, Roopa K.; El-Hassan, Abdulla Y.; Al-Metwalli, Roshdi R.

2003-01-01

Parotid lipomatosis is extremely rare in children. Only four cases have previously been reported in English language medical literature. Surgical excision is frequetly complicated by recurrence. We report a fifth case, on a five- month- old girl with rapidly progressivelipomatosis. Emphasis is laid on importance of preserving the unusually delicate tumor capsule to prevent tissue spillage and recurrance. The creation of appropriate cleavage between the mass and expanded skin with sparse subcutaneous fat, safeguarding the tumor capsule on one side and the skin blood supply on the other represents a rewarding technical challenge. (author)
Stationary facial nerve paresis after surgery for recurrent parotid pleomorphic adenoma

DEFF Research Database (Denmark)

Nøhr, Anders; Andreasen, Simon; Therkildsen, Marianne Hamilton

2016-01-01

The purpose was to assess degree of permanent facial nerve dysfunction after surgery for recurrent pleomorphic adenoma (RPA) of the parotid gland, including variables that might influence re-operation outcomes. Nationwide retrospective longitudinal cohort study including a questionnaire survey...... of patients undergoing surgery for RPA. Of 219 living patients, 198 (92 %) responded and 127 (63 %) reported no facial dysfunction. Statistically significant associations were found between number of surgeries and permanent facial nerve dysfunction of all degrees (OR 1.43, 95 % CI 1.16-1.78, p = 0.......001). A not significant tendency for females to be associated with worse outcome was found (p = 0.073). Risks of different degrees of paresis after the second-fourth surgeries were found (OR 1.86-2.19, p RPA of the parotid...

Impact of patient positioning on radiotherapy dose distribution: An assessment in parotid tumor

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Seema Sharma

2016-03-01

Full Text Available Purpose: We intended to study the impact of patient positioning on the dose distribution within target volume and organs at risk in patients with parotid malignancies treated with 3D conformal radiotherapy (3D-CRT with photon wedge pair (WP or intensity modulated radiotherapy (IMRT.Methods: Three patients with a non-Hodgkin’s lymphoma of the right parotid gland were consecutively immobilized using thermoplastic cast in 2 positions: supine with head in neutral position (HN and with head turned 90° to the left side (HT. Images for treatment planning purpose were acquired in both positions. For both positions, photon WP plans and 5 field IMRT plans were generated, after contouring clinical target volume (CTV, planning target volume (PTV= CTV + 5 mm margin and organs at risk (OAR. All plans were evaluated for target coverage and dose to OARs.Results: Both CTV and PTV were apparently larger in HN compared with HT (31.76±8.89 cc, 30.31±7.83 cc and 62.49±19.01 cc, 58.89±15.33 cc respectively. The CI value for PTV was slightly better for HT compared to HN position in both the WP and IMRT plans. The homogeneity was comparable in both the head positions in case of WP plan. The mean HI of PTV was increased in case of IMRT plan at HT versus HN position (1.108 vs. 1.097. A change in head position from HN to HT with wedge pair plan resulted in a reduction of brainstem Dmax and Dmean. Lesser dose was observed in HN position for contralateral parotid. A difference of 0.9 Gy in the average Dmax to spinal cord was seen. The values of Dmean to mandible, oral cavity, ipsilateral and contralateral cochlea were higher in the HT position. A change in head position from HN to HT with IMRT plan resulted in a dose reduction in average Dmax to brainstem. The spinal cord Dmax increased at the HT position by 1.2 Gy. The dose to contralateral parotid and cochlea was comparable in both the positions. However, the Dmean to oral cavity was reduced at HT position. Whereas
Acute parotiditis after cesarean section; case report

OpenAIRE

Cristina Moisei; Romina M. Sima; Liana Pleş

2017-01-01

The enlargement of the parotid gland develops in inflammatory or stenotic conditions but after Cesarean section the symptomatology is unusual. A 38 year old patient with no obstetrical history referred to our clinic for pregnancy, which followed our national program of prenatal care. The outcome of the pregnancy was favorable for both mother and fetus. During labor the fetus developed bradycardia and the patient delivered by Cesarean section a 3400 g baby-boy with 8 Apgar Score; the anesthesi...
Cutaneous Carcinosarcoma with Metastasis to the Parotid Gland

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Tze Ling Loh

2014-01-01

Full Text Available Cutaneous carcinosarcoma is a rare malignancy that exhibits both mesenchymal and epithelial components. It is similar to nonmelanoma skin cancers in terms of risk and prognostic factors. However, these malignancies are known to have a propensity for local recurrence and metastasis, even with adequate resection margins. Here we report a case of metastatic cutaneous carcinosarcoma to the parotid gland and review the relevant literature.
Cutaneous Carcinosarcoma with Metastasis to the Parotid Gland

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Loh, Tze Ling; Tomlinson, Jeanne; Chin, Ronald; Eslick, Guy D.

2014-01-01

Cutaneous carcinosarcoma is a rare malignancy that exhibits both mesenchymal and epithelial components. It is similar to nonmelanoma skin cancers in terms of risk and prognostic factors. However, these malignancies are known to have a propensity for local recurrence and metastasis, even with adequate resection margins. Here we report a case of metastatic cutaneous carcinosarcoma to the parotid gland and review the relevant literature.
Induction of salivary polypeptides associated with parotid hypertrophy by gallotannins administered topically into the mouse mouth.

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Gho, Francesca; Peña-Neira, Alvaro; López-Solís, Remigio O

2007-02-01

Isoproterenol-induced salivary polypeptides (IISP), a group of proline-rich proteins synthesized by mouse parotids, have been considered as markers for isoproterenol-induced parotid hypertrophy. Rodents fed diets containing high-tannin cereals (sorghum), also develop parotid hypertrophy. To test whether tannins are directly involved in provoking sialotrophic growth, we studied the effect of intraperitoneal and topical oral administrations of tannic acid (TA) on the induction of IISP polypeptides in endogamic mice (A/Snell). TA was characterized by HPLC chromatography and spectral analysis and shown to be composed solely of gallotannins, a complex family of glucose and gallic acid esters. IISP polypeptides were monitored in saliva by SDS-polyacrylamide gel electrophoresis during 36 h after ending TA stimulation. Single daily intraperitoneal administrations of TA for 3 consecutive days (0.033 mg/g bw/day), at variance of parallel administrations of isoproterenol (0.042 mg/g bw/day) failed to induce IISP polypeptides. However, repeated topical applications of TA into the mouse mouths (1.21 mg/g bw divided into three equal doses given at 4-h intervals within a single day) resulted in unequivocal induction of IISP polypeptides. That response was clearly intensified by increasing the stimulation frequency to eight equivalent doses given at 1.5-h intervals within a single day (corresponding to 3.23 mg/g bw) and even further by repeating this protocol for 3 days. Under these productive schemes of stimulations by TA, electrophoretic fractionation of parotid homogenates showed new polypeptide bands migrating in parallel to salivary IISP. These results suggest that topically administered gallotannins are effective inducers of trophic growth in mouse parotids.
Facial Nerve Morbidity Following Surgery for Benign Parotid Tumours

International Nuclear Information System (INIS)

Musani, M. A.; Suhail, Z.; Zafar, A.; Malik, S.; Mirza, D.

2014-01-01

Objective: To determine the frequency and severity of facial nerve dysfunction following surgery for benign parotid gland tumours. Study Design: A case series. Place and Duration of Study: ENT Department, Karachi Medical and Dental College and Abbasi Shaheed Hospital and Ziauddin University Hospital, from 1990 to 2010. Methodology: Data was collected of all patients who were surgically managed for benign parotid tumours from 1990 to 2010. Data was reviewed for presentation of tumour, age and gender of the patient, site of tumour, nature and morphology of the tumour, primary or recurrent, surgical procedure adopted and the complications of the surgery especially the facial nerve dysfunction, its severity, complete or partial paresis and transient or permanent and time of recovery. Results were described as frequency percentages. Results: Out of 235 patients, 159 (67.65%) were female and 76 (32.35%) were male. Age ranged from 18 to 70 years. Pleomorphic adenoma was the most common tumour (n=194, 82.6%), followed by Warthin's tumour. Superficial parotidectomy was done in 188 cases and extended parotidectomy in 47 cases. In the immediate postoperative period facial nerve function was normal in 169 (72%) patients and nerve dysfunction was observed in 66 (28%) patients. Complete paresis involving all the branches of facial nerve was seen in 25 (10.6%) patients and 41 (17.4%) patients were having incomplete dysfunction. Of these, 62 (26.3%) recovered and 04 (1.7%) had permanent facial nerve dysfunction. Marginal mandibular branch of facial nerve was involved in 57 (86.3%) cases. Conclusion: The frequency of temporary and permanent facial nerve dysfunction was 26.3% and 1.7% respectively in 235 consecutive parotidectomies for benign parotid gland tumours. Higher frequency of facial nerve dysfunction was found in recurrent and deep lobe tumours. (author)
Pleomorphic adenoma of the parotid gland with cystic degeneration: A rare case report

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Preeti Dhir

2014-01-01

Full Text Available Pleomorphic adenoma, also called benign mixed tumor, is the most common tumor of the salivary glands. Usually they are found as solitary, unilateral, firm and mobile, painless, slow growing masses. Only 10% of them occur in the minor salivary glands and 90% of them occur in the parotid gland. The incidence of parotid tumor is about 2.4 in 100000/year of all neoplasia of head and neck region, the right side being commonly involved and seen more often in males. Management involves surgical resection by superficial or total parotidectomy. This case report illustrates clinical features, imaging characteristics and histopathological features in a case of pleomorphic adenoma.
Parotid duct laceration repair in two horses : case report

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A. Olivier

1998-07-01

Full Text Available Repair of parotid duct lacerations in 2 horses is described using intraluminal silastic tubing as a stent. The duct was lacerated traumatically at the facial vessel notch (incisura vasorum facialium in the 1st horse, and iatrogenically after removal of an intraluminal sialolith after development of infection within the duct in the 2nd horse. In both cases, a silastic tube was passed retrograde into the duct via the salivary papilla, past the wound until the end lay rostroventral to the parotid salivary gland. The severed salivary ducts and the wounds were sutured. The external portion of the silastic tube was sutured to the skin and the tube left in place. Recovery in the 1st case was uneventful. In the 2nd case a salivary duct/cutaneous fistula formed at a wound distant from the sutured wound, which healed spontaneously. This technique differs from a similar described technique in that the stent tube exits the oral cavity and is attached to the outer skin surface.
Leiomyosarcoma Ex Pleomorphic Adenoma of the Parotid Gland: A Case Report and Literature Review

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Michael Coulter

2016-01-01

Full Text Available There is only one previously reported incident in the English literature of sarcoma ex pleomorphic adenoma of the parotid and there are only 8 cases of primary parotid leiomyosarcoma. In our case, a 79-year-old female patient presented to our care with left preauricular pain, swelling, and facial weakness. After CT imaging, she underwent left total parotidectomy. A spindle cell lesion was identified intraoperatively and the facial nerve was sacrificed. Subsequent analysis of the lesion yielded a diagnosis of leiomyosarcoma ex pleomorphic adenoma. After 30 fractions of radiation therapy, scans were negative for tumor. However, 18 months after first experiencing symptoms, she was found to have metastases to the brainstem and lung. When diagnosing sarcoma ex pleomorphic adenoma of the parotid gland, it is important to perform thorough immunohistochemical staining and exclude a previous history of sarcoma or other sources of metastases. Complete resection is critical due to the tumor’s local aggressiveness and metastatic potential. Although these tumors are not very responsive to chemotherapy or radiation, adjuvant treatment is commonly used when margins are unclear.
Acoustic neuromas: single dose vs fractionated therapy

International Nuclear Information System (INIS)

Fuss, M.; Debus, J.; Lohr, F.; Engenhart-Cabillic, R.; Wannenmacher, M.

1997-01-01

Purpose: Radiosurgical treatment (RS) of acoustic neuromas is a well established treatment. However, few data are available concerning conformal fractionated radiotherapy (FT) of this tumor entity. We evaluated treatment outcome and toxicity for both treatment modalities in 41 patients treated at our institution between 1984 and 1997. Material and Methods: All treatments were performed using a specially adapted linear accelerator and circular collimators for convergent beam RS or multi-leaf collimators (leaf thickness 1 or 3mm) for multi-field RS or fractionated treatment. 22 patients (7 male, 15 female, median age 60 years, range 20-83 years) were treated radiosurgically with single doses between 7 and 28 Gray (median 15 Gy) prescribed to the 80% isodose line. Tumor volumes ranged from 0.7 to 10.5 ccm with a median volume of 3.4 ccm. The median number of isocenters was 2 (1-4 isocenters). One patient was treated by a multi-field technique (14 isocentric irregularly shaped noncoplanar fields). 19 patients (5 male, 14 female, median age 55 years, range 20-81 years) were treated with stereotactic conformal radiotherapy. Median dose was 60 Gray with a median daily fraction size of 2 Gy and a median of 3 (1-4) irregularly shaped isocentric fields. Tumor volumes ranged from 0.7 to 32.4 ccm (median 15 ccm). Median follow-up was 30 months (7-149 months) for radiosurgical and 30 months (2-88 months) for fractionated treatment. Seven patients who underwent fractionated treatment had previously undergone neurosurgical resection on the contralateral side. One had undergone radiosurgery on the opposite side before. Results: All tumors were locally controlled. A volume reduction of more than 20% was seen in 16% after RS and 18% following FT. Typical posttherapeutic central reduction of contrast media enhancement was found in 73% following RS after a median of 8 (3-12) months and in 63% following FT after a median of 6 (1-12) months. Temporary brainstem edema was diagnosed in 4
Intermedius nerve involvement and testing in acoustic neuromas.

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Thomsen, J; Zilstorff, K

1975-01-01

The clinical findings in 125 patients with surgically confirmed acoustic neuromas are presented, with special regard to the involvement of the intermedius nerve in the diagnosis. In assessing the function of the intermedius nerve the examination of the nasolacrimal reflex and the sensation of taste on the anterior two-thirds of the tongue are used. The methods of investigation are described in detail. The material consisted of 20 medium-sized and 105 large tumours; no intracanalicular tumor was found. Hearing loss was the initial symptom in 85% of the patients, 10% had tinitus and 4% vertigo as the first symptom. Apart from the VIII cranial nerve symptoms, a defective nasolacrimal reflex was the most significant evidence of cerebellopontine angle pathology. The test was positive in 65% of the medium-sized tumours, in the entire material, 85%. The figures are higher than the incidence of trigeminal nerve symptoms. This in contrast to the reports of most authors. The tests described are simple and quick to perform, and it is emphasized that they should be applied to all patients with unilateral hearing loss of unknown origin.
Radiation Therapy for Cutaneous Squamous Cell Carcinoma Involving the Parotid Area Lymph Nodes: Dose and Volume Considerations

International Nuclear Information System (INIS)

Chen, Allen M.; Grekin, Roy C.; Garcia, Joaquin; Bucci, Mary K.; Margolis, Lawrence W.

2007-01-01

Purpose: The intraparotid and periparotid lymph nodes are the most commonly involved when skin cancer of the head and neck metastasizes beyond the primary site. We sought to report the clinical outcome of patients treated with radiation therapy for parotid-area metastases from cutaneous squamous cell carcinoma of the head and neck. Methods and Materials: The records of 36 patients treated with radiation therapy for cutaneous squamous cell carcinoma involving the parotid-area lymph nodes were reviewed. All patients had clinically N0 necks and were without evidence of distant disease. Thirty patients (83%) were treated postoperatively after gross total tumor resection. Median dose to the parotid area was 60 Gy (range, 50-72 Gy). Treatment of clinically N0 necks consisted of surgical dissection (7 patients), irradiation (15 patients), and observation (14 patients). Results: The 5-year estimate of local (parotid) control was 86% in patients treated using surgery with postoperative therapy and 47% in patients treated using radiation therapy alone. Three of 4 patients with tumors that relapsed locally after surgery and postoperative radiation received a dose of less than 60 Gy. Elective neck irradiation decreased the incidence of subsequent nodal failures from 50% to 0% and significantly improved neck control (p < 0.001). The 5-year overall survival rate was 63%. Conclusions: Surgery followed by radiation therapy to doses of at least 60 Gy results in effective local control for patients with parotid area metastasis from cutaneous squamous cell carcinoma. Routine irradiation of the clinically N0 neck is recommended
Bilateral painful parotid lumps and a lump in the groin: An uncommon presentation of common Kikuchi's disease

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Sumeet Prakash Mirgh

2016-01-01

Full Text Available Kikuchi-Fujimoto disease (KFD is an under-recognized disease most commonly presenting with cervical lymphadenopathy, fever, and cytopenias in young females. Bilateral parotid enlargement is usually caused by infections (e.g., mumps and autoimmune conditions (e.g., Sjogren syndrome. Parotid enlargement, inguinal lymphadenopathy, and pyrexia of unknown origin are uncommon presenting features of KFD and should be suspected in the appropriate setting.
Benign lymphoepithelial cysts of the parotid glands in HIV-positive patients. A case report

International Nuclear Information System (INIS)

Piqueras, R.M.; Marco, S.F.; Lazaro, S.; Gonzlez, M.

1997-01-01

Benign parotid lymphoepithelial cysts (BPLEC) with cervical lymph node involvement are a recently reported radiological sign of HIV infection in head and neck in patients ar risk for developing AIDS. These cysts lesions present in the parotid glands of HIV-positive individuals and are associated with cervical lymph node involvement. We present a case of BPLEC in a HIV-positive patients that was studied by ultrasound and computerized tomography. The diagnosis was confirmed by ultrasound-guided percutaneous biopsy. We describe the radiological signs of this lesion as detected by the imaging techniques employed and we establish the differential diagnosis. (Author) 14 refs
A functional and chemical study of radiation effects on rat parotid and submandibular/sublingual glands

International Nuclear Information System (INIS)

Vissink, A.; S-Gravenmade, E.J.; Ligeon, E.E.; Konings, W.T.

1990-01-01

The aim of this study was to monitor composition and rate of secretion of rat parotid and submandibular/sublingual saliva following local single doses of X-rays ranging from 5 to 20 Gy. Pilocarpine-stimulated samples of parotid and submandibular/sublingual saliva were simultaneously collected with miniaturized Lashley cups before and 1-30 days after irradiation. The lag phase (period between injection of pilocarpine and start of the secretion) and flow rate were recorded and the concentrations of sodium, potassium, calcium, phosphate, and amylase were measured. With increasing dose and time, the salivary flow rate as well as sodium concentration decreased, while potassium concentrations increased throughout the follow-up period. The lag phase and the concentration of amylase reached their maximum at 3 and 10 days after irradiation, respectively. The changes in lag phase and flow rate were most obvious after doses of 15 or 20 Gy and showed a great similarity for parotid and submandibular/sublingual saliva. No dose-response relationship was observed for the changes in concentrations of calcium and phosphate. It is concluded that for radiation doses of 10 Gy and above, irreversible changes (lag phase, flow rate, potassium, sodium) were observed. A saturation of the irradiation effects (lag phase, flow rate) seems to exist at doses larger than 15 Gy. No significant differences were observed between the radiation-induced functional changes in parotid and submandibular/sublingual salivary gland tissue
Outcomes of Direct Facial-to-Hypoglossal Neurorrhaphy with Parotid Release.

Science.gov (United States)

Jacobson, Joel; Rihani, Jordan; Lin, Karen; Miller, Phillip J; Roland, J Thomas

2011-01-01

Lesions of the temporal bone and cerebellopontine angle and their management can result in facial nerve paralysis. When the nerve deficit is not amenable to primary end-to-end repair or interpositional grafting, nerve transposition can be used to accomplish the goals of restoring facial tone, symmetry, and voluntary movement. The most widely used nerve transposition is the hypoglossal-facial nerve anastamosis, of which there are several technical variations. Previously we described a technique of single end-to-side anastamosis using intratemporal facial nerve mobilization and parotid release. This study further characterizes the results of this technique with a larger patient cohort and longer-term follow-up. The design of this study is a retrospective chart review and the setting is an academic tertiary care referral center. Twenty-one patients with facial nerve paralysis from proximal nerve injury at the cerebellopontine angle underwent facial-hypoglossal neurorraphy with parotid release. Outcomes were assessed using the Repaired Facial Nerve Recovery Scale, questionnaires, and patient photographs. Of the 21 patients, 18 were successfully reinnervated to a score of a B or C on the recovery scale, which equates to good oral and ocular sphincter closure with minimal mass movement. The mean duration of paralysis between injury and repair was 12.1 months (range 0 to 36 months) with a mean follow-up of 55 months. There were no cases of hemiglossal atrophy, paralysis, or subjective dysfunction. Direct facial-hypoglossal neurorrhaphy with parotid release achieved a functional reinnervation and good clinical outcome in the majority of patients, with minimal lingual morbidity. This technique is a viable option for facial reanimation and should be strongly considered as a surgical option for the paralyzed face.
Efectividad comunitaria de las vacunas frente a la Parotiditis Infecciosa. Estudio de casos

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Limón Mora Juan

1999-01-01

Full Text Available FUNDAMENTO: En nuestro país existen dos tipos de vacunas disponibles frente a la parotiditis infecciosa. En los últimos tiempos se han planteado dudas sobre la eficacia global de estas vacunas y de la eficacia comparada entre ambas (cepa Rubini y cepa Jeryl Lynn. En el distrito sanitario de A.P. "Sevilla Este" se registraron 256 casos durante 1997 (90,1 casos por 100.000 habitantes. Con este estudio se pretende aprovechar la aparición de casos de parotiditis para evaluar poblaciones afectadas e incidencia comparada según tipo de vacuna recibida durante la infancia. MÉTODOS: Análisis descriptivo de los casos (edad, distribución territorial, antecedentes vacunales,... y análisis evolutivo (tasas de incidencia anuales en el distrito sanitario y su entorno. Se evalúa la efectividad global de las vacunas frente a la parotiditis. Igualmente se estiman las tasas de incidencia de casos entre los vacunados con cepa Rubini y Jeryl Lynn. RESULTADOS: Se observan las tasas de incidencias más elevadas en niños entre 1 y 4 años. Se han estimado niveles de efectividad global para estas vacunas. Además se observa una incidencia de casos significativamente más elevada entre los niños vacunados con cepa Rubini que en los que lo hicieron con Jeryl Lynn (riesgo relativo de 6,5 con Intervalo de confianza 95% 3,6-11,8. CONCLUSIONES: La efectividad que se desprende de este estudio no parece ser tan buena como la eficacia teórica preconizada para las vacunas frente a la parotiditis. Se plantea la conveniencia de realizar otros estudios de casos según tipos de vacunas utilizadas. Igualmente son de gran interés los datos a suministrar por estudios seroepidemiológicos.
Effects of gender, age, and body mass index on fat contents and apparent diffusion coefficients in healthy parotid glands: an MRI evaluation

International Nuclear Information System (INIS)

Chang, Hing-Chiu; Juan, Chun-Jung; Hsu, Hsian-He; Chiu, Hui-Chu; Cheng, Cheng-Chieh; Chiu, Su-Chin; Liu, Yi-Jui; Chung, Hsiao-Wen

2014-01-01

To establish standard apparent diffusion coefficient (ADC) and the fat content as a function of age, gender and body mass index (BMI) in healthy parotid glands, and to address the influences of fat suppression on ADC measurements. A total of 100 healthy adults (gender and age evenly distributed) were prospectively recruited, with parotid fat content measured from gradient-echo images with fat-water separated using iterative decomposition with echo asymmetry and least squares (IDEAL). The ADCs were estimated using both fat-saturated and non-fat-saturated diffusion-weighted imaging via a periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) technique. Parotid fat content was larger in men than in women by about 10 percentage points (P < 0.005), and positively associated with BMI and age for both genders (mostly with P < 0.001). ADCs estimated with non-fat-saturated PROPELLER were significantly lower in men than in women (P < 0.005), but showed no gender difference if measured using fat-saturated PROPELLER (P = 0.840). The negative association between parotid ADC and age/BMI/fat (P < 0.001) showed greater regression slopes in non-fat-saturated PROPELLER than in fat-saturated data. Parotid fat content in healthy adults correlates positively with both age and BMI; the correlation with age is gender-dependent. Parotid ADC measurements are strongly influenced by fat saturation. (orig.)
Effects of gender, age, and body mass index on fat contents and apparent diffusion coefficients in healthy parotid glands: an MRI evaluation

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Chang, Hing-Chiu [National Taiwan University, Graduate Institute of Biomedical Electronics and Bioinformatics, Taipei (China); Duke University Medical Center, Brain Imaging and Analysis Center, Durham, NC (United States); GE Healthcare, Applied Science Laboratory, Taipei (China); Juan, Chun-Jung; Hsu, Hsian-He [National Defense Medical Center, Department of Radiology, Taipei (China); Tri-Service General Hospital, Department of Radiology, Taipei (China); Chiu, Hui-Chu [Tatung University, Graduate Institute of Design Science, Taipei (China); Cheng, Cheng-Chieh; Chiu, Su-Chin [National Taiwan University, Graduate Institute of Biomedical Electronics and Bioinformatics, Taipei (China); Liu, Yi-Jui [Feng Chia University, Department of Automatic Control Engineering, Taichung (China); Chung, Hsiao-Wen [National Taiwan University, Graduate Institute of Biomedical Electronics and Bioinformatics, Taipei (China); Tri-Service General Hospital, Department of Radiology, Taipei (China); National Taiwan University, MD.624, Department of Electrical Engineering, Taipei (China)

2014-09-15

To establish standard apparent diffusion coefficient (ADC) and the fat content as a function of age, gender and body mass index (BMI) in healthy parotid glands, and to address the influences of fat suppression on ADC measurements. A total of 100 healthy adults (gender and age evenly distributed) were prospectively recruited, with parotid fat content measured from gradient-echo images with fat-water separated using iterative decomposition with echo asymmetry and least squares (IDEAL). The ADCs were estimated using both fat-saturated and non-fat-saturated diffusion-weighted imaging via a periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) technique. Parotid fat content was larger in men than in women by about 10 percentage points (P < 0.005), and positively associated with BMI and age for both genders (mostly with P < 0.001). ADCs estimated with non-fat-saturated PROPELLER were significantly lower in men than in women (P < 0.005), but showed no gender difference if measured using fat-saturated PROPELLER (P = 0.840). The negative association between parotid ADC and age/BMI/fat (P < 0.001) showed greater regression slopes in non-fat-saturated PROPELLER than in fat-saturated data. Parotid fat content in healthy adults correlates positively with both age and BMI; the correlation with age is gender-dependent. Parotid ADC measurements are strongly influenced by fat saturation. (orig.)
Multiple Myopericytoma of the Face and Parotid Gland

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Yun-Ik Jung

2012-03-01

Full Text Available Myopericytoma is a benign tumor that is composed of myoid-appearing oval to spindle-shaped cells with a concentric perivascular pattern of growth. The tumor is morphologically heterogeneous and can exhibit a broad histologic spectrum. We describe a case of multiple myopericytoma occurring in the head and neck skin region with involvement of the parotid gland where it is known to occur very rarely. A 40-year-old woman noticed multiple enlarging, painless, round-shaped masses on her left cheek. The patient had experienced a similar lesion of the same area 8 years earlier which was completely excised and the pathological diagnosis was spindle cell type myoepithelioma. On a computed tomographic image, one mass involved the superficial parotid gland and was well encapsulated. Excision of the facial masses and superficial parotidectomy with facial nerve preservation were performed. A diagnosis of myopericytoma was established in light of the immunohistochemical pattern with the histopathological findings. Over the 4-year follow-up period, there was no evidence of recurrence. As many perivascular myoid neoplasms share common morphologic features with myopericytoma, we should consider the differential diagnosis, and confirm the histological findings with appropriate immunohistochemical staining. After identifying myopericytoma, it should be treated with wide surgical excision to prevent local recurrence.

Monoclonal antibody localization of Na+-K+-ATPase in the exocrine pancreas and parotid of the dog

International Nuclear Information System (INIS)

Smith, Z.D.J.; Caplan, M.J.; Forbush, B. III; Jamieson, J.D.

1987-01-01

A monoclonal antibody specific to the β-subunit of the canine 125 I-labeled-Na + -K + -ATPase has been characterized and used to directly localize the enzyme in thin frozen sections of dog pancreas and parotid. The antibody, 7-2M, recognizes only the β-subunit of the sodium pump as determined by immunoprecipitation and immunoblot and is not directed against an oligosaccharide determinant. 7-2M immunolocalizes to the same cellular and subcellular domains of renal tubular cells as do other, previously characterized, antibodies directed to the α-subunit of the sodium pump. In the pancreas the preponderance of the Na + -K + -ATPase is found on the basolateral membranes of centroacinar and intralobular duct cells. Interlobular duct cells also express a large component of basolaterally located enzyme, although comparatively little pump is seen on acinar cells. In the parotid a large amount of Na + -K + -ATPase is seen on the striated cut cells, with high levels also noted on cells of the intercalated ducts and serous demilunes. Again the acinar cells show comparatively low levels of Na + -K + -ATPase. In no instance is Na + -K + -ATPase found on the apical membranes of pancreas or parotid cells. These data suggest that Na + -K + -ATPase, located on the basolateral plasmalemma of duct-derived cells, may be involved in water and electrolyte secretion from the pancreas and parotid
A comparative study of the ultrastructure of submandibular, parotid and exocrine pancreas in diabetes and fasting

International Nuclear Information System (INIS)

Take, G.; Ilgaz, C.; Erdogan, D.; Ozogul, C.; Elmas, C.

2007-01-01

To comparatively analyze the ultrastructural changes in the submandibular and parotid glands and in the exocrine pancreas following diabetes induced by Streptozotocin exposure and the effects of fasting and insulin treatment on these alterations. For experimental procedure, we included 48 Sprague-Dawley type rats in July 2001-March 2002 at Gazi University, Turkey. We divided the rats into 8 groups following the infusion of Streptozotocin. While the degeneration manifested itself as accumulation of secretions within the mucous cells in the submandibular gland, lipid droplets were absent, being replaced by vacuolar structures. The parotid gland and exocrine pancreas, having similar properties, were affected similarly. Diabetes-induced loss of granules was observed in the serous cells in both glands. There was diffuse lipid accumulation within these cells. Regarding granule content, we observed the most prominent degenerative changes in the parotid gland. While cellular loss was observed in neither the submandibular, nor the parotid gland, we noted presence of apoptotic cells was noted in the pancreas. State of fasting was found to cause alterations within the glands indicating increased activity. While insulin treatment was seen to restore the structure to normal in general was in both of the 3 glands. This study demonstrated that both of the 3 glands are affected by diabetes and concomitant fasting, and this effect manifests itself via the granule content. (author)
Correlation between intravoxel incoherent motion MR parameters and MR nodular grade of parotid glands in patients with Sjögren’s syndrome: A pilot study

International Nuclear Information System (INIS)

Chu, Chen; Zhou, Nan; Zhang, Huayong; Dou, Xin; Li, Ming; Liu, Song; Zhu, Yun; Chen, Weibo; Chan, Queenie; He, Jian; Sun, Lingyun; Zhou, Zhengyang

2017-01-01

Highlights: • Parotid glands at grade 0–3 had significant values from those in healthy glands. • Parotid D and f values were correlated with MR nodule grade significantly. • There were significant differences of D, f, and D * values among glands at grade 0–3. - Abstract: Purpose: To explore the correlation between intravoxel incoherent motion (IVIM) magnetic resonance (MR) parameters and MR nodular grade of parotid glands in patients with Sjögren’s syndrome (SS). Materials and methods: A total of 31 consecutive patients with SS and 28 gender- and age-matched healthy volunteers underwent bilateral parotid 3.0T MR examination including the IVIM sequence (9 b values, 0–800 s/mm 2 ). The apparent diffusion coefficient (ADC), diffusion coefficient D, pseudo-diffusion coefficient D * , and perfusion fraction f of bilateral parotid glands were obtained, and the nodular grade of each parotid gland was evaluated according to the MR morphological appearance. Results: Sixty-two parotid glands in 31 patients with SS consisted of 32, 14, 8, and 8 parotid glands at MR nodular grades 0, 1, 2, and 3, respectively. In parotid glands of grade 0, 1, 2, 3 and healthy volunteers, the ADC values were (1.13 ± 0.25, 1.11 ± 0.17, 1.05 ± 0.24, 0.89 ± 0.04 and 1.00 ± 0.21) × 10 −3 mm 2 /s, D values were (0.92 ± 0.13, 0.90 ± 0.19, 0.90 ± 0.03, 0.67 ± 0.03, 0.81 ± 0.03) × 10 −3 mm 2 /s, f values were 0.20 ± 0.04, 0.18 ± 0.02, 0.15 ± 0.01, 0.11 ± 0.01, 0.15 ± 0.06, and D * values were (53.89 ± 28.26, 41.78 ± 16.35, 51.24 ± 18.69, 31.83 ± 18.03, 36.83 ± 16.14) × 10 −3 mm 2 /s respectively. The ADC, D, f, and D * values of parotid glands in patients with SS at grade 0 were significantly higher than those in healthy volunteers (all P < 0.05). Significant differences were observed in the D and f values of parotid glands in patients with SS among different grades (P = 0.003, < 0.001, respectively). The IVIM parameters (D, f) of parotid glands at early
Correlation between intravoxel incoherent motion MR parameters and MR nodular grade of parotid glands in patients with Sjögren’s syndrome: A pilot study

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Chu, Chen, E-mail: chuchen19920905@163.com [Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008 (China); Zhou, Nan, E-mail: snscorpion@163.com [Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008 (China); Zhang, Huayong, E-mail: 13770560567@163.com [Department of Rheumatology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008 (China); Dou, Xin, E-mail: douxin125@126.com [Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008 (China); Li, Ming, E-mail: lm069393@163.com [Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008 (China); Liu, Song, E-mail: liusongnj@126.com [Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008 (China); Zhu, Yun, E-mail: qqt111@hotmail.com [Department of Rheumatology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008 (China); Chen, Weibo, E-mail: Weibo.Chen@philips.com [Philips Healthcare, Shanghai, 200233 (China); Chan, Queenie, E-mail: queenie.chan@philips.com [Philips Healthcare, Hong Kong (China); He, Jian, E-mail: hjxueren@126.com [Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008 (China); Sun, Lingyun, E-mail: lysun_nju@163.com [Department of Rheumatology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008 (China); Zhou, Zhengyang, E-mail: zyzhou@nju.edu.cn [Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008 (China)

2017-01-15

Highlights: • Parotid glands at grade 0–3 had significant values from those in healthy glands. • Parotid D and f values were correlated with MR nodule grade significantly. • There were significant differences of D, f, and D{sup *} values among glands at grade 0–3. - Abstract: Purpose: To explore the correlation between intravoxel incoherent motion (IVIM) magnetic resonance (MR) parameters and MR nodular grade of parotid glands in patients with Sjögren’s syndrome (SS). Materials and methods: A total of 31 consecutive patients with SS and 28 gender- and age-matched healthy volunteers underwent bilateral parotid 3.0T MR examination including the IVIM sequence (9 b values, 0–800 s/mm{sup 2}). The apparent diffusion coefficient (ADC), diffusion coefficient D, pseudo-diffusion coefficient D{sup *}, and perfusion fraction f of bilateral parotid glands were obtained, and the nodular grade of each parotid gland was evaluated according to the MR morphological appearance. Results: Sixty-two parotid glands in 31 patients with SS consisted of 32, 14, 8, and 8 parotid glands at MR nodular grades 0, 1, 2, and 3, respectively. In parotid glands of grade 0, 1, 2, 3 and healthy volunteers, the ADC values were (1.13 ± 0.25, 1.11 ± 0.17, 1.05 ± 0.24, 0.89 ± 0.04 and 1.00 ± 0.21) × 10{sup −3} mm{sup 2}/s, D values were (0.92 ± 0.13, 0.90 ± 0.19, 0.90 ± 0.03, 0.67 ± 0.03, 0.81 ± 0.03) × 10{sup −3} mm{sup 2}/s, f values were 0.20 ± 0.04, 0.18 ± 0.02, 0.15 ± 0.01, 0.11 ± 0.01, 0.15 ± 0.06, and D{sup *}values were (53.89 ± 28.26, 41.78 ± 16.35, 51.24 ± 18.69, 31.83 ± 18.03, 36.83 ± 16.14) × 10{sup −3} mm{sup 2}/s respectively. The ADC, D, f, and D{sup *} values of parotid glands in patients with SS at grade 0 were significantly higher than those in healthy volunteers (all P < 0.05). Significant differences were observed in the D and f values of parotid glands in patients with SS among different grades (P = 0.003, < 0.001, respectively). The IVIM
TH-E-BRF-09: Gaussian Mixture Model Analysis of Radiation-Induced Parotid-Gland Injury: An Ultrasound Study of Acute and Late Xerostomia in Head-And-Neck Radiotherapy

International Nuclear Information System (INIS)

Liu, T; Yu, D; Beitler, J; Curran, W; Yang, X; Tridandapani, S; Bruner, D

2014-01-01

Purpose: Xerostomia (dry mouth), secondary to parotid-gland injury, is a distressing side-effect in head-and-neck radiotherapy (RT). This study's purpose is to develop a novel ultrasound technique to quantitatively evaluate post-RT parotid-gland injury. Methods: Recent ultrasound studies have shown that healthy parotid glands exhibit homogeneous echotexture, whereas post-RT parotid glands are often heterogeneous, with multiple hypoechoic (inflammation) or hyperechoic (fibrosis) regions. We propose to use a Gaussian mixture model to analyze the ultrasonic echo-histogram of the parotid glands. An IRB-approved clinical study was conducted: (1) control-group: 13 healthy-volunteers, served as the control; (2) acutetoxicity group − 20 patients (mean age: 62.5 ± 8.9 years, follow-up: 2.0±0.8 months); and (3) late-toxicity group − 18 patients (mean age: 60.7 ± 7.3 years, follow-up: 20.1±10.4 months). All patients experienced RTOG grade 1 or 2 salivary-gland toxicity. Each participant underwent an ultrasound scan (10 MHz) of the bilateral parotid glands. An echo-intensity histogram was derived for each parotid and a Gaussian mixture model was used to fit the histogram using expectation maximization (EM) algorithm. The quality of the fitting was evaluated with the R-squared value. Results: (1) Controlgroup: all parotid glands fitted well with one Gaussian component, with a mean intensity of 79.8±4.9 (R-squared>0.96). (2) Acute-toxicity group: 37 of the 40 post-RT parotid glands fitted well with two Gaussian components, with a mean intensity of 42.9±7.4, 73.3±12.2 (R-squared>0.95). (3) Latetoxicity group: 32 of the 36 post-RT parotid fitted well with 3 Gaussian components, with mean intensities of 49.7±7.6, 77.2±8.7, and 118.6±11.8 (R-squared>0.98). Conclusion: RT-associated parotid-gland injury is common in head-and-neck RT, but challenging to assess. This work has demonstrated that the Gaussian mixture model of the echo-histogram could quantify acute and
TH-E-BRF-09: Gaussian Mixture Model Analysis of Radiation-Induced Parotid-Gland Injury: An Ultrasound Study of Acute and Late Xerostomia in Head-And-Neck Radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Liu, T [Department of Radiation Oncology and Winship Cancer Institute, Emory Univ, Atlanta, GA (United States); Yu, D; Beitler, J; Curran, W; Yang, X [Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA (United States); Tridandapani, S [Department of Radiology and Imaging Sciences and Winship Cancer Institute, Emory University, Atlanta, GA (United States); Bruner, D [School of Nursing and Winship Cancer Institute, Emory Univesity, Atlanta, GA (United States)

2014-06-15

Purpose: Xerostomia (dry mouth), secondary to parotid-gland injury, is a distressing side-effect in head-and-neck radiotherapy (RT). This study's purpose is to develop a novel ultrasound technique to quantitatively evaluate post-RT parotid-gland injury. Methods: Recent ultrasound studies have shown that healthy parotid glands exhibit homogeneous echotexture, whereas post-RT parotid glands are often heterogeneous, with multiple hypoechoic (inflammation) or hyperechoic (fibrosis) regions. We propose to use a Gaussian mixture model to analyze the ultrasonic echo-histogram of the parotid glands. An IRB-approved clinical study was conducted: (1) control-group: 13 healthy-volunteers, served as the control; (2) acutetoxicity group − 20 patients (mean age: 62.5 ± 8.9 years, follow-up: 2.0±0.8 months); and (3) late-toxicity group − 18 patients (mean age: 60.7 ± 7.3 years, follow-up: 20.1±10.4 months). All patients experienced RTOG grade 1 or 2 salivary-gland toxicity. Each participant underwent an ultrasound scan (10 MHz) of the bilateral parotid glands. An echo-intensity histogram was derived for each parotid and a Gaussian mixture model was used to fit the histogram using expectation maximization (EM) algorithm. The quality of the fitting was evaluated with the R-squared value. Results: (1) Controlgroup: all parotid glands fitted well with one Gaussian component, with a mean intensity of 79.8±4.9 (R-squared>0.96). (2) Acute-toxicity group: 37 of the 40 post-RT parotid glands fitted well with two Gaussian components, with a mean intensity of 42.9±7.4, 73.3±12.2 (R-squared>0.95). (3) Latetoxicity group: 32 of the 36 post-RT parotid fitted well with 3 Gaussian components, with mean intensities of 49.7±7.6, 77.2±8.7, and 118.6±11.8 (R-squared>0.98). Conclusion: RT-associated parotid-gland injury is common in head-and-neck RT, but challenging to assess. This work has demonstrated that the Gaussian mixture model of the echo-histogram could quantify acute and
Assessment of absorbed dose to thyroid, parotid and ovaries in patients undergoing Gamma Knife radiosurgery

International Nuclear Information System (INIS)

Hasanzadeh, H; Sharafi, A; Verdi, M Allah; Nikoofar, A

2006-01-01

Stereotactic radiosurgery was originally introduced by Lars Leksell in 1951. This treatment refers to the noninvasive destruction of an intracranial target localized stereotactically. The purpose of this study was to identify the dose delivered to the parotid, ovaries, testis and thyroid glands during the Gamma Knife radiosurgery procedure. A three-dimensional, anthropomorphic phantom was developed using natural human bone, paraffin and sodium chloride as the equivalent tissue. The phantom consisted of a thorax, head and neck and hip. In the natural places of the thyroid, parotid (bilateral sides) and ovaries (midline), some cavities were made to place TLDs. Three TLDs were inserted in a batch with 1 cm space between the TLDs and each batch was inserted into a single cavity. The final depth of TLDs was 3 cm from the surface for parotid and thyroid and was 15 cm for the ovaries. Similar batches were placed superficially on the phantom. The phantom was gamma irradiated using a Leksell model C Gamma Knife unit. Subsequently, the same batches were placed superficially over the thyroid, parotid, testis and ovaries in 30 patients (15 men and 15 women) who were undergoing radiosurgery treatment for brain tumours. The mean dosage for treating these patients was 14.48 ± 3.06 Gy (10.5-24 Gy) to a mean tumour volume of 12.30 ± 9.66 cc (0.27-42.4 cc) in the 50% isodose curve. There was no significant difference between the superficial and deep batches in the phantom studies (P-value < 0.05). The mean delivered doses to the parotid, thyroid, ovaries and testis in human subjects were 21.6 ± 15.1 cGy, 9.15 ± 3.89 cGy, 0.47 ± 0.3 cGy and 0.53 ± 0.31 cGy, respectively. The data can be used in making decisions for special clinical situations such as treating pregnant patients or young patients with benign lesions who need radiosurgery for eradication of brain tumours
Irradiation Effect on Secreting Function, Amylase Activity and Nucleic Acid Contents of Rat Parotid Gland

International Nuclear Information System (INIS)

Cho, Young Jin; Park, Tae Won

1990-01-01

This experiment was performed to clarify the effects of 60 Co gamma irradiation on secretory function, amylase activity and contents of nucleic acids of parotid gland in rat. Experimental animals were divided into 6th hours, 3rd, 7th, 14th and 28th days after irradiation and control. The experimental animals are singly irradiated with 20 Gy (2,000 rad) through protective lead block. Secretory function of parotid gland was evaluated by uptake and clearance of 99m TcO 4 . 99m TcO 4 , 0.2μ ci/gm, was injected into peritonium in uptake groups. Rats were sacrificed with cervical dislocation after 30 minutes and gland was excised. In the clearance group, pilocarpine nitrate (8 mg/kg) was intraperitoneally injected at 30 minutes after 99m TcO 4 injection and rats were sacrificed 30 minutes after pilocarpine infection. Radioactivity of excised parotid gland was measured by using of gamma counter and stimulation-secretion coefficient, uptake radioactivity divided by clearance radioactivity, was calculated. Amylase activity and contents of DNA and RNA were determined by spectrophotometry. The results obtained were as follows: 1. In the uptake test, the radioactivity of 99m TcO 4 per unit weight increase in experimental group except 6th hours group, compared with control groups and showed a peak at 3rd days after irradiation. 2. In the clearance test, the radioactivity of 99m TcO 4 per unit weight rose to a peak at 3rd days after irradiation and gradually recovered thereafter. 3. Stimulation-secretion coefficient of parotid gland decreased at 6th hours, 3rd and 7th days after irradiation, and gradually increased. 4. Amylase activity of parotid gland decreased in 3rd and 7th days group, and especially lowest in 3rd days after irradiation. 5. The contents of DNA showed no definite difference in all the experimental groups, but RNA was seemed to decrease with time after irradiation.
LE CARCINOME ONCOCYTAIRE DE LA PAROTIDE : A PROPOS D ...

African Journals Online (AJOL)

Après chirurgie, les récidives sont fréquentes. Le rôle de la radio- thérapie et de chimiothérapie est toujours controversé.Le pronostic est mauvais. Mots clés : Carcinome oncocytaire, parotide, chirurgie, radiothérapie. SUMMARY. Introduction : Oncocyticcarcinomais a rare salivary gland tumor. its management is not codified ...
Radiotherapy of tumours of the parotid: Evaluation and findings

International Nuclear Information System (INIS)

El Mouaaouy, A.

1982-01-01

The author evaluated the results of radiotherapies of patients with tumours of the parotid who had received primary or post-surgical radiotherapy in the Tuebingen Institute of Medical Radiology between 1968 and 1979. Evaluation was difficult because of the small number of cases, the different histological findings, and the observation periods which were very short in some cases. (orig./MG) [de
Calculation of the uncertainty in complication probability for various dose-response models, applied to the parotid gland

International Nuclear Information System (INIS)

Schilstra, C.; Meertens, H.

2001-01-01

Purpose: Usually, models that predict normal tissue complication probability (NTCP) are fitted to clinical data with the maximum likelihood (ML) method. This method inevitably causes a loss of information contained in the data. In this study, an alternative method is investigated that calculates the parameter probability distribution (PD), and, thus, conserves all information. The PD method also allows the calculation of the uncertainty in the NTCP, which is an (often-neglected) prerequisite for the intercomparison of both treatment plans and NTCP models. The PD and ML methods are applied to parotid gland data, and the results are compared. Methods and Materials: The drop in salivary flow due to radiotherapy was measured in 25 parotid glands of 15 patients. Together with the parotid gland dose-volume histograms (DVH), this enabled the calculation of the parameter PDs for three different NTCP models (Lyman, relative seriality, and critical volume). From these PDs, the NTCP and its uncertainty could be calculated for arbitrary parotid gland DVHs. ML parameters and resulting NTCP values were calculated also. Results: All models fitted equally well. The parameter PDs turned out to have nonnormal shapes and long tails. The NTCP predictions of the ML and PD method usually differed considerably, depending on the NTCP model and the nature of irradiation. NTCP curves and ML parameters suggested a highly parallel organization of the parotid gland. Conclusions: Considering the substantial differences between the NTCP predictions of the ML and PD method, the use of the PD method is preferred, because this is the only method that takes all information contained in the clinical data into account. Furthermore, PD method gives a true measure of the uncertainty in the NTCP
Utilization of intensity modulated beam radiotherapy (IMBXRT) to diminish dose to the parotid gland in head and neck cancer

International Nuclear Information System (INIS)

Shiao, W. Woo; Grant, Walter H.; Butler, E. Brian

1996-01-01

Purpose/Objective: To determine if intensity conformal modulated radiotherapy could diminish the radiation dose to the parotid gland in the treatment of primary head and neck cancer. Materials and Methods: The NOMOS Peacock treatment system was utilized in the planning and delivery of conformal radiotherapy for the following diseases: 1) an oropharyngeal cancer that extends from the soft palate to the tonsillar fossa without nodal disease, 2) laryngeal hypopharyngeal cancer without nodal disease, 3) and adenocystic carcinoma, that originated in the hard palate. Patients were treated to areas suspicious for microscopic disease (nodal disease in 1 and 2, perineural spread in 3) at 2 Gy per fraction for a tc of 50 Gy in five weeks. The primary disease was treated at 2.4 Gy per fraction for a total of 60 Gy over five weeks. The percent of the volume of each parotid gland receiving < 20 Gy, <25 Gy and <30 Gy retrospectively was determined for each of the above mentioned optimized plans. The patients were observed for the clinical development of xerostomia. Results: No patient developed clinically apparent xerostomia within one month of completion of radiotherapy. Conclusion: IMBXRT could reduce the volume to parotid glands receiving high radiation doses. Sparing of the parotid glands appear to be most easily accomplished when irradiating head and neck tumors that do not require regional nodal treatment. For head and neck cancer that requires nodal treatment it is possible to spare a significant portion of the parotid glands if the disease originates below the hyoid bone where the primary site is not in close proximity to the parotid glands. Objective salivary flow data are being obtained pre ar post treatment, to confirm the subjective impression of lack of clinical xerostomia. IMBXRT is potentially beneficial in decreasing the morbidity of xerostomia related to head and neck irradiation
Evaluation of Dose and Position Compensation of Parotid Gland Using CT On-rail System in Head-and-Neck Cancer

International Nuclear Information System (INIS)

Jang, Hyeong Jun; Im, Chung Geun; Chun, Geum Sung; Jeong, Il Seon; Kim, Hoi Nam

2008-01-01

The checking method of target and normal structure are used by MVCBCT, KVCBCT, CT On-rail System, Ultrasound in H and N cancer patient. In case of MVCT, the utilization of bone structure is valuable to check around tissue. But the utilization of soft tissue is not enough. The point of this paper is dose variation in movable parotid and changeable volume of H and N cancer patient of CT On-rail System. The object of H and N cancer patient is 5 in this hospital. The selected patient are scanned ARTISTE CT Vision (CT On-ral System) a triweekly. After CT scanning, tranfered coordinates are obtained by movable of parotid gland comparison with planning image. Checking for the changeable volume of parotid gland. A Obtained CT image are tranfered to the RTP System. So dose variation are checked by following changed volume. The changes of target coordinate by the parotid gland movement are X: -0.4∼0.4 cm, Y: -0.4∼0.3 cm, Z: -0.3∼0.3 cm. the volume of GTV is decreased to about 7.11%/week and then both parotid gland volume are shrinked about 4.81%/week (Lt), 2.91%/week (Rt). At the same time, each parotid gland are diminished in radiation dose as 3.66%/week (Lt), 2.01%/week. Images from CT on the rail System which are able to aquire the better quality images of soft tissue in Target area than MVCBCT. After replanning and dose redistribution by required images, It could gain not only the correction of the patient set-tup errors but exact dose distribution. Accordingly, the delivery of compensated dose, It makes that we could do Adaptive Targeting Radiotherapy and need Real Time Adaptive Targeting Radiotherapy by reduce beam delivery time.
Parotid Gland Dose in Intensity-Modulated Radiotherapy for Head and Neck Cancer: Is What You Plan What You Get?

International Nuclear Information System (INIS)

O'Daniel, Jennifer C.; Garden, Adam S.; Schwartz, David L.; Wang He; Ang, Kian K.; Ahamad, Anesa; Rosenthal, David I.; Morrison, William H.; Asper, Joshua A.; Zhang Lifei; Tung Shihming; Mohan, Radhe; Dong Lei

2007-01-01

Purpose: To quantify the differences between planned and delivered parotid gland and target doses, and to assess the benefits of daily bone alignment for head and neck cancer patients treated with intensity-modulated radiotherapy (IMRT). Methods and Materials: Eleven head and neck cancer patients received two CT scans per week with an in-room CT scanner over the course of their radiotherapy. The clinical IMRT plans, designed with 3-mm to 4-mm planning margins, were recalculated on the repeat CT images. The plans were aligned using the actual treatment isocenter marked with radiopaque markers (BB) and bone alignment to the cervical vertebrae to simulate image-guided setup. In-house deformable image registration software was used to map daily dose distributions to the original treatment plan and to calculate a cumulative delivered dose distribution for each patient. Results: Using conventional BB alignment led to increases in the parotid gland mean dose above the planned dose by 5 to 7 Gy in 45% of the patients (median, 3.0 Gy ipsilateral, p = 0.026; median, 1.0 Gy contralateral, p = 0.016). Use of bone alignment led to reductions relative to BB alignment in 91% of patients (median, 2 Gy; range, 0.3-8.3 Gy; 15 of 22 parotids improved). However, the parotid dose from bone alignment was still greater than planned (median, 1.0 Gy, p = 0.007). Neither approach affected tumor dose coverage. Conclusions: With conventional BB alignment, the parotid gland mean dose was significantly increased above the planned mean dose. Using daily bone alignment reduced the parotid dose compared with BB alignment in almost all patients. A 3- to 4-mm planning margin was adequate for tumor dose coverage
Diagnostic Criteria on 18F-FDG PET/CT for Differentiating Benign from Malignant Focal Hypermetabolic Lesions of Parotid Gland

International Nuclear Information System (INIS)

Park, Soo Bin; Choi, Joon Young; Lee, Eun Jeong; Yoo, Jang; Cheon, Miju; Cho, Suk Kyong; Choe, Yearn Seong; Lee, Kyung-Han; Kim, Byung-Tae

2012-01-01

We investigated PET/CT diagnostic criteria for differentiating benign from malignant parotid lesions with focal 18 F-FDG uptake. The subjects of the study were 272 patients who exhibited focal 18 F-FDG uptake of the parotid gland. Sixty-eight pathologically confirmed parotid lesions from 67 patients were included. The maximum SUV (SUVmax), uptake patterns (homogeneous vs. heterogeneous), size measured by CT, maximum Housfield units (HUmax) and margins on CT (well vs. ill defined) of each parotid lesion on PET/CT images were compared with final diagnoses. Thirty- two parotid lesions were histologically proven to be malignant. There were significant differences in uptake patterns (cancer incidence, heterogeneous:homogeneous=79.2%:29.5%, p<0.0001) and margins on CT (cancer incidence, ill:well defined=84.4%:13.3%, p<0.0001) between benign and malignant lesions. The cancer risks of parotid lesions were 89.5% with heterogeneous uptake and ill-defined margins, 70.6% with heterogeneous uptake or ill-defined margins (no overlap in subjects) and 9.3% with homogeneous uptake and well-defined margins (p<0.0001). When any lesion with heterogeneous uptake or ill-defined margins was regarded as malignant, the sensitivity, positive predictive value, negative predictive value and accuracy were 90.6% (29/32) and 85.6% (58/68), respectively. For predicting malignancy, combined PET/CT criteria showed better sensitivity, NPV and accuracy than PET-only criteria, and had a tendency to have more accurate results than CT-only criteria, and had a tendency to have more accurate results than CT-only criteria. There were no significant differences in SUVmax, size or HUmax between benign and malignant lesions. Uptake patterns and margins on CT are useful PET/CT diagnostic criteria for differentiating benign from malignant lesions
Geometric Image Biomarker Changes of the Parotid Gland Are Associated With Late Xerostomia.

Science.gov (United States)

van Dijk, Lisanne V; Brouwer, Charlotte L; van der Laan, Hans Paul; Burgerhof, Johannes G M; Langendijk, Johannes A; Steenbakkers, Roel J H M; Sijtsema, Nanna M

2017-12-01

To identify a surrogate marker for late xerostomia 12 months after radiation therapy (Xer 12m ), according to information obtained shortly after treatment. Differences in parotid gland (PG) were quantified in image biomarkers (ΔIBMs) before and 6 weeks after radiation therapy in 107 patients. By performing stepwise forward selection, ΔIBMs that were associated with Xer 12m were selected. Subsequently other variables, such as PG dose and acute xerostomia scores, were added to improve the prediction performance. All models were internally validated. Prediction of Xer 12m based on PG surface reduction (ΔPG-surface) was good (area under the receiver operating characteristic curve, 0.82). Parotid gland dose was related to ΔPG-surface (Pxerostomia scores to the ΔPG-surface improved the prediction of Xer 12m significantly, and vice versa. The final model including ΔPG-surface and acute xerostomia had outstanding performance in predicting Xer 12m early after radiation therapy (area under the receiver operating characteristic curve, 0.90). Parotid gland surface reduction was associated with late xerostomia. The early posttreatment model with ΔPG-surface and acute xerostomia scores can be considered as a surrogate marker for late xerostomia. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.
Histomorphological study of parotid gland from young rats (Holtzman) submitted to ionizing radiation

International Nuclear Information System (INIS)

Roslindo, E.B.

1988-01-01

A study was performed on rats to verify v the effects of ionizing radiation on the structure of the parotid glands of young rats. Thirty twenty five-day old rats - Rattus norvegicus, albinus, Holtzman - with a medium body weight of 54,20 g were equally distributed in two experimental groups: group I - irradiated; group II - control. After intraperitoneal anesthetics with sodium Pentobarbital in 3% gad been applied, the group I - rats were immobilized in a dorsal position on special surgery tables. The region of the parotid glands were irradiated with a dose of 300 R, this procedure was repeated every 48 hours up to an exposition of 1200 R. The Group II - animals received a simulated treatment as control. The following conclusions may be drawn through the methodology used: the group I - rats gained body weight uniformly after the 13th day, this was not equivalent to the control group; the critical phase of glandular disorganization determined by irradiation corresponded to the experimental period of 8 days, decreasing in the subsequent days; the serous acini and the streated ducts showed to be more radium sensitive even under the use of low fractionated doses; the parotid gland showed indications of gradual morphological recovery after the last exposition to X-rays. (author)
[The value of high resolution diffusion weighted imaging in differentiating benign and malignant epithelial tumors of parotid gland].

Science.gov (United States)

Wen, B H; Cheng, J L; Zhang, H X; Zhang, Z X; Wang, F F; Xue, K K

2018-05-08

Objective: To investigate the diagnostic value of RESOLVE DWI in the evaluation of benign and malignant epithelial tumors of parotid gland. Methods: A total of 106 patients in the First Affiliated Hospital of Zhengzhou University with epithelial tumors of parotid gland confirmed by pathology from July 2015 to October 2017 were retrospectively analyzed. All patients underwent preoperative routine MRI and RESOLVE DWI, the ADC average values were calculated, t test were used to compare the ADC values of benign and malignant epithelial tumors of parotid gland. Diagnostic performance of ADC value was compared using receiver operating characteristic (ROC)curves. Results: All lesions were solitary, including 69 benign epithelial tumors and 37 malignant epithelial tumors. The mean ADC values of pleomorphic adenoma and basal cell adenoma, adenolymphoma and malignant epithelial tumors were (1.47±0.16)×10(-3) mm(2)/s, (0.83±0.19)×10(-3) mm(2)/s and(1.14±0.14)×10(-3) mm(2)/s, the mean ADC value of adenolymphoma lower than the rest of the two groups, there were statistically significant differences among them ( P benign and malignant epithelial tumors of parotid gland.
Structural and histochemical considerations of parotid gland from adult rats (Holtzmann) submitted to x-rays exposure

International Nuclear Information System (INIS)

Sposto, M.R.

1988-01-01

A histomorphological and histochemical study of the parotid gland of adult rats was carried out after subjecting the animals to a single X-ray irradiation dose of 900 R directed to the cervical region. The samples for the histological analysis were obtained at 2, 7, 15, 21, 30 and 45 days after radiation through desiccation and removal of the glands. The results showed clearly that the parotid gland is quite sensitive to X-ray irradiation with the serous acinar cells presenting heavier injuries than the mucous ones. A maximum in the deleterial action of the irradiation was detected at 15 days during the observation period. A comparative analysis of the glandular ducts showed that both of the types intercalated and striated were damaged, with the last presenting severe alterations in morphology and volume. By interpretation of the histochemical results it was concluded that a reduction in protein metabolism of the parotid gland occurred as a consequence of the X-ray irradiation. (author)
carcinome adénoïde kystique de la parotide

African Journals Online (AJOL)

veuses. Les auteurs rapportent trois cas de CAK de la glande parotide diagnostiqués et traités entre l'année 2000 et 2007. ... any cervical lymph nodes in the clinical exam. All the ... une tuméfaction parotidienne droite de 1,5 cm de dia- mètre ...

Ultrastructural morphometry of parotid acinar cells following fractionated irradiation

International Nuclear Information System (INIS)

Grehn, A.-L.; Gustafsson, H.; Franzen, L.; Thornell, L.-E.; Henriksson, R.

1997-01-01

The aim of this study was to evaluate the long term effects on the ultrastructure of parotid glands after fractionated irradiation. The method implemented involved 5 x 6 Gy and 5 x 8 Gy, Monday to Friday 6 MV photons. By unilateral irradiation, the contralateral parotid gland served as a control. Although irradiation diminished the acinar cell density in light microscopic sections from 75 to 32% after 5 x 8 Gy of irradiation, ultrastructural morphometry could not detect any statistically significant differences in acinar cell size, nuclear size, nuclear density, granule area, mean granule size, or granule density. In general, greater differences were seen between rats receiving 30 or 40 Gy, on both the irradiated and the control side, than between the irradiated side and the control side. This was interpreted as due to differences in the nutritional state of the animals. This analysis concluded that individual acinar cells that survive irradiation seem not to be damaged in the long term when evaluated at the ultrastructural level. The study further stresses the importance of adequate sampling sizes and the use of adequate controls. (author)
Optimisation of radiotherapy for carcinoma of the parotid gland: a comparison of conventional, three-dimensional conformal, and intensity-modulated techniques

International Nuclear Information System (INIS)

Nutting, Christopher M.; Rowbottom, Carl G.; Cosgrove, Vivian P.; Henk, J. Michael; Dearnaley, David P.; Robinson, Martin H.; Conway, John; Webb, Steve

2001-01-01

Background and purpose: To compare external beam radiotherapy techniques for parotid gland tumours using conventional radiotherapy (RT), three-dimensional conformal radiotherapy (3DCRT), and intensity-modulated radiotherapy (IMRT). To optimise the IMRT techniques, and to produce an IMRT class solution. Materials and methods: The planning target volume (PTV), contra-lateral parotid gland, oral cavity, brain-stem, brain and cochlea were outlined on CT planning scans of six patients with parotid gland tumours. Optimised conventional RT and 3DCRT plans were created and compared with inverse-planned IMRT dose distributions using dose-volume histograms. The aim was to reduce the radiation dose to organs at risk and improve the PTV dose distribution. A beam-direction optimisation algorithm was used to improve the dose distribution of the IMRT plans, and a class solution for parotid gland IMRT was investigated. Results: 3DCRT plans produced an equivalent PTV irradiation and reduced the dose to the cochlea, oral cavity, brain, and other normal tissues compared with conventional RT. IMRT further reduced the radiation dose to the cochlea and oral cavity compared with 3DCRT. For nine- and seven-field IMRT techniques, there was an increase in low-dose radiation to non-target tissue and the contra-lateral parotid gland. IMRT plans produced using three to five optimised intensity-modulated beam directions maintained the advantages of the more complex IMRT plans, and reduced the contra-lateral parotid gland dose to acceptable levels. Three- and four-field non-coplanar beam arrangements increased the volume of brain irradiated, and increased PTV dose inhomogeneity. A four-field class solution consisting of paired ipsilateral coplanar anterior and posterior oblique beams (15, 45, 145 and 170 degree sign from the anterior plane) was developed which maintained the benefits without the complexity of individual patient optimisation. Conclusions: For patients with parotid gland tumours
Parotid gland sparing IMRT for head and neck cancer improves xerostomia related quality of life

International Nuclear Information System (INIS)

Rij, CM van; Oughlane-Heemsbergen, WD; Ackerstaff, AH; Lamers, EA; Balm, AJM; Rasch, CRN

2008-01-01

To assess the impact of intensity modulated radiotherapy (IMRT) versus conventional radiation on late xerostomia and Quality of Life aspects in head and neck cancer patients. Questionnaires on xerostomia in rest and during meals were sent to all patients treated between January 1999 and December 2003 with a T1-4, N0-2 M0 head and neck cancer, with parotid gland sparing IMRT or conventional bilateral neck irradiation to a dose of at least 60 Gy, who were progression free and had no disseminated disease (n = 192). Overall response was 85% (n = 163); 97% in the IMRT group (n = 75) and 77% in the control group (n = 88) the median follow-up was 2.6 years. The prevalence of complaints was compared between the two groups, correcting for all relevant factors at multivariate ordinal regression analysis. Patients treated with IMRT reported significantly less difficulty transporting and swallowing their food and needed less water for a dry mouth during day, night and meals. They also experienced fewer problems with speech and eating in public. Laryngeal cancer patients in general had fewer complaints than oropharynx cancer patients but both groups benefited from IMRT. Within the IMRT group the xerostomia scores were better for those patients with a mean parotid dose to the 'spared' parotid below 26 Gy. Parotid gland sparing IMRT for head and neck cancer patients improves xerostomia related quality of life compared to conventional radiation both in rest and during meals. Laryngeal cancer patients had fewer complaints but benefited equally compared to oropharyngeal cancer patients from IMRT
A longitudinal evaluation of early anatomical changes of parotid gland in intensity modulated radiotherapy of nasopharyngeal carcinoma patients with parapharyngeal space involvement.

Science.gov (United States)

Zhang, Yingting; Lin, Chengguang; Wu, Jianhua; Jiang, Xiaobo; Lee, Shara W Y; Tam, Shing-Yau; Wu, Vincent W C

2017-09-01

Radiotherapy of nasopharyngeal carcinoma patients with parapharyngeal space (PPS) involvement may deliver high dose to the parotid gland. This study evaluated parotid gland changes during and up to 3 months after radiotherapy. Kilovoltage computed tomography (CT) scans of head and neck region of 39 nasopharyngeal carcinoma patients with PPS involvement were performed at pre-radiotherapy, 10th, 20th and 30th fractions and 3 months after treatment. The parotid glands were contoured in pre-radiotherapy planning CT scan and in subsequent scans. Dice similarity coefficient (DSC), percentage volume change and centroid movement between the planning CT and the subsequent CTs were obtained from the contouring software. In addition, the distance between medial and lateral borders of parotid glands from the mid-line at various time intervals were also measured. The ipsilateral parotid gland received a mean dose of about 5 Gy higher than the contralateral side. The mean DSC and parotid volume decreased by more than 30% at 20th fraction and reached the minimum at 30th fraction. Partial recovery was observed at 3 months after treatment. The centroid displacement followed a similar pattern, which moved medially and superiorly by an average of 0.30 cm and 0.18 cm, respectively, at 30th fraction. The changes in ipsilateral gland were slightly greater than the contralateral side. Substantial volume change and medial movement of parotid gland were observed with slightly greater magnitude in the ipsilateral side. Adaptive radiotherapy was suggested at around 15th to 20th fraction so as to optimise the original dose distribution of the plan. © 2017 The Authors. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.
VACCINATION OF CHILDREN AGAINST MEASLES, PAROTIDITIS AND VITAMINOTHERAPY

OpenAIRE

S.M. Kharit; T.V. Chernyaeva; E.P. Nacharova; O.V. Goleva

2007-01-01

The researchers observed 45 children inoculated with the Russian divalent vaccine (measles–parotiditis). 25 children received mineral and vitamin complex «jungle» for a month since the date of vaccination. The application of «jungle» medication was efficient and conduced to prophylaxis of the complication of the vaccination, prevention of the inter current diseases among the vaccinated, as well as positively affected the intensity of the special antibody formation because of activation of cel...
Acute neonatal parotid abscess: A rare case report

Directory of Open Access Journals (Sweden)

Shreesh Kolekar

2016-01-01

Full Text Available Acute suppurative parotitis is uncommon in children and is very rare in neonates. Most common organism isolated is Staphylococcus aureus. We present a 15-day-old full-term breast-fed female neonate with left-sided acute parotid abscess. The baby presented with a left preauricular swelling, pain and redness. Pus was exuded from left Stensen's duct on compression of the gland externally. Early diagnosis and proper intravenous antibiotics are the keys to the treatment.
Acute neonatal parotid abscess: A rare case report

Science.gov (United States)

Kolekar, Shreesh; Chincholi, Tejas S.; Kshirsagar, Ashok; Porwal, Narendra

2016-01-01

Acute suppurative parotitis is uncommon in children and is very rare in neonates. Most common organism isolated is Staphylococcus aureus. We present a 15-day-old full-term breast-fed female neonate with left-sided acute parotid abscess. The baby presented with a left preauricular swelling, pain and redness. Pus was exuded from left Stensen's duct on compression of the gland externally. Early diagnosis and proper intravenous antibiotics are the keys to the treatment. PMID:28051052
Incorporating single-side sparing in models for predicting parotid dose sparing in head and neck IMRT

International Nuclear Information System (INIS)

Yuan, Lulin; Wu, Q. Jackie; Yin, Fang-Fang; Yoo, David; Jiang, Yuliang; Ge, Yaorong

2014-01-01

Purpose: Sparing of single-side parotid gland is a common practice in head-and-neck (HN) intensity modulated radiation therapy (IMRT) planning. It is a special case of dose sparing tradeoff between different organs-at-risk. The authors describe an improved mathematical model for predicting achievable dose sparing in parotid glands in HN IMRT planning that incorporates single-side sparing considerations based on patient anatomy and learning from prior plan data. Methods: Among 68 HN cases analyzed retrospectively, 35 cases had physician prescribed single-side parotid sparing preferences. The single-side sparing model was trained with cases which had single-side sparing preferences, while the standard model was trained with the remainder of cases. A receiver operating characteristics (ROC) analysis was performed to determine the best criterion that separates the two case groups using the physician's single-side sparing prescription as ground truth. The final predictive model (combined model) takes into account the single-side sparing by switching between the standard and single-side sparing models according to the single-side sparing criterion. The models were tested with 20 additional cases. The significance of the improvement of prediction accuracy by the combined model over the standard model was evaluated using the Wilcoxon rank-sum test. Results: Using the ROC analysis, the best single-side sparing criterion is (1) the predicted median dose of one parotid is higher than 24 Gy; and (2) that of the other is higher than 7 Gy. This criterion gives a true positive rate of 0.82 and a false positive rate of 0.19, respectively. For the bilateral sparing cases, the combined and the standard models performed equally well, with the median of the prediction errors for parotid median dose being 0.34 Gy by both models (p = 0.81). For the single-side sparing cases, the standard model overestimates the median dose by 7.8 Gy on average, while the predictions by the combined
The feasibility of sugammadex for general anesthesia and facial nerve monitoring in patients undergoing parotid surgery.

Science.gov (United States)

Lu, I-Cheng; Chang, Pi-Ying; Su, Miao-Pei; Chen, Po-Nien; Chen, Hsiu-Ya; Chiang, Feng-Yu; Wu, Che-Wei

2017-08-01

The use of neuromuscular blocking agent (NMBA) during anesthesia may interfere with facial nerve monitoring (FNM) during parotid surgery. Sugammadex has been reported to be an effective and safe reversal of rocuronium-induced neuromuscular block (NMB) during surgery. This study investigated the feasibility and clinical effectiveness of sugammadex for NMB reversal during FNM in Parotid surgery. Fifty patients undergoing parotid surgery were randomized allocated into conventional anesthesia group (Group C, n = 25) and sugammadex group (Group S, n = 25). Group C did not receive any NMBA. Group S received rocuronium 0.6 mg/kg at anesthesia induction and sugammadex 2 mg/kg at skin incision. The intubating condition and influence on FNM evoked EMG results were compared between groups. The intubation condition showed significantly better in group S patients than C group patients (excellent in 96% v.s. 24%). In group S, rapid reverse of NMB was found and the twitch (%) recovered from 0 to >90% within 10 min. Positive and high EMG signals were obtained in all patients at the time point of initial facial nerve stimulation in both groups. There was no significant difference as comparing the EMG amplitudes detected at the time point of initial and final facial nerve stimulation in both groups. Implementation of sugammadex in anesthesia protocol is feasible and reliable for successful FNM during parotid surgery. Copyright © 2017. Published by Elsevier Taiwan.
Radioprotective effect of amifostine on parotid gland functioning is region dependent

NARCIS (Netherlands)

Konings, AWT; Faber, H; Vissink, A; Coppes, RP

2005-01-01

Purpose: To investigation the protective ability of amifostine during partial irradiation of the rat parotid gland. Methods and Materials: Single-dose X-ray irradiation was performed by use of collimators with conformal radiation portals for either the 100% volume (15 Gy) or the 50% cranial/caudal
Accumulation of Kv7.2 channels in putative ectopic transduction zones of mice nerve-end neuromas

Directory of Open Access Journals (Sweden)

Lopez-García Jose A

2011-08-01

Full Text Available Abstract Background Modulation of M-type currents has been proposed as a new strategy for the treatment of neuropathic pain due to their role in regulating neuronal excitability. Using electrophysiological techniques we showed previously that the opening of Kv7 channels with retigabine, blocked ectopic discharges from axotomized fibers but did not alter transduction at intact skin afferents. We hypothesized that after nerve damage, accumulation of Kv7 channels in afferent fibers may increase M-type currents which then acquired a more important role at regulating fiber excitability. Findings In this study, we used an immunohistochemical approach to examine patterns of expression of Kv7.2 channels in afferent fibers after axotomy and compared them to patterns of expression of voltage gated Na+ channels (Nav which are key electrogenic elements in peripheral axons known to accumulate in experimental and human neuromas. Axotomy induced an enlargement and narrowing of the nodes of Ranvier at the proximal end of the neuroma together with a dramatic demyelination and loss of structure at its distal end in which naked accumulations of Nav were present. In addition, axotomy also induced accumulations of Kv7.2 that co-localized with those of Nav channels. Conclusions Whilst Nav channels are mandatory for initiation of action potentials, (i.e. responsible for the generation/propagation of ectopic discharges an increased accumulation of Kv7.2 channels after axotomy may represent a homeostatic compensation to over excitability in axotomized fibers, opening a window for a peripheral action of M-current modulators under conditions of neuropathy.
Radiation effects on the parotid gland of mammals. Pt. 3. Behaviour of enzyme activity after irradiation

Energy Technology Data Exchange (ETDEWEB)

Tomassi, I; Balzi, M; Cremonini, D; Becciolini, A; Giannardi, G [Florence Univ. (Italy). Istituto di Radiologia; Pelu, G [I.N.R.C.A., Florence (Italy). Inst. of Radiology

1979-08-01

Modifications of some enzyme activities in parotid tissue homogenates have been studied in animals which were also examined for morphological changes and for plasma and parotid amylase activity. Results from irradiated animals show a certain increase in maltase activity. Alkaline phosphatase and LAP show no significant variations; a similar behaviour is shown by lysosomal enzymes and protein content. A different pattern was seen by comparing the curves of these enzymes with those of the same activity in the small intestine. This result appears to be due to the different radiosensitivity of these tissues.
Pooled analysis of case-control studies on acoustic neuroma diagnosed 1997-2003 and 2007-2009 and use of mobile and cordless phones.

Science.gov (United States)

Hardell, Lennart; Carlberg, Michael; Söderqvist, Fredrik; Mild, Kjell Hansson

2013-10-01

We previously conducted a case-control study of acoustic neuroma. Subjects of both genders aged 20-80 years, diagnosed during 1997-2003 in parts of Sweden, were included, and the results were published. We have since made a further study for the time period 2007-2009 including both men and women aged 18-75 years selected from throughout the country. These new results for acoustic neuroma have not been published to date. Similar methods were used for both study periods. In each, one population-based control, matched on gender and age (within five years), was identified from the Swedish Population Registry. Exposures were assessed by a self-administered questionnaire supplemented by a phone interview. Since the number of acoustic neuroma cases in the new study was low we now present pooled results from both study periods based on 316 participating cases and 3,530 controls. Unconditional logistic regression analysis was performed, adjusting for age, gender, year of diagnosis and socio-economic index (SEI). Use of mobile phones of the analogue type gave odds ratio (OR) = 2.9, 95% confidence interval (CI) = 2.0-4.3, increasing with >20 years latency (time since first exposure) to OR = 7.7, 95% CI = 2.8-21. Digital 2G mobile phone use gave OR = 1.5, 95% CI = 1.1-2.1, increasing with latency >15 years to an OR = 1.8, 95% CI = 0.8-4.2. The results for cordless phone use were OR = 1.5, 95% CI = 1.1-2.1, and, for latency of >20 years, OR = 6.5, 95% CI = 1.7-26. Digital type wireless phones (2G and 3G mobile phones and cordless phones) gave OR = 1.5, 95% CI = 1.1-2.0 increasing to OR = 8.1, 95% CI = 2.0-32 with latency >20 years. For total wireless phone use, the highest risk was calculated for the longest latency time >20 years: OR = 4.4, 95% CI = 2.2-9.0. Several of the calculations in the long latency category were based on low numbers of exposed cases. Ipsilateral use resulted in a higher risk than contralateral for both mobile and cordless phones. OR increased per 100 h
Selective fine needle aspiration of parotid masses. FNA should be performed in all patients older than 60 years.

LENUS (Irish Health Repository)

Kieran, S M

2012-02-01

OBJECTIVES: The exact role of fine needle aspiration in the pre-operative assessment of patients presenting with parotid masses is controversial. Some surgeons propose that fine needle aspiration be performed only selectively in those patients with likely malignant disease, whilst others recommend it for all patients presenting with such a mass. Intuitively, one would expect older patients to be more likely to suffer from primary malignant parotid tumours and secondary deposits of malignant skin tumours. Therefore, we hypothesised that older patients with a parotid mass should undergo fine needle aspiration regardless of their medical history. DESIGN: We retrospectively reviewed 197 consecutive parotidectomies to test this hypothesis. RESULTS: One hundred and twenty-one patients (61.4 per cent) were diagnosed with benign disease, whilst 76 (38.6 per cent) were diagnosed with malignant disease. Eighty-three per cent of patients aged 60 years or younger had benign disease, as opposed to 35.6 per cent of patients aged more than 60 years. Malignant disease occurred more commonly in patients older than 60 years (odds ratio 8.962, 95 per cent confidence interval 4.607-17.434). CONCLUSION: In patients with a parotid mass, fine needle aspiration should be performed on all those aged 60 years or older.
Three-dimensional verification of 125I seed stability after permanent implantation in the parotid gland and periparotid region

International Nuclear Information System (INIS)

Fan, Yi; Huang, Ming-Wei; Zheng, Lei; Zhao, Yi-Jiao; Zhang, Jian-Guo

2015-01-01

To evaluate seed stability after permanent implantation in the parotid gland and periparotid region via a three-dimensional reconstruction of CT data. Fifteen patients treated from June 2008 to June 2012 at Peking University School and Hospital of Stomatology for parotid gland tumors with postoperative adjunctive 125 I interstitial brachytherapy were retrospectively reviewed in this study. Serial CT data were obtained during follow-up. Mimics and Geomagic Studio software were used for seed reconstruction and stability analysis, respectively. Seed loss and/or migration outside of the treated area were absent in all patients during follow-up (23–71 months). Total seed cluster volume was maximized on day 1 post-implantation due to edema and decreased significantly by an average of 13.5 % (SD = 9.80 %; 95 % CI, 6.82–17.68 %) during the first two months and an average of 4.5 % (SD = 3.60 %; 95 % CI, 2.29–6.29 %) during the next four months. Volume stabilized over the subsequent six months. 125 I seed number and location were stable with a general volumetric shrinkage tendency in the parotid gland and periparotid region. Three-dimensional seed reconstruction of CT images is feasible for visualization and verification of implanted seeds in parotid brachytherapy
FDG-PET Assessment of the Effect of Head and Neck Radiotherapy on Parotid Gland Glucose Metabolism

Energy Technology Data Exchange (ETDEWEB)

Roach, Michael C. [School of Medicine, Duke University Medical Center, Duke University, Durham, NC (United States); Turkington, Timothy G. [Department of Radiology, Duke University Medical Center, Duke University, Durham, NC (United States); Department of Biomedical Engineering, Duke University Medical Center, Duke University, Durham, NC (United States); Higgins, Kristin A. [Department of Radiation Oncology, Duke University Medical Center, Duke University, Durham, NC (United States); Hawk, Thomas C. [Department of Radiology, Duke University Medical Center, Duke University, Durham, NC (United States); Hoang, Jenny K. [Department of Radiology, Duke University Medical Center, Duke University, Durham, NC (United States); Department of Radiation Oncology, Duke University Medical Center, Duke University, Durham, NC (United States); Brizel, David M., E-mail: david.brizel@duke.edu [Department of Radiation Oncology, Duke University Medical Center, Duke University, Durham, NC (United States); Department of Surgery, Duke University Medical Center, Duke University, Durham, NC (United States)

2012-01-01

Purpose: Functional imaging with [F-18]-fluorodeoxyglucose positron emission tomography (FDG-PET) provides the opportunity to define the physiology of the major salivary glands before and after radiation therapy. The goal of this retrospective study was to identify the radiation dose-response relationship of parotid gland glucose metabolism in patients with head and neck squamous cell carcinoma (HNSCC). Materials and Methods: Forty-nine adults with HNSCC were identified who had curative intent intensity-modulated radiation therapy (IMRT) and FDG-PET imaging before and after treatment. Using a graphical user interface, contours were delineated for the parotid glands on axial CT slices while all authors were blinded to paired PET slices. Average and maximal standard uptake values (SUV) were measured within these anatomic regions. Changes in SUV and volume after radiation therapy were correlated with parotid gland dose-volume histograms from IMRT plans. Results: The average parotid gland volume was 30.7 mL and contracted 3.9 {+-} 1.9% with every increase of 10 Gy in mean dose (p = 0.04). However, within the first 3 months after treatment, there was a uniform reduction of 16.5% {+-} 7.3% regardless of dose. The average SUV{sub mean} of the glands was 1.63 {+-} 0.48 pretreatment and declined by 5.2% {+-} 2.5% for every increase of 10 Gy in mean dose (p = 0.04). The average SUV{sub max} was 4.07 {+-} 2.85 pretreatment and decreased in a sigmoid manner with mean dose. A threshold of 32 Gy for mean dose existed, after which SUV{sub max} declined rapidly. Conclusion: Radiation dose responses of the parotid glands can be measured by integrated CT/FDG-PET scans. Retrospective analysis showed sigmoidal declines in the maximum metabolism but linear declines in the average metabolism of the glands with dose. Future studies should correlate this decline in FDG uptake with saliva production to improve treatment planning.
Acoustic neuroma risk in relation to mobile telephone use: Results of the INTERPHONE international case-control study

DEFF Research Database (Denmark)

Berg-Beckhoff, Gabi

2011-01-01

Background: The rapid increase in mobile telephone use has generated concern about possible health risks of radiofrequency electromagnetic fields from these devices. Methods: A case-control study of 1105 patients with newly diagnosed acoustic neuroma (vestibular schwannoma) and 2145 controls...... was conducted in 13 countries using a common protocol. Past mobile phone use was assessed by personal interview. In the primary analysis, exposure time was censored at one year before the reference date (date of diagnosis for cases and date of diagnosis of the matched case for controls); analyses censoring...
SU-F-J-98: Improvement and Evaluation Of Deformation Image Registration On Parotid Glands During Radiation Therapy for Nasopharyngeal Cancer

Energy Technology Data Exchange (ETDEWEB)

Xu, S [Tsinghua University, Beijing (China); PLA General Hospital, Beijing (China); Wu, Z; Liu, Y [Tsinghua University, Beijing (China); Liu, B; Li, Y; Zhou, F [Beihang University, Beijing (China); Gong, H; Qu, B [PLA General Hospital, Beijing (China)

2016-06-15

Purpose: To quantitatively evaluate the strategic innovation and accuracy variation of deformation registration algorithm for parotid glands using the similarity Dice coefficient during the course of radiation therapy (RT) for nasopharyngeal cancer (NPC). Methods: Daily MVCT data for 10 patients with pathologically proven nasopharyngeal cancers were analyzed. The data were acquired using tomotherapy (TomoTherapy, Accuray) at the PLA General Hospital. The prescription dose to the primary target was 70Gy in 33 fractions. Two kinds of contours for parotid glands on daily MVCTs were obtained by populating these contours from planning CTs to the daily CTs via rigid-body registration with or without the rotation shifts using the in-house tools and the Adaptive plan software (Adaptive Plan, TomoTherapy), and were edited manually if necessary. The diffeomorphic Demons algorithm developed in the in-house tool was used to propagate the parotid structures from the daily CTs to planning CTs. The differences of the mapped parotid contours in two methods were evaluated using Dice similarity index (DSI). Two-tailed t-test analysis was carried out to compare the DSI changes during the course of RT. Results: For 10 patient plans, the accuracy of deformation image registration (DIR) with the rotation shift was obviously better than those without the rotation shift. The Dice scores of the ipsi- and contra-lateral parotids for with and without the rotation shifts were found to be correlated with each other [0.904±0.031 vs 0.919±0.030 (p<0.001); 0.900±0.031 vs 0.910±0.032 (p<0.001)]. The Dice scores for the parotids have shown the reduction with the changes of parotid volumes during RT. The DSI values between the first and last fraction were 0.932±0.020 vs 0.899±0.030 in 10 patient plans. Conclusion: DIR was successfully improved using the strategic innovation for ART. And the decrease of DIR accuracy has also been found during the delivery of fractionated radiotherapy. This work
Modified Functional Superficial Parotidectomy With Ligation of the Major Branch of the Parotid Duct Extending to the Superficial Lobe.

Science.gov (United States)

Chang, Jung Woo; Leem, Soo Seong; Choi, Hwan Jun; Lee, Jang Hyun

2017-05-01

A functional superficial parotidectomy can maintain salivary function by preserving the Stensen duct. However, this technique still brings the possibility of salivary leakage, because major branches of the parotid duct from the resected site do not get ligated. To reduce this complication, this study introduces a modified technique with major branch ligation. From December 2008 to February 2015, 14 patients who underwent superficial parotidectomy were divided into 2 groups. Group A was treated with the modified functional superficial parotidectomy involving the major branch between the superficial lobe and parotid duct. Group B was treated with the conventional superficial parotidectomy without involving the major branch of the parotid duct. The clinical complications, period of Hemovac usage, and surgical duration were noted in each group. Two of 8 patients in group A had a major branch from Stensen duct that was ligated, and there was no evidence of salivary leakage or sialocele in any of the patients of group A, whereas group B contained 2 cases of salivary leakage, one of which became sialocele. Group A had a significantly longer Hemovac maintenance period than group B (P < 0.05), and the duration of surgery was also significantly different between the 2 groups (P < 0.05). Because a solitary major branch of the main parotid duct occasionally extends toward the superficial lobe, our modified technique-functional superficial parotidectomy with ligation of the major branch toward the superficial lobe-is a useful option for treatment of a benign parotid mass in such cases.
TERATOME MATURE DE LA PAROTIDE : A PROPOS D'UNE ...

African Journals Online (AJOL)

Le tératome de la parotide est une malformation tumorale vestigiale rare contenant des dérivés plus ou moins différenciés, des trois feuillets embryonnaires. A la lumière d'une nouvelle observation et des données de la littérature, on se propose de mettre l'accent sur les aspects cliniques, histologiques et thérapeutiques de ...

LE CARCINOME MUCOÉPIDERMOÏDE DE LA PAROTIDE : A ...

African Journals Online (AJOL)

16 juin 2006 ... INTRODUCTION. Le carcinome mucoépidermoïde représente 1 à 4% de l'en- semble des tumeurs parotidiennes. Il s'agit de la tumeur maligne la plus fréquente de la glande parotide. Il peut être observé à tout âge avec une égalité entre les 2 sexes. Il s'agit d'une tumeur à croissance lente avec une ...
Parotid gland sparing IMRT for head and neck cancer improves xerostomia related quality of life

Science.gov (United States)

van Rij, CM; Oughlane-Heemsbergen, WD; Ackerstaff, AH; Lamers, EA; Balm, AJM; Rasch, CRN

2008-01-01

Background and purpose To assess the impact of intensity modulated radiotherapy (IMRT) versus conventional radiation on late xerostomia and Quality of Life aspects in head and neck cancer patients. Patients and nethods Questionnaires on xerostomia in rest and during meals were sent to all patients treated between January 1999 and December 2003 with a T1-4, N0-2 M0 head and neck cancer, with parotid gland sparing IMRT or conventional bilateral neck irradiation to a dose of at least 60 Gy, who were progression free and had no disseminated disease (n = 192). Overall response was 85% (n = 163); 97% in the IMRT group (n = 75) and 77% in the control group (n = 88) the median follow-up was 2.6 years. The prevalence of complaints was compared between the two groups, correcting for all relevant factors at multivariate ordinal regression analysis. Results Patients treated with IMRT reported significantly less difficulty transporting and swallowing their food and needed less water for a dry mouth during day, night and meals. They also experienced fewer problems with speech and eating in public. Laryngeal cancer patients in general had fewer complaints than oropharynx cancer patients but both groups benefited from IMRT. Within the IMRT group the xerostomia scores were better for those patients with a mean parotid dose to the "spared" parotid below 26 Gy. Conclusion Parotid gland sparing IMRT for head and neck cancer patients improves xerostomia related quality of life compared to conventional radiation both in rest and during meals. Laryngeal cancer patients had fewer complaints but benefited equally compared to oropharyngeal cancer patients from IMRT. PMID:19068126
Parotid gland sparing IMRT for head and neck cancer improves xerostomia related quality of life

Directory of Open Access Journals (Sweden)

Balm AJM

2008-12-01

Full Text Available Abstract Background and purpose To assess the impact of intensity modulated radiotherapy (IMRT versus conventional radiation on late xerostomia and Quality of Life aspects in head and neck cancer patients. Patients and nethods Questionnaires on xerostomia in rest and during meals were sent to all patients treated between January 1999 and December 2003 with a T1-4, N0-2 M0 head and neck cancer, with parotid gland sparing IMRT or conventional bilateral neck irradiation to a dose of at least 60 Gy, who were progression free and had no disseminated disease (n = 192. Overall response was 85% (n = 163; 97% in the IMRT group (n = 75 and 77% in the control group (n = 88 the median follow-up was 2.6 years. The prevalence of complaints was compared between the two groups, correcting for all relevant factors at multivariate ordinal regression analysis. Results Patients treated with IMRT reported significantly less difficulty transporting and swallowing their food and needed less water for a dry mouth during day, night and meals. They also experienced fewer problems with speech and eating in public. Laryngeal cancer patients in general had fewer complaints than oropharynx cancer patients but both groups benefited from IMRT. Within the IMRT group the xerostomia scores were better for those patients with a mean parotid dose to the "spared" parotid below 26 Gy. Conclusion Parotid gland sparing IMRT for head and neck cancer patients improves xerostomia related quality of life compared to conventional radiation both in rest and during meals. Laryngeal cancer patients had fewer complaints but benefited equally compared to oropharyngeal cancer patients from IMRT.
Tumors in the parotid are not relatively more often malignant in children than in adults

DEFF Research Database (Denmark)

Stevens, E; Andreasen, S; Bjørndal, K

2015-01-01

INTRODUCTION: Tumors of the parotid gland in children are rare and very little data has been published regarding the incidence of these tumors. We present a nationwide survey on this topic. METHODS: Data regarding benign and malignant tumors in the parotid gland in children from January 1st, 1990......) followed by the mucoepidermoid carcinoma (n=3) and adenoid cystic carcinoma (n=2). The overall female-to-male ratio was 1.18, with a ratio of 1.08 and 2.0 in the benign and malignant groups, respectively. At the end of follow-up (August 1st, 2014) two patients had died, one with adenoid cystic carcinoma...
A Type I first branchial cleft cyst masquerading as a parotid tumor.

Science.gov (United States)

Krishnamurthy, Arvind; Ramshanker, Vijayalakshmi

2014-01-01

Branchial cleft anomalies are caused by incomplete regression of the cervical sinus of "His" during the 6(th) and 7(th) weeks of embryologic development. Although congenital in origin, first branchial cleft cysts (FBCCs) can present later in life. FBCCs are rare causes of parotid swellings, accounting for branchial cleft abnormalities. The diagnosis of FBCCs is a clinical challenge; the condition is often overlooked and mismanaged. We report a case of Type 1 FBCC in a 22-year-old female with an asymptomatic 3.5 cm × 2.5 cm sized cystic mass. It was removed completely under the impression of a cystic tumor of the parotid. On histopathology, the cyst had a squamous epithelium-lined wall with lymphoid aggregation which was characteristic of a branchial cleft cyst. A good understanding of the regional anatomy and embryology can lead to an early diagnosis and thereby effective management of FBCC.
Low dose radiation in the treatment of HIV related benign lymphoepithelial lesions of the parotid gland

International Nuclear Information System (INIS)

Tchelebi, Anca E.; Ming Teng; Moscatello, Augustine; Moorthy, Chitti R.; Kaufmann, Thomas; Ahmed, Tauseef

1996-01-01

Purpose/Objective: To determine the effectiveness of Radiation Therapy (RT) in the treatment of human immunodeficiency virus (HIV) related benign lymphoepithelial (BLL) of the parotid gland. Materials and Methods: The records of 16 patients treated between 1991 to 1995 with BLL were retrospectively reviewed. Three patients had bilateral disease, thus 19 parotid glands were radiated. Only (2(16)) had AIDS. Virtually all patients were on antiretroviral therapy. There were 11 males and 5 females. The median age was 38 years (range 31 to 58 years). The median duration of parotid enlargement was 1.5 years (range 1 month to 6 years). All patients had biopsy prior to treatment. Histopathology revealed two patterns: solid or cystic. Patient were treated using electron beam RT. The beam energy was determined by computed transaxial tomography. The median dose delivered was 1000 cGy in 5 fractions over 5 days (range 600 cGy to 2160 cGy in daily fractions ranging from 180 cGy to 200 cGy). Results: Six parotid glands achieved a complete response (CR), 5 a partial response (PR), while 8 were non-responders (NR). Our overall response rate was therefore 58% Of the NR's, 3 patients were re-treated. Two achieved a PR, one was an NR. Toxicity was minimal and limited to mild xerostomia. Conclusion: RT in patients with HIV related BLL is well tolerated. Our preliminary results show that while this modality of treatment has marked activity in the solid pattern. Higher doses may be required for large lesions or cystic in nature
Parotid gland tumours: MR tractography to assess contact with the facial nerve.

Science.gov (United States)

Attyé, Arnaud; Karkas, Alexandre; Troprès, Irène; Roustit, Matthieu; Kastler, Adrian; Bettega, Georges; Lamalle, Laurent; Renard, Félix; Righini, Christian; Krainik, Alexandre

2016-07-01

To assess the feasibility of intraparotid facial nerve (VIIn) tractographic reconstructions in estimating the presence of a contact between the VIIn and the tumour, in patients requiring surgical resection of parotid tumours. Patients underwent MR scans with VIIn tractography calculated with the constrained spherical deconvolution model. The parameters of the diffusion sequence were: b-value of 1000 s/mm(2); 32 directions; voxel size: 2 mm isotropic; scan time: 9'31'. The potential contacts between VIIn branches and tumours were estimated with different initial fractional anisotropy (iFA) cut-offs compared to surgical data. Surgeons were blinded to the tractography reconstructions and identified both nerves and contact with tumours using nerve stimulation and reference photographs. Twenty-six patients were included in this study and the mean patient age was 55.2 years. Surgical direct assessment of VIIn allowed identifying 0.1 as the iFA threshold with the best sensitivity to detect tumour contact. In all patients with successful VIIn identification by tractography, surgeons confirmed nerve courses as well as lesion location in parotid glands. Mean VIIn branch FA values were significantly lower in cases with tumour contact (t-test; p ≤ 0.01). This study showed the feasibility of intraparotid VIIn tractography to identify nerve contact with parotid tumours. • Diffusion imaging is an efficient method for highlighting the intraparotid VIIn. • Visualization of the VIIn may help to better manage patients before surgery. • We bring new insights to future trials for patients with VIIn dysfunction. • We aimed to provide radio-anatomical references for further studies.
Continuous analysis of parotid saliva during resting and short-duration simulated chewing

NARCIS (Netherlands)

Neyraud, E.; Bult, J.H.F.; Dransfield, E.

2009-01-01

Objective: Parotid saliva flow is increased by mastication and its composition is also modified. The aim of this work was to clarify the relationships between flow rate, pH and protein concentration, during resting and short-duration simulated chewing, using continuous and fractional saliva
Polymorphous Low Grade Adenocarcinoma of the Parotid in a Teenager

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Divya Khosla

2017-09-01

Full Text Available Abstract Introduction: Polymorphous low grade adenocarcinoma (PLGA is a rare salivary gland neoplasm with an indolent course. It occurs primarily in the minor salivary glands but can rarely occur in the major salivary glands. It usually occurs in the fifth to seventh decades of life with female preponderance. Case Report: A 16-year-old male presented with recurrent painless swelling in the right preauricular region and with a history of surgical intervention at the same site in the past. His histopathology report was suggestive of pleomorphic adenoma. The swelling recurred after one year of excision and a superficial parotidectomy was performed. The detailed histopathological examination was suggestive of Polymorphous low grade adenocarcinoma. In view of close margins, the patient was given adjuvant radiotherapy. Thirty-three months post-surgery, he is alive and disease-free. We describe a rare case of PLGA of the parotid gland in a teenager with its clinical characteristics, histopathological features, and treatment. Conclusion: The occurrence of PLGA in the parotid gland is rare with only a few cases reported in literature. The diagnosis of PLGA is challenging due to morphological diversity.
The effect of X-ray irradiation on the function and saliva composition of rat parotid and submandibular/sublingual glands

International Nuclear Information System (INIS)

Hashida, Tatsuo; Kamemoto, Hiromasa; Fuchihata, Hajime; Ooshima, Takashi

1999-01-01

Radiation therapy to the head and neck area frequently causes severe salivary gland dysfunction and xerostomia. Morphological studies of irradiated salivary glands have suggested that the submandibular/sublingual gland may be less radiosensitive than the parotid gland. The purpose of this study was to evaluate the effect of radiation on major salivary gland functions in rats with radiation-induced xerostomia. The effect of salivary gland irradiation on salivary function was examined in specific pathogen-free Sprague-Dawley rats. The animals were irradiated with a single exposure of either 22 Gy or 32 Gy. Stimulated saliva excretion time was measured for the parotid and submandibular/sublingual glands, and the total protein in saliva was analysed. Our results showed that the saliva flow rate and protein concentration of parotid saliva were significantly reduced in the 32 Gy-irradiated rats. (author)
Indications of elective neck dissection and postoperative radiotherapy for parotid cancers

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Shibata, Tomohisa; Yonezawa, Kouichiro; Morimoto, Koichi; Yamashita, Daisuke; Otsuki, Naoki; Nishimura, Hideki; Sasaki, Ryohei; Nibu, Ken-ichi

2011-01-01

Regional lymph node metastases significantly influence the prognosis of patients with parotid cancer. To assess our indications of elective neck dissection and postoperative radiotherapy for parotid cancer, a retrospective chart review was performed. Between 2001 and 2009, 35 patients with parotid cancer were initially treated at our department. The median follow-up was 30 months (range, 10-90 months). Out of all patients, 31 (89%) patients were preoperatively diagnosed as malignant, while 4 (11%) patients were initially diagnosed as benign. Mucoepidermoid carcinoma was the most common histological type (10 patients). Twenty-two tumors (63%) were pathologically diagnosed as high-grade. The numbers of patients with Stages I, II, III, and IVA were 3, 10, 7, and 15, respectively. Ipsilateral neck dissection (Level II-V) was performed in seven patients with clinically positive neck metastasis (cN+), and in ten patients without lymph node metastasis who had T4 disease, high-grade malignancy, or positive neck (Level II) metastasis during intraoperative evaluation. Postoperative radiotherapy was performed in 24 patients with pathological T4, high-grade malignancy, positive surgical margin, multiple neck metastasis and/or extranodal extension (ENI). Seven of 28 (25%) patients with clinically N0 had pathologically positive neck metastasis (pN+). Regional recurrence developed in one patient with high-grade malignancy and ENI (T4N2b). Disease-specific survival rates for Stages I, II, III, and IVA at 3 years were 100%, 73%, 100%, and 37%, respectively. Loco-regional control rates for pN0 (21 patients) and pN+ (14 patients) at 3 years were 90% and 95%, respectively. Our present favorable loco-regional control supported our current indications of elective neck dissection and postoperative radiotherapy. We also recommend intraoperative biopsy of level IIB nodes to study the need for elective neck dissection. (author)
Transmasseteric anterior parotid approach for condylar fractures: experience of 129 cases.

Science.gov (United States)

Narayanan, Vinod; Ramadorai, Ashok; Ravi, Poornima; Nirvikalpa, Natarajan

2012-07-01

We have evaluated the transmasseteric anterior parotid (TMAP) approach in the treatment of 163 condylar fractures in 129 patients. Ninety-five patients presented with unilateral, and 34 with bilateral, fractures. The inclusion criteria were patient's choice for open reduction and internal fixation, displaced unilateral condylar fractures with occlusal derangement, and displaced bilateral condylar fractures with anterior open bite. Mean (SD) maximum interincisal opening after 3 months was 44(5)mm. There were no differences in lateral movements during the reviews 6 weeks and 3 months postoperatively. Protrusive movement at the end of 3 months was 7(2)mm. All patients achieved functional occlusion identical to the pretraumatic occlusion and good reduction of the condyles. No patient developed temporary or permanent facial palsy, sialocele, salivary fistula, or Frey syndrome. The mean (SD) operating time was 46(11)min. The TMAP approach avoids the complications of incision of the parotid gland, minimises the risk of facial nerve palsy, and offers excellent access to the fractured condyle. Copyright © 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
A Type I first branchial cleft cyst masquerading as a parotid tumor

Science.gov (United States)

Krishnamurthy, Arvind; Ramshanker, Vijayalakshmi

2014-01-01

Branchial cleft anomalies are caused by incomplete regression of the cervical sinus of “His” during the 6th and 7th weeks of embryologic development. Although congenital in origin, first branchial cleft cysts (FBCCs) can present later in life. FBCCs are rare causes of parotid swellings, accounting for branchial cleft abnormalities. The diagnosis of FBCCs is a clinical challenge; the condition is often overlooked and mismanaged. We report a case of Type 1 FBCC in a 22-year-old female with an asymptomatic 3.5 cm × 2.5 cm sized cystic mass. It was removed completely under the impression of a cystic tumor of the parotid. On histopathology, the cyst had a squamous epithelium-lined wall with lymphoid aggregation which was characteristic of a branchial cleft cyst. A good understanding of the regional anatomy and embryology can lead to an early diagnosis and thereby effective management of FBCC. PMID:25298726
Parotiditis crónicas recidivantes: Nuestra experiencia

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Manuel Estrada Sarmiento

1998-08-01

Full Text Available Se realizó una investigación observacional, prospectiva y descriptiva de 27 pacientes con el diagnóstico clínico e histopatológico de parotiditis crónica, con el objetivo de conocer su comportamiento en nuestro medio durante el período 1994-1995. De los 27 pacientes, 19 eran femeninos (70,4 % y 8 masculinos. En el 3,7 % se observó una edad inferior a los 10 años; la parótida izquierda fue la más afectada. La técnica quirúrgica de Blair se empleó en 19 pacientes (70,4 % y la mortalidad operativa fue nula. Cuatro pacientes (14,8 % presentaron complicaciones. Esta entidad es frecuente en niños, su cuadro clínico oscila entre meses y años, por lo cual no es poco frecuente después de las primeras décadas de la vida.An observational prospective and descriptive study of 27 patients clinically and histopathologically diagnosed with chronic parotitis was performed with the objective of finding out the behaviour of such disease in our context from 1994- to 1995. 19 were females (70.4 % and 8 were males. 3.7 % were under 10 years and the laft parotid gland was the most affected. Blair’s surgical technique was successfully used in 19 patients (70.4 % and none of them died. Complications occured in 4 patients (14.8 %. This disease is common in children, its clinical pattern ranges from months to years, so, it is not an uncommon disease after the first decades of life.
[Parotid involvement in Churg-Strauss syndrome].

Science.gov (United States)

Bonnet, R; Bertin, H; Delemazure, A S; Clairand, R; Mercier, J; Corre, P

2014-06-01

Churg-Strauss syndrome is a rare systemic vascularitis. This disease causes eosinophilic tissue infiltration. The most frequent manifestations are cortico-dependent asthma, mono- or polyneuropathy, paranasal sinus polyposis, and digestive and renal dysfunction. Salivary glands are very rarely involved. We describe a case of CSS in a patient presenting with bilateral parotid swelling. The morphological study of salivary glands revealed an unusual thickening of the salivary duct walls. Salivary gland involvement in Churg and Strauss syndrome can be difficult to demonstrate histologically; it does not usually present in the clinical foreground of the disease, and can be a source of misdiagnosis. The biopsy should be performed in the symptomatic gland, away from any previous corticoid treatment. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
{sup 125}I seed implant brachytherapy for the treatment of parotid gland cancers in children and adolescents

Energy Technology Data Exchange (ETDEWEB)

Zheng, L.; Zhang, J.; Song, T.; Zhang, J.; Yu, G.; Zhang, Y. [Peking University School and Hospital of Stomatology, Beijing (China). Dept. of Oral and Maxillofacial Surgery

2013-05-15

Background and purpose: There is a lack of optimal treatment strategies for managing salivary gland cancers in children and adolescents. This study is aimed at assessing the effect of {sup 125}I seed implantation for the treatment of parotid cancers in children and adolescents. Patients and methods: A total of 12 patients younger than 16 years with parotid gland malignant tumors underwent {sup 125}I seed implant brachytherapy between October 2003 and November 2008. All patients were assessed after treatment and at the local tumor control appointments. Facial nerve function, maxillofacial development, and radioactive side-effects were assessed. Results: The follow-up period ranged from 41-104 months. One patient with T4b died of pulmonary metastasis. The other patients were alive during the follow-up period. There were no serious radiation-related complications. The treatment did not affect facial nerve function and dentofacial growth in any of the children. Conclusion: For parotid gland cancers in children, {sup 125}I seed implant brachytherapy may be an acceptable treatment without serious complications and with satisfactory short-term effects. (orig.)
Regional radiation dose susceptibility within the parotid gland: Effects on salivary loss and recovery

Energy Technology Data Exchange (ETDEWEB)

Clark, Haley, E-mail: hdclark@phas.ubc.ca; Reinsberg, Stefan [Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1 (Canada); Hovan, Allan [Oral Oncology/Dentistry, British Columbia Cancer Agency–Vancouver Centre, Vancouver, British Columbia V5Z 4E6 (Canada); Moiseenko, Vitali [Department of Radiation Medicine and Applied Sciences, University of California–San Diego, La Jolla, California 92093 (United States); Thomas, Steven [Department of Medical Physics, British Columbia Cancer Agency–Vancouver Centre, Vancouver, British Columbia V5Z 4E6 (Canada); Wu, Jonn [Radiation Oncology, British Columbia Cancer Agency–Vancouver Centre, Vancouver, British Columbia V5Z 4E6 (Canada)

2015-04-15

Purpose: Xerostomia is one of the most likely late toxic effects of radiotherapy treatment in patients with head-and-neck cancers. Modern treatment techniques can incorporate knowledge of complication risk into treatment plans. To this end, the authors attempt to quantify the regional radiotherapy dose-dependence of salivary output loss and recovery in a prospective study. Methods: Salivary output was collected from patients undergoing radiotherapy treatment for head-and-neck cancers at the BC Cancer Agency between February 2008 and May 2013. Regional dose-dependence (i.e., dose susceptibility) of loss and recovery is quantified using nonparametric (Spearman’s rank correlation coefficients, local linear regression) and parametric (least-sum of squares, least-median of squares) techniques. Results: Salivary flow recovery was seen in 79 of 102 patients considered (p < 0.0001, Wilcoxon sign rank test). Output loss was strongly correlated with left- and right parotid combined dose φ = min (D{sub L}, 45 Gy) + min (D{sub R}, 45 Gy), and can be accurately predicted. Median early loss (three months) was 72% of baseline, while median overall loss (1 yr) was 56% of baseline. Fitting an exponential model to whole parotid yields dose sensitivities A{sub 3m} = 0.0604 Gy{sup −1} and A{sub 1y} = 0.0379 Gy{sup −1}. Recovery was not significantly associated with dose. Hints of lateral organ sub-segment dose–response dimorphism were observed. Conclusions: Sub-segmentation appears to predict neither loss nor recovery with any greater precision than whole parotid mean dose, though it is not any worse. Sparing the parotid to a combined dose φ of <50 Gy is recommended for a patient to keep ≈40% of baseline function and thus avoid severe xerostomia at 12 months post-treatment. It seems unlikely that a population’s mean recovery will exceed 20%–30% of baseline output at 1 yr after radiotherapy treatment using current (whole-organ based) clinical guidelines.
External beam radiotherapy for head and neck carcinomas with preservation of parotid function: indications, techniques and long term results

International Nuclear Information System (INIS)

Ding-Jen, Lee; Fairbanks, Robert; Lee, Frank C.

1995-01-01

Purpose/Objective: To reduce the incidence of radiotherapy induced xerostomia, we developed techniques of external beam irradiation with preservation of parotid function for patients with early to intermediate stage carcinomas of the head and neck. This analysis reports the efficacy of our methods. Materials and Methods: From 1985 to 1993, 42 patients with early to intermediate stage (T 1-3 N 0-2 M 0 ) head and neck carcinomas received a course of external beam radiotherapy. There were 13 patients with carcinoma of the oropharynx, 26 with carcinomas of the oral cavity and 3 with carcinomas of the hypopharynx (lateral wall). 7 patients received a course of definitive radiotherapy (66 to 72 Gy), while 35 patients received a course of postoperative radiotherapy (60-66 Gy). The fraction size was 2 Gy per day. In terms of treatment planning, the primary site (plus a margin) and the ipsilateral neck were covered by the irradiation volume. The ipsilateral parotid gland was within the treatment volume while the contralateral parotid gland was not. The most frequently used field arrangement was a paired wedge fields with an AP (medially just across the mid-line) and an ipsilateral posterior oblique field (usually 30 deg. off vertical axis with a spinal cord block). Multiple level of contours were taken and transmission blocks were used to improve dose homogeneity. In all patients, the ipsilateral parotid gland (and the neck) was irradiated while the contralateral parotid gland (and the neck) was not. Results: With a median follow up of 4 years (ranged from 1.5 to 9 years), only one patient developed symptomatic xerostomia. None had radiation induced dental caries. No patient developed recurrent disease in the contralateral neck. The local control rate was (38(42)) (90%) in the primary site and(41(42)) (98%) in the ipsilateral neck. Conclusion: With appropriate treatment planning, external beam irradiation with parotid function preservation can be achieved. Our results
Parotitis and Sialendoscopy of the Parotid Gland.

Science.gov (United States)

Hernandez, Stephen; Busso, Carlos; Walvekar, Rohan R

2016-04-01

Nonneoplastic disorders of the salivary glands involve inflammatory processes. These disorders have been managed conservatively with antibiotics, warm compresses, massage, sialogogues, and adequate hydration. Up to 40% of patients may have an inadequate response or persistent symptoms. When conservative techniques fail, the next step is operative intervention. Sialendoscopy offers a minimally invasive option for the diagnosis and management of chronic inflammatory disorders of the salivary glands and offers the option of gland and function preservation. In this article, we review some of the more common nonneoplastic disorders of the parotid gland, indications for diagnostic and interventional sialendoscopy, and operative techniques. Copyright © 2016 Elsevier Inc. All rights reserved.
Longitudinal changes over 2 years in parotid glands of patients treated with preoperative 30-Gy irradiation for oral cancer

International Nuclear Information System (INIS)

Tomitaka, Etsushi; Murakami, Ryuji; Teshima, Keiko

2011-01-01

The objective of this study was to evaluate longitudinal changes in parotid volumes and saliva production over 2 years after 30 Gy irradiation. We retrospectively evaluated 15 assessable patients treated for advanced oral cancer. Eligibility criteria were a pathologic diagnosis of squamous cell carcinoma, preoperative radiation therapy with a total dose of 30 Gy delivered in 15 fractions, and the availability of longitudinal data of morphological assessments by computed tomography and functional assessments with the Saxon test spanning 2 years after radiation therapy. In the Saxon test, saliva production was measured by weighing a folded sterile gauze pad before and after chewing; the low-normal value is 2 g/2 min. Repeated-measures analysis of variance with Bonferroni adjustment for multiple comparisons was used to determine the longitudinal changes. The normalized ipsilateral parotid volumes 2 weeks and 6-, 12- and 24 months after radiation therapy were found to be 72.5, 63.7, 66.9 and 78.1%, respectively; the normalized contralateral volumes were 69.8, 64.6, 72.2 and 82.0%, respectively. The bilateral parotid volumes were significantly decreased after radiation therapy (P<0.01). The nadir appeared at 6 months post-radiation therapy and the volumes substantially recuperated 24 months after radiation therapy (P<0.01). Mean saliva production before radiation therapy was 3.7 g; the longitudinal changes after radiation therapy were 31.3, 38.0, 43.3 and 69.6%, respectively. Substantial recuperation of saliva production was observed 24 months after radiation therapy (P=0.01). Although parotid volumes and saliva production were decreased after 30 Gy irradiation, we observed the recuperation of morphological and functional changes in the parotid glands 2 years after radiation therapy. (author)

Monoclonal antibody localization of Na sup + -K sup + -ATPase in the exocrine pancreas and parotid of the dog

Energy Technology Data Exchange (ETDEWEB)

Smith, Z.D.J.; Caplan, M.J.; Forbush, B. III; Jamieson, J.D. (Yale Univ. School of Medicine, New Haven, CT (USA))

1987-08-01

A monoclonal antibody specific to the {beta}-subunit of the canine {sup 125}I-labeled-Na{sup +}-K{sup +}-ATPase has been characterized and used to directly localize the enzyme in thin frozen sections of dog pancreas and parotid. The antibody, 7-2M, recognizes only the {beta}-subunit of the sodium pump as determined by immunoprecipitation and immunoblot and is not directed against an oligosaccharide determinant. 7-2M immunolocalizes to the same cellular and subcellular domains of renal tubular cells as do other, previously characterized, antibodies directed to the {alpha}-subunit of the sodium pump. In the pancreas the preponderance of the Na{sup +}-K{sup +}-ATPase is found on the basolateral membranes of centroacinar and intralobular duct cells. Interlobular duct cells also express a large component of basolaterally located enzyme, although comparatively little pump is seen on acinar cells. In the parotid a large amount of Na{sup +}-K{sup +}-ATPase is seen on the striated cut cells, with high levels also noted on cells of the intercalated ducts and serous demilunes. Again the acinar cells show comparatively low levels of Na{sup +}-K{sup +}-ATPase. In no instance is Na{sup +}-K{sup +}-ATPase found on the apical membranes of pancreas or parotid cells. These data suggest that Na{sup +}-K{sup +}-ATPase, located on the basolateral plasmalemma of duct-derived cells, may be involved in water and electrolyte secretion from the pancreas and parotid.
Radiation effects on the parotid gland of mammals. Pt. 4. Biochemical and morphological changes after local irradiation

Energy Technology Data Exchange (ETDEWEB)

Becciolini, A; Balzi, M; Cremonini, D; Tomassi, I; Giannardi, G [Florence Univ. (Italy). Istituto di Radiologia; Pelu, G

1980-01-01

A morphological and biochemical study was done on rat parotids to evaluate the modifications after 2400 rad in the parotid area only. As previously observed, whole-body irradiation with lower doses produced only slight effects on the gland. The enzymes peculiar to glandular function decreased significantly 3 days after irradiation, later they fluctuated on control values. Increase in alkaline phosphatase, LAP, and decrease in protein content was a constant result, ..beta..-glucuronidase only among lysosomal enzymes increased significantly at some intervals. Morphological alterations in the glandular sections of the sacrificed animals appeared modest and mostly consisted of progressive fibrosis.
Assessment of Parotid Gland Dose Changes During Head and Neck Cancer Radiotherapy Using Daily Megavoltage Computed Tomography and Deformable Image Registration

International Nuclear Information System (INIS)

Lee, Choonik; Langen, Katja M.; Lu Weiguo; Haimerl, Jason; Schnarr, Eric; Ruchala, Kenneth J.; Olivera, Gustavo H.; Meeks, Sanford L.; Kupelian, Patrick A.; Shellenberger, Thomas D.; Manon, Rafael R.

2008-01-01

Purpose: To analyze changes in parotid gland dose resulting from anatomic changes throughout a course of radiotherapy in a cohort of head-and-neck cancer patients. Methods and Materials: The study population consisted of 10 head-and-neck cancer patients treated definitively with intensity-modulated radiotherapy on a helical tomotherapy unit. A total of 330 daily megavoltage computed tomography images were retrospectively processed through a deformable image registration algorithm to be registered to the planning kilovoltage computed tomography images. The process resulted in deformed parotid contours and voxel mappings for both daily and accumulated dose-volume histogram calculations. The daily and cumulative dose deviations from the original treatment plan were analyzed. Correlations between dosimetric variations and anatomic changes were investigated. Results: The daily parotid mean dose of the 10 patients differed from the plan dose by an average of 15%. At the end of the treatment, 3 of the 10 patients were estimated to have received a greater than 10% higher mean parotid dose than in the original plan (range, 13-42%), whereas the remaining 7 patients received doses that differed by less than 10% (range, -6-8%). The dose difference was correlated with a migration of the parotids toward the high-dose region. Conclusions: The use of deformable image registration techniques and daily megavoltage computed tomography imaging makes it possible to calculate daily and accumulated dose-volume histograms. Significant dose variations were observed as result of interfractional anatomic changes. These techniques enable the implementation of dose-adaptive radiotherapy
Histological and histochemical study of the protective role of rosemary extract against harmful effect of cell phone electromagnetic radiation on the parotid glands.

Science.gov (United States)

Ghoneim, Fatma M; Arafat, Eetmad A

2016-06-01

Electromagnetic fields (EMFs) are a class of non-ionizing radiation (NIR) that is emitted from mobile phone. It may have hazardous effects on parotid glands. So, we aimed to investigate the histological and histochemical changes of the parotid glands of rats exposed to mobile phone and study the possible protective role of rosemary against its harmful effect. Forty adult male albino rats were used in this study. They were classified into 4 equal groups. Group I (control), group II (control receiving rosemary), group III (mobile phone exposed group) and group IV (mobile exposed, rosemary treated group). Parotid glands were dissected out for histological and histochemical study. Moreover, measurement of oxidative stress markers; malondialdehyde (MDA) and total antioxidant capacity (TAC) was done. The results of this study revealed that rosemary has protective effect through improving the histological and histochemical picture of the parotid gland in addition of its antioxidant effect. It could be concluded from the current study, that exposure of parotid gland of rat models to electromagnetic radiation of mobile phone resulted in structural changes at the level of light and electron microscopic examination which could be explained by oxidative stress effect of mobile phone. Rosemary could play a protective role against this harmful effect through its antioxidant activity. Copyright © 2016 Elsevier GmbH. All rights reserved.
Acinic cell carcinoma of parotid gland metastasis to left cavernous sinus: a case report and review of literature

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LIN Xiao-yan

2013-12-01

Full Text Available Objective To investigate the clinical manifestations and pathological features of parotid gland papillary acinic cell carcinoma metastasis to left cavernous sinus. Methods The clinical manifestations, pathological features and differential diagnosis were studied in one case of parotid papillary acinic cell carcinoma metastasis to left cavernous sinus. Related literatures were also reviewed. Results The patient was a 50-year-old female who presented paroxysmal dizziness for 5 months and blurred vision in her left eye for 10 months. The MRI examination showed left parasellar space-occupying mass in the cavernous sinus. In operation, the tumor was located in the superior wall of left cavernous sinus, soft and red-grey in color, with abundant blood supply. The histomorphological examination revealed the tumor cells were arranged in solid, acinar or papillary pattern. The tumor cells were large, with eosinophilic cytoplasm, round or oval nuclei and small nucleoli. Immunohistochemical staining found that the tumor cells expressed cytokeratin (CK, epithelial membrane antigen (EMA, vimentin (Vim and S-100 protein (S-100, and showed weak positive expression of glial fibrillary acidic protein (GFAP and focal positive expression of P53 protein. Ki-67 labeling index was about 5%-10% . The tumor cells were negative for neuroendocrine markers and pituitary hormone protein markers. This case was difficult to differentiate from other primary intracalvarium tumors, including papillary meningioma, papillary tumor of choroid plexus, papillary ependymoma, papillary glioneuronal tumors as well as chordoma. According to the medical history and the comparison of histomorphology and immunophenotyping between parotid gland tumor cells and left cavernous sinus tumor cells, the final diagnosis was metastatic papillary parotid acinar cell carcinoma of the left cavernous sinus. The patient was followed for 21 months and no recurrence was seen. Conclusion It is very rare and
INTRA graphical package - INTRA-Graph 1.0

International Nuclear Information System (INIS)

Hofman, D.; Edlund, O.

2001-04-01

INTRA-Graph 1.0 has been developed at Studsvik Eco and Safety AB in the frame of the European Fusion Technology Programme for application in the safety analysis using the INTRA code. INTRA-Graph 1.0 is a graphical package producing 2-dimensional plots of results generated by the INTRA code. INTRA-Graph 1.0 has been developed by extending the Grace package source code, distributed under the terms of GNU General Public License. The changes in the Grace source files are limited to provide easy updates of the INTRA-Graph when a new version of Grace will be released. The INTRA-related functionality has been implemented in new source files. The present report describes and gives complete listing of these files. The changes in the Grace source files are also described and the listing of the changed parts of the files is presented. The report gives detailed explanations and examples of files required for installation and configuration of INTRA-Graph on the different types of Unix workstations
Parotid duct injury secondary to shark bite injury: Repair with a Crawford stent

Directory of Open Access Journals (Sweden)

Mallory Highstein

2016-12-01

Conclusion: Clinicians should have a high level of suspicion for parotid duct injury in a patient presenting with injury to the face, particularly with laceration type injuries. Our patient had a unique injury that required a novel Crawford stent repair over traditional silicone catheters.
Hypofractionated stereotactic radiotherapy of acoustic neuroma. Volume changes and hearing results after 89-month median follow-up

International Nuclear Information System (INIS)

Kranzinger, Manfred; Fastner, Gerd; Zehentmayr, Franz; Sedlmayer, Felix; Oberascher, Gerhard; Merz, Florian; Rahim, Hassan; Nairz, Olaf

2014-01-01

The goal of this work was to evaluate toxicity and local control following hypofractionated stereotactic radiation treatment with special focus on changes in tumor volume and hearing capacity. In all, 29 patients with unilateral acoustic neuroma were treated between 2001 and 2007 within a prospective radiation protocol (7 x 4 Gy ICRU dose). Median tumor volume was 0.9 ml. Follow-up started at 6 months and was repeated annually with MRI volumetry and audiometry. Hearing preservation was defined as preservation of Class A/B hearing according to the guidelines of the American Academy of Otolaryngology (1995). No patient had any intervention after a median imaging follow-up of 89.5 months, one patient showed radiological progression. Transient increase of tumor volume developed in 17/29 patients, whereas 22/29 patients (75.9 %) presented with a volume reduction at last follow-up. A total of 21 patients were eligible for hearing evaluation. Mean pure tone average (PTA) deteriorated from 39.3 to 65.9 dB and mean speech discrimination score (SDS) dropped from 74.3 to 38.1 %. The 5-year actuarial Class A/B hearing preservation rate was 50.0 ± 14.4 %. Radiation increases only minimally, if at all, the hearing deterioration which emerges by observation alone. Presbyacusis is not responsible for this deterioration. Transient tumor enlargement is common. Today radiation of small- and medium-sized acoustic neuroma can be performed with different highly conformal techniques as fractionated treatment or single low-dose radiosurgery with equal results regarding tumor control, hearing preservation, and side effects. Hypofractionation is more comfortable for the patient than conventional regimens and represents a serious alternative to frameless radiosurgery. (orig.) [de
Electron microscopic study of the spilt irradiation effects on the rat parotid ductal cells

International Nuclear Information System (INIS)

Kim, Sung Soo; Lee, Sang Rae

1988-01-01

This study was designed to investigate the effects of split irradiation on the salivary ductal cells, especially on the intercalated cells of the rat parotid glands. For this study, 24 Sprague-Dawley strain rats were irradiated on the head and neck region with two equal split doses of 9 Gy for a 4 hours interval by Co-60 teletherapy unit, Picker's mode l 4M 60. The conditions of irradiation were that field size, dose rate, SSD and depth were 12 X 5 cm, 222 cGy/min, 50 cm and 1 cm, respectively. The experimental animals were sacrificed 1, 2, 3, 6, 12, hours and 1, 3, 7, days after the irradiation and the changes of the irradiated intercalated cells of the parotid glands were examined under light and electron microscope. The results were as follows: 1. By the split irradiation, the degenerative changes of intercalated cells of the parotid glands appeared at 3 hours after irradiation and the most severe cellular degeneration observed at 6 hours after irradiation. The repair processes began from 12 hours after irradiation and have matured progressively. 2. Under electron microscope, loss of nuclear membrane, microvilli and secretory granules, derangement of chromosomes, degeneration of cytoplasm, atrophy or reduction of intracytoplasmic organelles were observed in the intercalated ductal cells after split irradiation. 3. Under light microscope, derangement of ductal cells, widening of cytoplasms and nuclei, hyperchromatism and proliferation of ductal cells were observed in intercalated ducts after split irradiation.
Recurrent parotid swelling secondary to masseter muscle hypertrophy: a multidisciplinary diagnostic and therapeutic approach.

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Capaccio, Pasquale; Gaffuri, Michele; Pignataro, Lorenzo; Assandri, Fausto; Pereira, Pollyanna; Farronato, Giampietro

2016-11-01

To present a patient with an atypical recurrent parotid swelling due to masseter muscle hypertrophy and the diagnostic/therapeutic assessment to treat this condition. A patient referring recurrent right facial swelling underwent a complete multidisciplinary assessment of the parotid region that revealed masseter muscle hypertrophy, confirmed by means of clinical (otolaryngological and gnathological evaluation), radiological (utrasonography, dynamic magnetic resonance imaging, and cone beam computed tomography), instrumental (electromyography to evaluate the right masseter muscle function and kinesiography to evaluate maximum right deflection - MaxRDefl and maximum opening - MaxMO) and sialendoscopy assessment where T0 indicates the pre-treatment values. All electromyographic and kinesiographic parameters were evaluated six months after the orthodontic application of a neuromuscular orthosis at T1. At T1, the effectiveness of the orthodontic therapy was demonstrated by the complete resolution of symptoms, and instrumental results documented more efficient muscle activity at rest and during clenching and a better mandibular position. At EMG T1, the resting and post-TENS values were, respectively, 1.2 and 1.8 microV. At kinesiography, MaxRDefl increased from 10.2 (T0) to 10.5 mm (T1); maxMO increased from 41.2 (T0) to 48 mm (T1). The proposed multidisciplinary assessment based on otolaryngological, gnathological, and radiological evaluation may be useful in the case of recurrent parotid swelling secondary to masseter muscle hypertrophy to plan an appropriate management with a removable neuromuscular orthosis.
The combined use of US and MR imaging for the diagnosis of masses in the parotid region

International Nuclear Information System (INIS)

Goto, T.K.; Yoshiura, K.; Nakayama, E.; Yuasa, K.; Tabata, O.; Nakano, T.; Kawazu, T.; Tanaka, T.; Miwa, K.; Shimizu, M.; Chikui, T.; Okamura, K.; Kanda, S.

2000-01-01

To evaluate the usefulness of the combination of the two non-invasive modalities US and MR imaging to diagnose masses in the parotid region. The US and MR findings of 21 patients with parotid masses were analyzed retrospectively by two radiologists without any clinical or histopathological information. The specific points evaluated were location, shape, margin, internal architecture, and intensity level on both US and MR, posterior echo enhancement on US, and capsule-like lining of the tumor on MR. The findings concerning the shape and margin on US and MR were in fairly good agreement. Concerning the findings of the internal architecture, US could reveal the minute structures of the tumor while MR demonstrated differences in the signal intensities of histological tissue types of the various tumors. The posterior echo enhancement on US and the capsule-like lining on MR of the tumors were also useful for the diagnosis. Our results suggest that the combination of US and MR is useful for examining soft tissue masses in the parotid region to make a more accurate diagnosis, and not just differentiate malignant lesions from those which are benign
VALIDITY OF CORE NEEDLE BIOPSY IN THE HISTOPATHOLOGICAL VERIFICATION OF PAROTID GLAND LESIONS

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Oroz Aleksandar

2016-07-01

Full Text Available Background and purpose: An adequate diagnosis of a parotid gland enlargement is crucial for an appropriate treatment. The aim of the study was to evaluate effectiveness and minimal invasiveness of diagnostic procedures of core-needle biopsy. Materials and Methods: This study involved 67 patients, aged 40 to 90 years, with a tumor mass in the submandibular and parotid region. Method used for taking samples of pathological masses was BD Disposable guillotine spring-loaded needle for biopsies on soft tissues. Final diagnoses were established on the basis of surgical-pathological results in 67 cases, and on the basis of histopathological analysis of core-biopsy samples. Results: Compared with results of surgical biopsy, core-needle biopsy had sensitivity of 100% in differentiating benign from malignant lesions and in setting up an adequate diagnosis. Its positive predictive values were 100% in diagnosing malignancy. There were found 28 non-malignant and 39 malignant lesions with fewer disadvantages for patients.
Function of the parotid gland in juvenile recurrent parotitis: a case series.

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Xie, Li-song; Pu, Yi-ping; Zheng, Ling-yan; Yu, Chuang-qi; Wang, Zhi-jun; Shi, Huan

2016-04-01

Our aim was to find out how the parotid gland functions in 44 patients with juvenile recurrent parotitis, and to assess the value of measuring the serum amylase activity. Clinical and personal details were recorded, and all patients had their serum amylase activity measured together with sialography during the chronic phase. The function of the gland was classified by sialographic images. The chi square test and Spearman's rank correlation coefficient were used in the statistical analyses. There was a significant association between the degree of glandular function and serum amylase activity (p=0.014). The patients with unilateral and bilateral disease differed significantly in their degree of glandular function (p=0.020), those with bilateral disease having poorer function. There were no significant correlations between other clinical variables and glandular function. Serum amylase activity is an important diagnostic variable in juvenile recurrent parotitis, and poor parotid function reflects the severity of the disease. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Radiotherapy in treatment of carcinoma of the parotid gland, an approach for the medically or technically inoperable patient

International Nuclear Information System (INIS)

Matthiesen, Chance; Thompson, Spencer; Steele, Alisha; Ahmad, Salahuddin; Bogardus Jr, Carl; Thompson, David

2010-01-01

Full text: Initial surgical resection is considered the standard of care for patients diagnosed with tumours involving the salivary glands. We reviewed our institutional outcomes of patients treated with initial radiation therapy (RT) for diagnosed carcinoma of the parotid gland. Methods: This review examined seventeen patients that received RT as initial therapy for tumours involving the parotid gland. Fifteen patients had primary salivary gland cancer, and two patients had metastatic carcinoma to the parotid gland. Sixteen patients (94.1%) following surgical evaluation had operative risk of facial nerve impairment or sacrifice with initial surgery, four (23.5%) had clinical objective evidence of nerve involvement at evaluation, five (29.4%) were poor surgical candidates and three (17.6%) refused initial surgery. Primary tumour stages ranged T2-T4b, and disease stages ranged II-IVb. RT median dose was 70 Gy, and median follow-up was 12 months. Results: Eleven patients (64.7%) achieved a clinical complete response (CR) to therapy. Of these CR patients eight (72.7%) received definitive RT and three (27.3%) underwent surgery following RT. Two surgical patients avoided facial nerve impairment while one required nerve sacrifice. The other six patients (35.3%) achieved an unfavourable response to RT and had unresectable or metastatic disease at follow-up. No long-term complications were reported. Conclusion: Initial radiation therapy for tumours involving the parotid gland is effective to achieve clinical CR, eliminate surgical resection for many patients, and decrease risk of facial nerve impairment or sacrifice for those patients requiring surgery following RT.
Unique cellular structures in the parotid gland of an Old world fruit bat, Pteropus lylei (Lyle's flying fox).

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Lanlua, Passara; Sricharoenvej, Sirinush; Niyomchan, Apichaya; Chico, Diane E

2007-01-01

Pteropus lylei (Lyle's flying fox), an Old World fruit bat, consumes only ripe fruit, which contains low protein and sodium. The carpophagous diet of P. lylei presents an adaptive challenge for salivary glands to conserve sufficient nutrition for living. Therefore, the parotid glands in both sexes were investigated by using light microscopy and transmission electron microscopy. No structural difference was observed in the parotid glands between sexes. The acinar cell contained dense serous secretory granules, prominent luminal microvilli and intercellular canaliculi. The intercalated duct exhibited simple cuboidal epithelium with no secretory granule. Striated duct consisted of simple columnar epithelium with basal striation, numerous elongated mitochondria, and apical vesicles. In the interlobular duct, simple tall columnar epithelium and apocrine secretion were found. The interlobar and excretory ducts surprisingly contained continuous capillaries that intervened in stratified cuboidal epithelium. In addition, there were several blood vessels around the interlobular, interlobar and excretory ducts. The morphological adaptation of the parotid gland observed in P. lylei enables this species to obtain sufficient nutrients from the preferred consumption of ripe fruit. Serous secretory granule was suitable for digestion of ripe fruit. A well-developed striated duct, continuous capillaries among the epithelial cells of interlobar and excretory ducts, and numerous blood vessels around these ducts enhanced the reabsorption of amino acids and ions. Structural variations in the parotid gland can indicate not only a correlation to diet and survival but also a close relationship of the Old World fruit bat to other kinds of bats.
The influence of parotid gland sparing on radiation damages of dental hard tissues.

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Hey, Jeremias; Seidel, Johannes; Schweyen, Ramona; Paelecke-Habermann, Yvonne; Vordermark, Dirk; Gernhardt, Christian; Kuhnt, Thomas

2013-07-01

The aim of the present study was to evaluate whether radiation damage on dental hard tissue depends on the mean irradiation dose the spared parotid gland is subjected to or on stimulated whole salivary flow rate. Between June 2002 and October 2008, 70 patients with neck and cancer curatively irradiated were included in this study. All patients underwent dental treatment referring to the guidelines and recommendations of the German Society of Dental, Oral and Craniomandibular Sciences prior, during, and after radiotherapy (RT). During the follow-up period of 24 months, damages on dental hard tissues were classified according to the RTOG/EORTC guidelines. The mean doses (D(mean)) during spared parotid gland RT were determined. Stimulated whole saliva secretion flow rates (SFR) were measured before RT and 1, 6, 12, 24 months after RT. Thirty patients showed no carious lesions (group A), 18 patients developed sporadic carious lesions (group B), and 22 patients developed general carious lesions (group C). Group A patients received a D mean of 21.2 ± 11.04 Gy. Group B patients received a D(mean) of 26.5 ± 11.59 Gy and group C patients received a D(mean) of 33.9 ± 9.93 Gy, respectively. The D(mean) of group A was significantly lower than the D(mean) of group C (p dental hard tissue correlates with increased mean irradiation doses as well as decreased salivary flow rates. Parotid gland sparing resulting in a dose below 20 Gy reduces radiation damage on dental hard tissues, and therefore, the dose may act as a predictor for the damage to be expected.
Bilateral Parotid Sialadenosis Associated with Long-Standing Bulimia: A Case Report and Literature Review.

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Garcia Garcia, Blas; Dean Ferrer, Alicia; Diaz Jimenez, Nelida; Alamillos Granados, Francisco Jesus

2018-06-01

Bulimia is a common cause of sialadenosis. This paper presents a case of bilateral parotid sialadenosis associated with long-standing bulimia, and reviews the relevant literature and current treatment options. A 32-year-old woman had severe bilateral parotid sialomegaly for the last 6 years, which had occurred secondary to bulimia nervosa, which she had since 14 years. Treatment with pilocarpine was unsuccessful, so she underwent bilateral conservative parotidectomy. This procedure not only improved the aesthetic appearance of the patient but also improved her social and work life and overall quality of life. Sialomegaly secondary to bulimia results in a major alteration of the aesthetics of a patient's face. Conservative measures are not enough in many cases, and parotidectomy may be the only viable option, as it can also significantly improve adherence to psychiatric treatment for bulimia, in addition to correcting the facial aesthetics.
Primary unclassified sarcoma of the parotid gland: a case of diagnostic and therapeutic challenge.

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Saravakos, Panagiotis; Hartwein, Joerg; Fayyazi, Afshin

2017-05-01

Malignant salivary gland sarcomas represent a clinically and histologically diagnostic challenge. Primary unclassified sarcomas of the parotid gland consist a rare salivary gland tumor. We report an unusual case of such a tumor, which occurred in the right parotid gland of a 54-year-old male and presented as an asymptomatic painless mass. The pathologoanatomical examination revealed a rhabdoid large-cell unclassified sarcoma. The patient was treated with superficial parotidectomy and adjuvant radiotherapy. No recurrence was noted in a 10-year follow-up period. Due to the rare occurrence of primary unclassified sarcomas, there is no evidence-based treatment of choice. An optimal approach is best planned in a multidisciplinary setting, taking into consideration the resectability of the tumor, individual patient characteristics, presence of local or distant metastatic activity, local infiltrative behavior and tumor stage. A close follow-up of the patient is strongly recommended.
Pooled analysis of case-control studies on acoustic neuroma diagnosed 1997–2003 and 2007–2009 and use of mobile and cordless phones

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HARDELL, LENNART; CARLBERG, MICHAEL; SÖDERQVIST, FREDRIK; MILD, KJELL HANSSON

We previously conducted a case-control study of acoustic neuroma. Subjects of both genders aged 20–80 years, diagnosed during 1997–2003 in parts of Sweden, were included, and the results were published. We have since made a further study for the time period 2007–2009 including both men and women aged 18–75 years selected from throughout the country. These new results for acoustic neuroma have not been published to date. Similar methods were used for both study periods. In each, one population-based control, matched on gender and age (within five years), was identified from the Swedish Population Registry. Exposures were assessed by a self-administered questionnaire supplemented by a phone interview. Since the number of acoustic neuroma cases in the new study was low we now present pooled results from both study periods based on 316 participating cases and 3,530 controls. Unconditional logistic regression analysis was performed, adjusting for age, gender, year of diagnosis and socio-economic index (SEI). Use of mobile phones of the analogue type gave odds ratio (OR) = 2.9, 95% confidence interval (CI) = 2.0–4.3, increasing with >20 years latency (time since first exposure) to OR = 7.7, 95% CI = 2.8–21. Digital 2G mobile phone use gave OR = 1.5, 95% CI = 1.1–2.1, increasing with latency >15 years to an OR = 1.8, 95% CI = 0.8–4.2. The results for cordless phone use were OR = 1.5, 95% CI = 1.1–2.1, and, for latency of >20 years, OR = 6.5, 95% CI = 1.7–26. Digital type wireless phones (2G and 3G mobile phones and cordless phones) gave OR = 1.5, 95% CI = 1.1–2.0 increasing to OR = 8.1, 95% CI = 2.0–32 with latency >20 years. For total wireless phone use, the highest risk was calculated for the longest latency time >20 years: OR = 4.4, 95% CI = 2.2–9.0. Several of the calculations in the long latency category were based on low numbers of exposed cases. Ipsilateral use resulted in a higher risk than contralateral for both mobile and cordless
Parotid salivary parameters in bulimic patients – a controlled clinical trial.

OpenAIRE

Elżbieta Paszyńska; Agnieszka Słopień; Monika Węglarz; Roger W.A. Linden

2015-01-01

Objectives The aim of this study was to determine whether patients with purging-type bulimia and/or non-bulimic patients, treated with serotonin reuptake inhibitor SI-5-HT (fluoxetine), have dental erosion and changes in selected buffer components of parotid saliva (bicarbonates, phosphates, urea), compared with the healthy population. Methods A controlled clinical trial was designed for three, age-matched, female groups of 94 patients: 1) bulimic patients treated with fluoxetin...

Optimization of radiologic technique in parotid sialography

International Nuclear Information System (INIS)

Scribano, E.; Vitulo, F.; Raffaele, L.; Blandino, G.

1988-01-01

A suitable choice of film-screen combination is certainly the essential condition for achieving diagnostically reliable results together with the benefit of a low dosage for patients. In parotid sialography, the choice of one particular film-screen combination depends on the different thickness of various glandular areas and on the particular anatomical site of the gland which inevitably causes the superimposition of the thinnest canalicular ducts with the adjacent areas. An experimental-clinical study has been performed in order to evaluate the combination which can guarantee the most elevated diagnostic increase. The analysis of the rasults shows useful indication as far as the use of mammographic systems is concerned. These allow more diagnostic information together with a sufficiently low dosage for the patients
Diagnostic accuracy of ultrasonic histogram features to evaluate radiation toxicity of the parotid glands: a clinical study of xerostomia following head-and-neck cancer radiotherapy.

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Yang, Xiaofeng; Tridandapani, Srini; Beitler, Jonathan J; Yu, David S; Chen, Zhengjia; Kim, Sungjin; Bruner, Deborah W; Curran, Walter J; Liu, Tian

2014-10-01

To investigate the diagnostic accuracy of ultrasound histogram features in the quantitative assessment of radiation-induced parotid gland injury and to identify potential imaging biomarkers for radiation-induced xerostomia (dry mouth)-the most common and debilitating side effect after head-and-neck radiotherapy (RT). Thirty-four patients, who have developed xerostomia after RT for head-and-neck cancer, were enrolled. Radiation-induced xerostomia was defined by the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer morbidity scale. Ultrasound scans were performed on each patient's parotids bilaterally. The 34 patients were stratified into the acute-toxicity groups (16 patients, ≤ 3 months after treatment) and the late-toxicity group (18 patients, > 3 months after treatment). A separate control group of 13 healthy volunteers underwent similar ultrasound scans of their parotid glands. Six sonographic features were derived from the echo-intensity histograms to assess acute and late toxicity of the parotid glands. The quantitative assessments were compared to a radiologist's clinical evaluations. The diagnostic accuracy of these ultrasonic histogram features was evaluated with the receiver operating characteristic (ROC) curve. With an area under the ROC curve greater than 0.90, several histogram features demonstrated excellent diagnostic accuracy for evaluation of acute and late toxicity of parotid glands. Significant differences (P xerostomia monitoring and assessment. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.
Does cell phone use increase the chances of parotid gland tumor development? A systematic review and meta-analysis.

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de Siqueira, Elisa Carvalho; de Souza, Fabrício Tinoco Alvim; Gomez, Ricardo Santiago; Gomes, Carolina Cavalieri; de Souza, Renan Pedra

2017-08-01

Prior epidemiological studies had examined the association between cell phone use and the development of tumors in the parotid glands. However, there is no consensus about the question of whether cell phone use is associated with increased risk of tumors in the parotid glands. We performed a meta-analysis to evaluate the existing literature about the mean question and to determine their statistical significance. Primary association studies. Papers that associated cell phone use and parotid gland tumors development were included, with no restrictions regarding publication date, language, and place of publication. Systematic literature search using PubMed, SciELO and Embase followed by meta-analysis. Initial screening included 37 articles, and three were included in meta-analysis. Using three independent samples including 5087 subjects from retrospective case-control studies, cell phone use seems to be associated with greater odds (1.28, 95%- confidence interval: 1.09-1.51) to develop salivary gland tumor. Results should be read with caution due to the limited number of studies available and their retrospective design. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Combined effects of x-irradiation and bleomycin on the proliferation of isoproterenol-stimulated mouse parotid glands

International Nuclear Information System (INIS)

Shoju, Masumi

1977-01-01

Effects of x-irradiation and bleomycin (BLM) on DNA synthesis in isoproterenol (IPR)-stimulated mouse parotid glands were investigated. The incorporation of thymidine- 3 H into DNA in parotid glands increased remarkably in 16 hours with a peak at 22 hours after the injection of IPR. When x-irradiation (250 rads) was given at 1 hour after IPR (early G 1 phase), the stimulation of DNA synthesis was inhibited by about 50%, and the beginning of DNA synthesis was delayed nearly 6 hours. BLM injected in the early G 1 phase was also effective in inhibiting DNA synthesis. However, the injection of BLM in the late G 1 or S phase did not interfere with DNA synthesis. Combined x-irradiation and BLM inhibited DNA synthesis and delayed the beginning of the S phase far more strikingly than did x-irradiation alone. When BLM was injected at various intervals before and after x-irradiation, the greatest inhibition was found just after irradiation. Therefore, a longer interval between x-irradiation and BLM injection had a tendency to decrease the rate of inhibiting DNA synthesis. These findings were confirmed by measuring the labeling index and the mitotic index in the acinar cells of the mouse parotid gland. These results suggest that simultaneous application of x-irradiation and BLM has the greatest effect. (Evans, J.)
Effects of large pressure amplitude low frequency noise in the parotid gland perivasculo-ductal connective tissue.

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Oliveira, Pedro; Brito, José; Mendes, João; da Fonseca, Jorge; Águas, Artur; Martins dos Santos, José

2013-01-01

In tissues and organs exposed to large pressure amplitude low frequency noise fibrosis occurs in the absence of inflammatory signs, which is thought to be a protective response. In the parotid gland the perivasculo-ductal connective tissue surrounds arteries, veins and the ductal tree. Perivasculo-ductal connective tissue is believed to function as a mechanical stabilizer of the glandular tissue. In order to quantify the proliferation of perivasculo-ductal connective tissue in large pressure amplitude low frequency noise-exposed rats we used sixty Wistar rats which were equally divided into 6 groups. One group kept in silence, and the remaining five exposed to continuous large pressure amplitude low frequency noise: g1-168h (1 week); g2-504h (3 weeks); g3-840h (5 weeks); g4-1512h (9 weeks); and g5-2184h (13 weeks). After exposure, parotid glands were removed and the perivasculo-ductal connective tissue area was measured in all groups. We applied ANOVA statistical analysis, using SPSS 13.0. The global trend is an increase in the average perivasculo-ductal connective tissue areas, that develops linearly and significantly with large pressure amplitude low frequency noise exposure time (p connective tissue. Hence, these results show that in response to large pressure amplitude low frequency noise exposure, rat parotid glands increase their perivasculo-ductal connective tissue.
Management of a patient undergoing sitting position craniotomy for acoustic neuroma with co-existing interstitial lung disease

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Deepa Suvarna

2015-01-01

Full Text Available A 38-year-old woman with acoustic neuroma associated with occupational interstitial lung disease (ILD was successfully managed for sitting position craniotomy using carefully titrated desflurane-based anaesthesia. The anaesthetic challenges included maintenance an adequate depth of anaesthesia, reducing perioperative airway events and ensuring smooth recovery. While dealing with ILD patient in sitting position, careful risk assessment is important because it will help us predict the course of the perioperative events. Balanced general anaesthesia using desflurane fulfilled the requirement of good depth and smooth recovery in this patient. Though there are reports of maintenance of anaesthesia with other inhalational agents, there are scanty reports of using desflurane in these cases.
Associação entre tamanho e potencial proliferativo em neurinomas do acústico Size and proliferative index correlation in acoustic neuromas

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Oswaldo Inácio de Tella

2006-03-01

Full Text Available Schwanomas do acústico são os tumores mais freqüentes localizados no ângulo pontocerebelar. Os mecanismos moleculares que levam a sua geração e crescimento ainda não são bem conhecidos. Várias características clínicas, radiológicas e imuno-histoquímicas já foram estudadas e correlacionadas ao crescimento tumoral. Estudamos e correlacionamos aspectos clínicos e imuno-histoquímicos (MIB-1 de 11 schwanomas do acústico operados no Hospital São Paulo/UNIFESP. O tamanho dos tumores correlacionou-se com o índice proliferativo (Ki-67, não havendo correlação com significância estatística entre a idade dos pacientes, duração dos sintomas e índice proliferativo.Acoustic neuromas are the most common tumors in the cerebellopontine angle. The molecular mechanisms involved in generation and growth of these tumors are not completly elucidated. Many radiological, clinic and imunohistochemystry data were correlated to tumor growth. We studied 11 acoustic neuromas surgically treated at Hospital São Paulo/Unifesp and correlated clinical and radiological data with proliferative index (Ki-67. The size of the tumors were positively correlationated with proliferative index. No other correlation had statistic significativity.
Brote de parotiditis vírica en un colegio de Bizkaia en 2006

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Eduardo Millán Ortuondo

2007-01-01

Full Text Available Fundamento: Recientemente se han registrado brotes de parotiditis en España y en otros países desarrollados. Los motivos barajados son la baja cobertura vacunal de las poblaciones afectadas y/o la baja efectividad de las cepas vacunales empleadas. Este trabajo describe un brote de parotiditis ocurrido en Bizkaia y valora la efectividad de las cepas vacunales y la utilidad de las pruebas diagnósticas actualmente empleadas. Métodos: Se etiquetaron como casos aquéllos con clínica compatible y vínculo epidemiológico en el periodo de estudio (febrero-mayo-2006. Se recogieron muestras de sangre para estudio de IgM e IgG y de saliva para detección de RNA y genotipo. Se averiguó el estado vacunal y la cepa empleada mediante los registros del reparto vacunal. Se realizó un análisis univariante de los datos y se obtuvieron riesgos relativos según las cepas vacunales empleadas. Resultados: Se detectaron 63 casos; 52 eran alumnos del mismo colegio. El 50% tenía entre 9 y 13 años. El 88,5% de los casos del colegio estaba correctamente vacunado. La sensibilidad de la IgM fue del 9% y la de la PCR del 37%. El riesgo relativo de los alumnos vacunados con una primera dosis de cepa Rubini frente a los vacunados con cepa Jeryl-Lynn fue de 3,8 (IC95% 2,27-6,49. Conclusiones: La elevada cobertura vacunal no impide el desarrollo de brotes en lugares con un alto grado de exposición. La IgM se muestra poco sensible para el diagnóstico de parotiditis. Parece necesario replantearse las estrategias vacunales y los métodos diagnósticos actuales.
The effects of antidepressants and pilocarpine on rat parotid glands: an immunohistochemical study

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Tatiana Maria Folador Mattioli

2011-01-01

Full Text Available OBJECTIVES: To evaluate the effects of antidepressants and pilocarpine on the quantity of myoepithelial cells and on the proliferation index of the epithelial cells of rat parotid glands. INTRODUCTION: Hyposalivation, xerostomia, and alterations in saliva composition are important clinical side effects related to the use of antidepressants. METHODS: Ninety male Wistar rats were allocated to nine groups. The control groups received saline for 30 (group C30 or 60 days (group C60 or pilocarpine for 60 days (group Pilo. The experimental groups were administered fluoxetine (group F30 or venlafaxine for 30 days (group V30; fluoxetine (group FS60 or venlafaxine (group VS60 with saline for 60 days; or fluoxetine (group FP60 or venlafaxine (group VP60 with pilocarpine for 60 days. Parotid gland specimens were processed, and the immunohistochemical expression of calponin and proliferating cell nuclear anti-antigen on the myoepithelial and parenchymal cells, respectively, was evaluated. Analysis of variance (ANOVA, Tukey HSD and Games-Howell tests were applied to detect differences among groups (p<0.05. RESULTS: Compared with the controls, chronic exposure to antidepressants was associated with an increase in the number of positively stained cells for calponin. In addition, venlafaxine administration for 30 days was associated with an increase in the number of positively stained cells for proliferating cell nuclear anti-antigen. Fluoxetine and pilocarpine (group FP60 induced a significant decrease in the number of positively stained cells for calponin compared with all other groups. CONCLUSIONS: The number of positively stained cells for calponin increased after chronic administration of antidepressants. The proliferation index of the epithelial cells of rat parotid glands was not altered by the use of antidepressants for 60 days.
Effect of mobile phone use on salivary concentrations of protein, amylase, lipase, immunoglobulin A, lysozyme, lactoferrin, peroxidase and C-reactive protein of the parotid gland.

Science.gov (United States)

Hashemipour, M S; Yarbakht, M; Gholamhosseinian, A; Famori, H

2014-05-01

The possibility of side effects associated with the electromagnetic waves emitted from mobile phones is a controversial issue. The present study aimed to evaluate the effect of mobile phone use on parotid gland salivary concentrations of protein, amylase, lipase, immunoglobulin A, lysozyme, lactoferrin, peroxidase and C-reactive protein. Stimulated salivary samples were collected simultaneously from both parotid glands of 86 healthy volunteers. Salivary flow rate and salivary concentrations of proteins, amylase, lipase, lysozyme, lactoferrin, peroxidase, C-reactive protein and immunoglobulin A, were measured. Data were analysed using t-tests and one-way analyses of variance. Salivary flow rate and parotid gland salivary concentrations of protein were significantly higher on the right side compared to the left in those that predominantly held mobile phones on the right side. In addition, there was a decrease in concentrations of amylase, lipase, lysozyme, lactoferrin and peroxidase. The side of dominant mobile phone use was associated with differences in salivary flow rate and parotid gland salivary concentrations, in right-dominant users. Although mobile phone use influenced salivary composition, the relationship was not significant.
Presentation of a 3D conformal radiotherapy technique for head-and-neck tumors resulting in substantial protection of the parotid glands

International Nuclear Information System (INIS)

Kuhnt, T.; Janich, M.; Gerlach, R.; Haensgen, G.; Goetz, U.; Chiricuta, I.C.

2006-01-01

Purpose: the aim of this study was to improve the irradiation technique for the treatment of head-and-neck tumors and, in particular, to make use of the advantages found in modern 3D planning to protect the parotid glands. Patients and methods: for this investigation the 3D dataset of a standard patient with oropharyngeal carcinoma of UICC stage IVA was used. In the CT scans (slice thickness 5 mm) the planning target volume (PTV), the boost volume and both parotids were delineated. Three different techniques were calculated for two different dose levels (50 Gy for PTV and 64 Gy for boost volume, using single doses of 2 Gy). For technique 1 (T1) a parallel opposed field photon/electron irradiation was designed, for technique 2 (T2) an opposed/arc field irradiation was employed, and for technique 3 (T3) a combination of a static coplanar and arc field irradiation was designed. The sum doses D min , D max and D mean for PTV, boost volume, and ipsilateral and contralateral parotid gland were evaluated, and the time needed for calculation of the plans was also determined. Results: for all techniques used, the calculated doses in the PTV (D min 5.6 ± 0.1 Gy, D max 73.7 ± 0.1 Gy, and D mean 57.9 ± 0.5 Gy) and in the boost volume (D min 46.9 ± 1.5 Gy, D max 73.8 ± 0.12 Gy, and D mean 65.8 ± 0.9 Gy) were equal. Significant differences were found regarding the three different techniques, e.g., for the ipsilateral parotid gland D min (T1 = 47.4, T2 = 50.6, and T3 = 38.4 Gy) as well as for the contralateral parotid gland D min (T1 = 42.1, T2 = 44.2, and T3 = 17.8 Gy) and D mean (T1 = 51.3, T2 = 52.8, and T3 = 32.6 Gy). Regarding the three different techniques, significant differences were found in favor of T3. The determined planning times were as follows: T1 = 90, T2 = 60, and T3 = 90 min. Conclusion: the combination of static coplanar and arc field technique (T3) resulted in a substantially better protection as compared to both other techniques. This was especially the
Infratemporal fossa extension of primary parotid squamous cell carcinoma: a rare entity with diagnosis dilemma

International Nuclear Information System (INIS)

Karaf, J.H.; Gendeh, B.S.; Yunus, M.R.M.

2015-01-01

Primary squamous cell carcinoma of parotid gland is rare but it is an aggressive neoplasm that can have extension into the infratemporal fossa. We report a 60-year-old female presenting with toothache over left lower molar causing a diagnostic dilemma. (author)
Parotid gland-sparing 3-dimensional conformal radiotherapy results in less severe dry mouth in nasopharyngeal cancer patients: A dosimetric and clinical comparison with conventional radiotherapy

International Nuclear Information System (INIS)

Jen, Y.-M.; Shih Rompin; Lin, Y.-S.; Su, W.-F.; Ku, C.-H.; Chang, C.-S.; Shueng, P.-W.; Hwang, J.-M.; Liu, D.-W.; Chao, H.-L.; Lin, H.-Y.; Chang, L.-P.; Shum, W.-Y.; Lin, C.-S.

2005-01-01

Background and purpose: This study examined the efficacy of parotid gland sparing of three-dimensional conformal radiotherapy (3DCRT) compared with conventional radiotherapy for NPC patients. Both the dose given to the parotids and clinical assessment of dry mouth were conducted. Materials and methods: Dry mouth was assessed for 108 patients treated with conventional technique and 72 treated with 3DCRT. Dose analysis was performed in 48 patients of the 3DCRT group. A dose of 70 Gy was given to the midplane in conventional radiotherapy and to 90% isodose volume in 3DCRT. Prognostic factors affecting the severity of dry mouth were analyzed using Generalized Estimating Equation (GEE). Results: In the 3DCRT group about 50% of the patients' parotid glands received less than 25 Gy. Parallel analysis of dry mouth shows a significant decrease in the incidence of severe xerostomia after 3DCRT. The proportion of patients without dry mouth was also significantly higher in the 3DCRT group than the conventional group at 1-3 years after completion of radiotherapy. Although 3DCRT delivered a higher dose to the tumor, it spared the parotid gland significantly better than the conventional treatment. Late toxicities were mostly similar between the 2 groups while local control in T4 patients and survival were improved for 3DCRT. Conclusion: Dosimetrically and clinically 3DCRT is better than conventional technique regarding parotid gland protection
Management of acoustic neuromas with fractionated stereotactic radiotherapy (FSRT): Long-term results in 106 patients treated in a single institution

International Nuclear Information System (INIS)

Combs, Stephanie E.; Volk, Sigrid; Schulz-Ertner, Daniela; Huber, Peter E.; Thilmann, Christoph; Debus, Juergen

2005-01-01

Purpose: To assess the long-term outcome and toxicity of fractionated stereotactic radiotherapy for acoustic neuromas in 106 patients treated in a single institution. Patients and Methods: Between October 1989 and January 2004, fractionated stereotactic radiotherapy (FSRT) was performed in 106 patients with acoustic neuroma (AN). The median total dose applied was 57.6 Gy in median single fractions of 1.8 Gy in five fractions per week. The median irradiated tumor volume was 3.9 mL (range, 2.7-30.7 mL). The median follow-up time was 48.5 months (range, 3-172 months). Results: Fractionated stereotactic radiotherapy was well tolerated in all patients. Actuarial local tumor control rates at 3- and 5- years after FSRT were 94.3% and 93%, respectively. Actuarial useful hearing preservation was 94% at 5 years. The presence of neurofibromatosis (NF-2) significantly adversely influenced hearing preservation in patients that presented with useful hearing at the initiation of RT (p = 0.00062). Actuarial hearing preservation without the diagnosis of NF-2 was 98%. In cases with NF-2, the hearing preservation rate was 64%. Cranial nerve toxicity other than hearing impairment was rare. The rate of radiation induced toxicity to the trigeminal and facial nerve was 3.4% and 2.3%, respectively. Conclusion: Fractionated stereotactic radiotherapy is safe and efficacious for the treatment of AN, with mild toxicity with regard to hearing loss and cranial nerve function. FSRT might be considered as an equieffective treatment modality compared to neurosurgery and therefore represents an interesting alternative therapy for patients with AN
Allometric and radioautographic study on developing parotid gland of the golden hamster at early postnatat period

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Luca, I M.S. de [Universidade Estadual de Campinas, SP (Brazil). Inst. de Biologia

1989-02-01

The post-natal development of golden hamster parotid gland and the rate of proliferation of the cells are studied in the first month of the life. A comparative evaluation with other rodents is presented. (M.A.C.).
Effects of continuous hyperfractionated accelerated and conventionally fractionated radiotherapy on the parotid and submandibular salivary glands of rhesus monkeys

International Nuclear Information System (INIS)

Price, R.E.; Ang, K.K.; Stephens, L.C.; Peters, L.J.

1995-01-01

Radiotherapy is a major treatment modality for head and neck cancer. It is often not possible to exclude the salivary glands from the treatment fields. The unique susceptibility of the serous cells of the salivary glands to irradiation often results in xerostomia with ensuing secondary complications and discomfort to the patients. Recent reports have suggested that continuous hyperfractionated accelerated radiotherapy (CHART) can lead to considerably less reduction in salivary flow of the parotid salivary gland than conventional radiotherapy. This study was undertaken to assess histologic changes of salivary glands induced by CHART and conventional radiation fractionation schedules. The parotid and submandibular salivary glands of adult rhesus monkeys were irradiated with cobalt-60 γ radiation at 50 Gy/20 fractions/4 weeks, 55 Gy/25 fractions/5 weeks, or 54 Gy/36 fractions/12 days (CHART). Salivary tissues were harvested at 16 weeks following irradiation and evaluated histopathologically. Microscopically, the glands receiving 50 Gy, 55 Gy, or CHART were virtually indistinguishable. There was severe atrophy and fibrosis of all glands. Quantitative analysis revealed that 50 Gy, 55 Gy, and CHART induced a reduction of serous acini in parotid glands by 86.4%, 84.8%, and 88.8%, respectively. In submandibular glands, serous acini were reduced by 99.4%, 99.0%, and 100%, respectively. The corresponding reduction in mucous acini were 98.4%, 98.4%, and 99.2%, respectively. These histopathologic and quantitative morphologic studies show that the magnitude of serous gland atrophy in the parotid and submandibular salivary glands of rhesus monkeys was similar at 16 weeks after receiving 50 Gy in 20 fractions, 55 Gy in 25 fractions, or CHART
Brote por virus de la parotiditis G1 en la provincia de Almería en el año 2005

OpenAIRE

Pilar Barroso García; Ma Ángeles Lucerna Méndez; Amparo Navarro Monzón

2007-01-01

Fundamento:A pesar de que en España se registran coberturas elevadas de la vacuna de parotiditis siguen notificándose brotes epidémicos de parotiditis. El objetivo de este trabajo es describir un brote notificado en la provincia de Almería en el año 2005 y valorar la afectación en población vacunada. Métodos: Estudio descriptivo de los casos notificados. Variables estudiadas: Zona Básica de Salud, municipio, edad, sexo, tipo de población (autóctona y extranjera), fecha in...
Clinical Analysis of Parotid Tumors in Patients Over 60-year-old: A Retrospective Study of 78 Cases

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Dong Hoon Lee

2017-06-01

Conclusions: Warthin tumor was the most common benign tumor, and salivary duct carcinoma was the most frequent malignant tumor in this study. Surgical treatment is the mainstay treatment for benign and malignant parotid tumors.
Parotid saliva composition during and after irradiation of head and neck cancer

International Nuclear Information System (INIS)

Funegaard, U.; Franzen, L.; Ericson, Th.; Henriksson, R.

1994-01-01

Parotid saliva composition was studied before, during and up to 18 months after the irradiation period in 16 cancer patients treated for malignancies in the head and neck region. Stimulated parotid saliva was collected prior to radiotherapy and, when possible, weekly during treatment. New samples were taken 2, 4, 6, 12 and 18 months after the end of radiotherapy. Nine of the 16 patients were treated with bilateral irradiation fields and 7 patients with unilateral irradiation fields, with a total dose not exceeding 52 Gy. During the entire irradiation period the fraction of glands producing measurable volumes of saliva decreased to 40%. In the post irradiation period the number of active glands gradually increased and saliva secretion rate returned to an average of 72% of the initial value 18 months after the end of irradiation. The concentrations of the measured variables increased already during the first week of radiotherapy and at the end of the treatment period the concentrations for total protein, salivary peroxidase, hexosamine and salivary IgA were significantly increased. The concentrations for total protein, salivary peroxidase and salivary IgA were still increased 6 months after the end of irradiation. At the 18-months observation all concentrations had returned to normal. (author)
Sequentially delivered boost plans are superior to simultaneously delivered plans in head and neck cancer when the boost volume is located further away from the parotid glands

International Nuclear Information System (INIS)

Lamers-Kuijper, Emmy; Heemsbergen, Wilma; Mourik, Anke van; Rasch, Coen

2011-01-01

Purpose: To find parameters that predict which head and neck patients benefit from a sequentially delivered boost treatment plan compared to a simultaneously delivered plan, with the aim to spare the salivary glands. Methods and materials: We evaluated 50 recently treated head and neck cancer patients. Apart from the clinical plan with a sequentially (SEQ) given boost using an Intensity Modulated Radiotherapy Technique (IMRT), a simultaneous integrated boost (SIB) technique plan was constructed with the same beam set-up. The mean dose to the parotid glands was calculated and compared. The elective nodal areas were bilateral in all cases, with a boost on either one side or both sides of the neck. Results: When the parotid gland volume and the Planning Target Volume (PTV) for the boost overlap there is on average a lower dose to the parotid gland with a SIB technique (-1.2 Gy), which is, however, not significant (p = 0.08). For all parotid glands with no boost PTV overlap, there is a benefit from a SEQ technique compared to a SIB technique for the gland evaluated (on average a 2.5 Gy lower dose to the parotid gland, p < 0.001). When the distance between gland and PTV is 0-1 cm, this difference is on average 0.8 Gy, for 1-2 cm distance 2.9 Gy and for glands with a distance greater than 2 cm, 3.3 Gy. When the lymph nodes on the evaluated side are also included in the boost PTV, however, this relationship between the distance and the gain of a SEQ seems less clear. Conclusions: A sequentially delivered boost technique results in a better treatment plan for most cases, compared to a simultaneous integrated boost IMRT technique, if the boost PTV is more than 1 cm away from at least one parotid gland.

Early events of secretory granule formation in the rat parotid acinar cell under the influence of isoproterenol. An ultrastructural and lectin cytochemical study

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F D’Amico

2009-12-01

Full Text Available The events involved in the maturation process of acinar secretory granules of rat parotid gland were investigated ultrastructurally and cytochemically by using a battery of four lectins [Triticum vulgaris agglutinin (WGA, Ulex europaeus agglutinin I (UEA-I, Glycine max agglutinin (SBA, Arachys hypogaea agglutinin (PNA]. In order to facilitate the study, parotid glands were chronically stimulated with isoproterenol to induce secretion. Specimens were embedded in the Lowicryl K4M resin. The trans-Golgi network (TGN derived secretory granules, which we refer to as immature secretory granules, were found to be intermediate structures in the biogenesis process of the secretory granules in the rat parotid acinar cell. These early structures do not seem to be the immediate precursor of the mature secretory granules: in fact, a subsequent interaction process between these early immature granule forms and TGN elements seems to occur, leading, finally, to the mature granules. These findings could explain the origin of the polymorphic subpopulations of the secretory granules in the normal acinar cells of the rat parotid gland. The lectin staining patterns were characteristic of each lectin. Immature and mature secretory gran- ules were labelled with WGA, SBA, PNA, and lightly with UEA-I. Cis and intermediate cisternae of the Golgi apparatus were labelled with WGA, and trans cisternae with WGA and SBA.
Radiotherapy for a cystadenolymphoma of the parotid gland (Warthin's tumor)

International Nuclear Information System (INIS)

Stallmann, C.; Vacha, P.; Vesely, H.; Richter, E.; Feyerabend, T.

2001-01-01

Background: With 17.6% of all primary parotid neoformations the benign Warthin's tumor (cystadenolymphoma) is the second common parotid gland tumor. Males > 50 years are affected predominantly. After surgery the recurrence rate is less than 5%. Histomorphologically the tumor is characterized by cystoid ducts lined by epithelial cells as well as lymphoid stroma. The lymphoid component has been described as radioresponsive whereas the epithelial parts are less radiosensitive. Since 1960 only one patient treated by primary radiotherapy has been published. Case report: A 77-year-old woman suffered from cystadenolymphoma (maximal diameter 7 cm). Because of its extension and the reduced performance status of the patient surgery was no option. Radiotherapy was performed with a total dose of 50 Gy. Clinically, the tumor regressed completely after 30 Gy, which was confirmed by CT at 6 weeks after completion of radiotherapy. After 6 and 12 months the patient stayed free of tumor. Epicrisis: In our case the cystadenolymphoma was unusually large (7 cm). Radiotherapy with 50 Gy induced complete tumor regression. The good clinical response after 30 Gy suggests that the necessary dose may be lower for less extended cystadenolymphomas. Conclusion: We present a case of cystadenolymphoma treated by radiotherapy with 50 Gy resulting in a complete remission. Due to missing published experiences no common recommendation for the total dose can be given. In the following situations radiotherapy should be considered: 1. high surgical risk of damage to the facial nerve, 2. unfavorable cosmetic outcome after surgery, 3. inoperability for internal risks, 4. refusal of operation. (orig.) [de
Macro and microscopic structure of parotids salivary glands in two species of procyonidae: raccoon (Procyon cancrivorus, G. Cuvier, 1798 and coati (Nasua nasua, Linnaeus, 1766

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Celina Almeida Furlanetto Mançanares

2012-03-01

Full Text Available Coati (Nasua nasua, a diurnal animal, and raccoon (Procyon cancrivorus, a crepuscular and nocturnal one, are species of terrestrial mammals, belonging to the procyonidae family, that are widely found in the Brazilian territory. For this work were used three adult coatis and two adult raccoons adults from the Scientific Breeding-Cecrimpas of Centro Universitario da Fundacão de Ensino Octávio Bastos (Ibama 02027.003731/04-76 were used, from which tissue samples of parotid salivary glands were obtained and stained H.E. for light microscopy. It was found that the parotid glands of coatis and raccoons has a positioning similar to that of the other domestic carnivores, opening their ducts within the oral cavity close to the fourth upper premolar tooth, as well as that histologically the parotid glands of coatis and raccoons are formed by serous acini, similarly to most of the domestic animals, humans beings and rodents, and differently from the results found in young dogs, lambs and some carnivores such as the ferret which have mixed acini and other ones which have serous. One concludes that the similarity in serous constitution of the parotid glands of coatis and raccoons might be due to the omnivorous feeding habit shared by these two species.
Changes in human parotid salivary protein and sialic acid levels during pregnancy.

Science.gov (United States)

D'Alessandro, S; Curbelo, H M; Tumilasci, O R; Tessler, J A; Houssay, A B

1989-01-01

Saliva was collected with a Carlson-Crittenden device, under citric acid stimulation, in 107 pregnant women, 9 puerperal and 7 non-pregnant controls. No significant changes were found in salivary flow rate, pH and amylase levels. The total protein levels were decreased during pregnancy and the puerperium. The sialic acid levels decreased gradually but markedly during pregnancy, returning to normal levels in the puerperium. These changes in parotid saliva may be related to the hormonal changes of pregnancy.
[Mobile phones and head tumours: it is time to read and highlight data in a proper way].

Science.gov (United States)

Levis, Angelo G; Minicucci, Nadia; Ricci, Paolo; Gennaro, Valerio; Garbisa, Spiridione

2011-01-01

The uncertainty about the relationship between the use of mobile phones (MPs: analogue and digital cellulars, and cordless) and the increase of head tumour risk can be solved by a critical analysis of the methodological elements of both the positive and the negative studies. Results by Hardell indicate a cause/effect relationship: exposures for or latencies from ≥ 10 years to MPs increase by up to 100% the risk of tumour on the same side of the head preferred for phone use (ipsilateral tumours) - which is the only one significantly irradiated - with statistical significance for brain gliomas, meningiomas and acoustic neuromas. On the contrary, studies published under the Interphone project and others produced negative results and are characterised by the substantial underestimation of the risk of tumour. However, also in the Interphone studies a clear and statistically significant increase of ipsilateral head tumours (gliomas, neuromas and parotid gland tumours) is quite common in people having used MPs since or for ≥ 10 years. And also the metaanalyses by Hardell and other Authors, including only the literature data on ipsilateral tumours in people having used MPs since or for ≥ 10 years - and so also part of the Interphone data - still show statistically significant increases of head tumours.
Effect of Intra Vitreal Injection of Bevacizumab on Intra-Occular Pressure

International Nuclear Information System (INIS)

Jaffar, S.; Tayyab, A.; Matin, Z. I.; Masrur, A.; Naqaish, R.

2016-01-01

Background: Bevacizumab has been in use as a therapeutic agent for macular oedema for several years. While its efficacy has been well documented, its use has been shown to cause a transient rise in the intra-ocular pressure. The aim of this study was to evaluate the long term effect of intra-vitreal injection of Bevacizumab on Intra-ocular pressure. Methods: One hundred eyes (n=100) of one hundred patients, requiring intra-vitreal injection of Bevacizumab for diabetic macular oedema were recruited from Shifa Foundation Community Health Centre (SFCHC) between January and December 2014. Patients of glaucoma, ocular hyper-tension, known allergy to Bevacizumab or had injections of Bevacizumab prior to the study were excluded. Intra-ocular pressure was measured using a Goldmann applanation tonometer, prior to, and at six and twelve months after the injection. The pre- and post- injection Intra-ocular pressure was entered into the database. Test of significance was applied to investigate whether there was a significant change in intra-ocular pressure after the injection. Results: The mean age of the patient was 56.97 years (±14.97). The mean intra-ocular pressure was 13.86 (±3.16) mmHg before injection, while post-injection mean Intra-Ocular pressure was 14.21 (±3.12) mmHg and 13.79 (±3.07) at six and twelve months respectively. Between baseline and six months there was a statistically significant difference in intra-ocular pressure (p=0.03), while no significant difference existed in the intra-ocular pressure between baseline and twelve months (p=0.92). Conclusion: Intra-vitreal injection of Bevacizumab is associated with a statically significant rise in intra-ocular pressure at six months, while no significant difference was seen at twelve months compared to baseline. (author)
Nodular hidradenocarcinoma over the parotid gland: a pathologic presentation.

Science.gov (United States)

Verret, D J; Kabbani, Wareef; DeFatta, Robert J

2007-02-01

Nodular hidradenocarcinoma (NHAC), an eccrine carcinoma, has been reported in the dermatology and pathology literature, but few references have been made in the otolaryngology literature even though the head and neck is a common site of occurrence. A case report of a 37-year-old Hispanic man with a right-sided neck mass diagnosed preoperatively as a parotid mass by imaging and fine-needle aspiration is presented. After presentation at our multidisciplinary tumor board, excision of the mass was undertaken. Final pathology revealed a NHAC, which is presented in our report. NHAC is an aggressive malignant tumor that is often misdiagnosed preoperatively and that must be treated with aggressive multimodality therapy for increased survival.
Isolated secretion granules from parotid glands of chronically stimulated rats possess an alkaline internal pH and inward-directed H+ pump activity

International Nuclear Information System (INIS)

Arvan, P.; Castle, J.D.

1986-01-01

Secretion granules have been isolated from the parotid glands of rats that have been chronically stimulated with the β-adrenergic agonist, isoproterenol. These granules are of interest because they package a quantitatively different set of secretory proteins in comparison with granules from the normal gland. Polypeptides enriched in proline, glycine, and glutamine, which are known to have pI's >10, replace α-amylase (pI's = 6.8) as the principal content species. The internal pH of granules from the treated rats changes from 7.8 in a potassium sulfate medium to 6.9 in a choline chloride medium. The increased pH over that of normal parotid granules (∼6.8) appears to protect the change in composition of the secretory contents. Whereas normal mature parotide granules have practically negligible levels of H + pumping ATPase activity, the isolated granules from isoproterenol-treated rats undergo a time-dependent internal acidification that requires the presence of ATP and is abolished by an H + ionophore. Additionally, an inside-positive granule transmembrane potential develops after ATP addition that depends upon ATP hydrolysis. Two independent methods have been used that exclude the possibility that contaminating organelles are the source of the H + -ATPase activity. Together these data provide clear evidence for the presence of an H + pump in the membranes of parotid granules from chronically stimulated rats. However, despite the presence of H + -pump activity, fluorescence microscopy with the weak base, acridine orange, reveals that the intragranular pH in live cells is greater than that of the cytoplasm
Comparison of doses received in the mandibular condyle, cochlea, and parotid gland in neuroaxial treatment

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Oliveira, Fernanda L.; Lima, Fabiana F. de; Vilela, Eudice, E-mail: fluoliveira@gmail.com [Centro Regional de Ciencias Nucleares do Nordeste (CRCN-NE/CNEN-PE), Recife, PE (Brazil); Fo, Joao Antonio, E-mail: jaf@ufpe.br [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil). Departamento de Energia Nuclear

2015-07-01

Sensorineural hearing loss is a common side effect in patients who undergo radiotherapy for the treatment of cancer tumors in the head and neck. In fractioned doses of radiotherapy, in the majority of intracranial tumors, the cochlea is the most affected organ. In addition to the cochlea, the mandible and the parotid glands are also exposed to radiation, which commonly leads to Osteoradionecrosis of the mandible and Xerostomia. In the head and neck regions, this can be complicated by the semi-independence of the positioning in this region, as regards the rigid cranium, connected to the semi-rigid mandible, and successive levels of the upper cervical spine and thoracic spine, which can lead to uncertainty in rotation as well as in head-neck movements, both up and down and side to side. The present study performed an intercomparison of the doses applied through four radiotherapy planning techniques for the neuro axial regions of the cochlea, mandible, and parotid glands, considering the changes carried out in each planning technique, including the protective shield, the angulations gantry and the field size. The results obtained by applying the half beam and angled field techniques varied in the cochlea by an average of 113.8% from the prescribed dose, whereas when applying the angled field technique with and without the mobile gap, the results varied in 104.5%. In the mandible, the half beam and angled field techniques showed that the dose varied an average of 16.5%, while in the techniques with and without the mobile gap, the variation showed an average of 116.4%. These values were also received by the parotid glands, which overlap the mandible. It can therefore be concluded that the protection shields of the first two techniques were less efficient in protecting the mandible due to its modeling. (author)
Late radiation side-effects in three patients undergoing parotid irradiation for benign disease.

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Armour, A; Ghanna, P; O'Rielly, B; Habeshaw, T; Symonds, P

2000-01-01

We report three patients in whom standard radiation therapy was given and serious late radiation damage was seen. The first patient suffered recurrent parotiditis and a parotid fistula. He was treated initially with 20 Gy in ten fractions via a 300 kV field. Further irradiation was required 1 year later and 40 Gy was given in 2 Gy fractions by an oblique anterior and posterior wedged photon pair. Ten years later he developed localized temporal bone necrosis. The second patient, with pleomorphic salivary adenoma, developed localized temporal bone necrosis 6 years after 60 Gy had been given using standard fractionation and technique. The third patient received 55 Gy in 25 fractions for a pleomorphic salivary adenoma and after 3 years developed temporal bone necrosis. Sixteen years later the same patient developed cerebellar and brainstem necrosis. All patients developed chronic persistent infection during or shortly after the radiation therapy, which increased local tissue sensitivity to late radiation damage. As a result, severe bone, cerebellar and brainstem necrosis was observed at doses that are normally considered safe. We therefore strongly recommend that any infection in a proposed irradiated area should be treated aggressively, with surgical debridement if necessary, before radiotherapy is administered, or that infection developing during or after irradiation is treated promptly.
Parotid Glands Dose–Effect Relationships Based on Their Actually Delivered Doses: Implications for Adaptive Replanning in Radiation Therapy of Head-and-Neck Cancer

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Hunter, Klaudia U. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Fernandes, Laura L. [Department of Biostatistics, University of Michigan, Ann Arbor, Michigan (United States); Vineberg, Karen A.; McShan, Daniel; Antonuk, Alan E. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Cornwall, Craig [Department of Hospital Dentistry, University of Michigan, Ann Arbor, Michigan (United States); Feng, Mary [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Schipper, Mathew J. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Department of Biostatistics, University of Michigan, Ann Arbor, Michigan (United States); Balter, James M. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Eisbruch, Avraham, E-mail: eisbruch@umich.edu [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States)

2013-11-15

Purpose: Doses actually delivered to the parotid glands during radiation therapy often exceed planned doses. We hypothesized that the delivered doses correlate better with parotid salivary output than the planned doses, used in all previous studies, and that determining these correlations will help make decisions regarding adaptive radiation therapy (ART) aimed at reducing the delivered doses. Methods and Materials: In this prospective study, oropharyngeal cancer patients treated definitively with chemoirradiation underwent daily cone-beam computed tomography (CBCT) with clinical setup alignment based on the C2 posterior edge. Parotid glands in the CBCTs were aligned by deformable registration to calculate cumulative delivered doses. Stimulated salivary flow rates were measured separately from each parotid gland pretherapy and periodically posttherapy. Results: Thirty-six parotid glands of 18 patients were analyzed. Average mean planned doses was 32 Gy, and differences from planned to delivered mean gland doses were −4.9 to +8.4 Gy, median difference +2.2 Gy in glands in which delivered doses increased relative to planned. Both planned and delivered mean doses were significantly correlated with posttreatment salivary outputs at almost all posttherapy time points, without statistically significant differences in the correlations. Large dispersions (on average, SD 3.6 Gy) characterized the dose–effect relationships for both. The differences between the cumulative delivered doses and planned doses were evident at first fraction (r=.92, P<.0001) because of complex setup deviations (eg, rotations and neck articulations), uncorrected by the translational clinical alignments. Conclusions: After daily translational setup corrections, differences between planned and delivered doses in most glands were small relative to the SDs of the dose–saliva data, suggesting that ART is not likely to gain measurable salivary output improvement in most cases. These differences were
Accuracy of FNAC and CT in the differentiation of benign and malignant parotid tumours in a case series.

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Gavín-Clavero, Marina A; Usón-Bouthelier, Tomás; Jariod-Ferrer, Úrsula M; Fernández-Larrañaga, Arancha; Pantilie, Bianca; Lobera-Molina, Fernando; Simón-Sanz, M Victoria; Nadal Cristóbal, Bartolomé

Parotid tumours, in addition to the wide variety of types, are histologically complex. Differentiating between benign and malignant tumours in preoperative diagnosis is important in deciding the type of surgery required. Fine needle aspiration cytology (FNAC) is a simple, quick, low-cost, low-invasive and well-tolerated tool used in the preoperative diagnosis of these tumours. we calculated the sensitivity, specificity, predictive positive value (PPV) and negative predictive value (NPV) of FNAC and computed tomography (CT) in the differentiation of benign and malignant parotid tumours operated between 2010 to 2014 in the oral and maxillofacial surgery department of the University Hospital Miguel Servet. The sensitivity of FNAC is 50%, while the specificity is high, at 98.7%. FNAC offers high reliability in the diagnosis of malignant tumours, despite its low sensitivity. However, when the diagnosis is indeterminate or benign, other than pleomorphic adenoma or Whartin tumour, the reliability to exclude malignancy decreases. The low sensitivity of FNAC to differentiate malignant from benign parotid tumours, means that we cannot rule out other diagnostic tests, clinical symptoms and especially the intraoperative vision of each surgeon. Especially when the diagnosis is indeterminate. Nevertheless, it is a technique used in a systematised way and helps in pre-surgical decision-making. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.
Rules of parotid gland dose variations and shift during intensity modulated radiation therapy for nasopharyngeal carcinoma

International Nuclear Information System (INIS)

Wang, Wei; Yang, Haihua; Mi, Yucheng; Hu, Wei; Ding, Weijun; Xie, Youyou; Cai, Yujie; Chen, Xiaofeng

2015-01-01

To determine the position and dose delivery changes rules of parotid gland (PG) during the course of intensity modulated radiation therapy (IMRT) in nasopharyngeal carcinoma patients (NPC). One hundred and forty one competed tomography (CT) images from 47 NPC patients (three images for each patient were acquired before treatment, at the 15th and 25th fraction during the treatment) who underwent radical IMRT were selected for this study. A total of 70-76Gy at 2.12–2.3 Gy/fraction/d was given to the GTVnx in 33 fractions. The distances between the lateral/medial aspects of PG and midline (DLM and DMM) at the level of odontoid process were measured. The dose differences between plan and actual delivery were calculated. The volume reductions of PGs between fractions 15 and 25 were larger than those in the first 15 fractions (4.68 ± 3.23 cc vs. 2.46 ± 4.55 cc for the right PG and 5.96 ± 2.99 cc vs. 2.06 ± 2.99 cc for the left PG). However, the percentage of gland volume receiving ≥30 Gy (V30) of bilateral PGs decreased more significantly in the first 15 fractions than that between fractions 15 and 25 (5.61 ± 16.04% vs. 1.14 ± 21.54% for the right PG and 6.87 ± 15.58% vs. 0.81 ± 15.94% for the left PG). The gross tumor volume of the nasopharynx (GTVnx) decreased more significantly in the first 15 fractions than that between the 15th and 25th fraction (8.23 ± 13.61 cc vs. 3.30 ± 8.09 cc). The DMM of ipsilateral PGs reduced in the first 15 fractions (0.80 ± 2.96 mm) but increased between fraction 15 and 25 (−2.19 ± 3.96 mm). While ipsilateral PG shifted into target volume but shifted out target volume between fraction 15 and 25. Parotid glands V30 was correlated with GTVnx, GTVnx reduction and DMM reduction (p < 0.01). Our results indicate that the reduction of GTVnx leads to the positional change of the parotid gland, which results in more significant dose change of the parotid gland in the first 15 fractions than that between fraction 15 and 25
Parotid lipoblastoma in a child: Rare presentation as huge infratemporal mass with cervical extension

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Anantharajan Natarajan

2010-01-01

Full Text Available Lipoblastomas arising within the parotid gland and extending into the infratemporal fossa are very rare. They are common in children < 3 years of age. Access to the tumour requires careful planning and interpretation of imaging studies. Lipoblastomas tend to recur. Meticulous dissection of the tumour is needed to prevent recurrence. By adopting the appropriate approach, complete removal is possible with minimal morbidity.
Treatment planning aspects for tumours in the region of parotid

International Nuclear Information System (INIS)

Narayanan, S.S.; Saju, Sherly; Deshpande, D.D.; Agarwal, J.P.; Dinshaw, K.A.

2001-01-01

The treatment of carcinoma of parotid/external ear needs careful planning in respect of dose to the normal organs surrounding the tumour such as eye(s), pituitary and normal brain. In many centres, generally, manual contours are generated for a two dimensional planning, wherein Anterior-Posterior (A-P) oblique fields (patient in Lateral Position) are planned. However, such a field orientation is not always useful in terms of minimum possible dose to the said normal organs, especially for eye. In this centre, a different field arrangement has been attempted, which helps in dose reduction to the normal structures to a large extent in comparison with the conventional 2D planning method
Parotid gland tumors: A comparison of postoperative radiotherapy techniques using three dimensional (3D) dose distributions and dose-volume histograms (DVHs)

International Nuclear Information System (INIS)

Yaparpalvi, Ravindra; Fontenla, Doracy P.; Tyerech, Sangeeta K.; Boselli, Lucia R.; Beitler, Jonathan J.

1998-01-01

Purpose: To compare different treatment techniques for unilateral treatment of parotid gland tumors. Methods and Materials: The CT-scans of a representative parotid patient were used. The field size was 9 x 11 cm, the separation was 15.5 cm, and the prescription depth was 4.5 cm. Using 3D dose distributions, tissue inhomogeneity corrections, scatter integration (for photons) and pencil beam (for electrons) algorithms and dose-volume histogram (DVH), nine treatment techniques were compared. [1] unilateral 6 MV photons [2] unilateral 12 MeV electrons [3] unilateral 16 MeV electrons [4] an ipsilateral wedge pair technique using 6 MV photons [5] a 3-field AP (wedged), PA (wedged) and lateral portal technique using 6 MV photons [6] a mixed beam technique using 6 MV photons and 12 MeV electrons (1:4 weighting) [7] a mixed beam technique using 6 MV photons and 16 MeV electrons (1:4 weighting) [8] a mixed beam technique using 18 MV photons and 20 MeV electrons (2:3 weighting) [9] a mixed beam technique using 18 MV photons and 20 MeV electrons (1:1 weighting). Results: Using dose-volume histograms to evaluate the dose to the contralateral parotid gland, the percentage of contralateral parotid volume receiving ≥ 30% of the prescribed dose was 100% for techniques [1], [8] and [9], and < 5% for techniques [2] through [7]. Evaluating the 'hottest' 5 cc of the ipsilateral mandible and temporal lobes, the hot spots were: 152% and 150% for technique [2], 132% and 130% for technique [6]. Comparing the exit doses, techniques [1], [8] and [9] contributed to ≥ 50% of the prescribed dose to the contralateral mandible and the temporal lobes. Only techniques [2] and [6] kept the highest point doses to both the brain stem and the spinal cord below 50% of the prescribed dose. Conclusion: The single photon lateral field [1] and the mixed electron-photon beams [8] and [9] are not recommended treatment techniques for unilateral parotid irradiation because of high doses delivered to the
Parotid gland tumors: a comparison of postoperative radiotherapy techniques using three dimensional (3-D) dose distributions and dose-volume histograms (DVH)

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Yaparpalvi, R.; Tyerech, S.K.; Boselli, L.R.; Fontenla, D.P.; Beitler, J.J.; Vikram, B.

1996-01-01

Purpose/Objective: To compare different treatment techniques for unilateral treatment of parotid gland tumors. Materials and Methods: Twenty patients previously treated postoperatively for parotid gland tumors were retrospectively reviewed. Average field size was 9 x 11 cm, average separation was 15.5 cm, and the average prescription depth was 4.5 cm. Using 3-D dose distributions, tissue inhomogeneity corrections, scatter integration (for photons) and pencil beam (for electrons) algorithms and DVH, nine treatment techniques were compared using a representative patient. The treatment techniques investigated were: [1] unilateral 6 MV photons. [2] unilateral 12 MeV electrons. [3] unilateral 16 MeV electrons. [4] a ipsilateral wedge pair technique using 6 MV photons and a 45-degree wedge. [5] a 3-field AP (wedged), PA (wedged) and lateral portal technique using 6 MV photons. [6] a mixed beam technique using 6 MV photons and 12 MeV electrons (1:4 weighting). [7] a mixed beam technique using 6 MV photons and 16 MeV electrons (1:4 weighting). [8] a mixed beam technique using 18 MV photons and 20 MeV electrons (2:3 weighting). [9] a mixed beam technique using 18 MV photons and 20 MeV electrons (1:1 weighting). Results: Using dose-volume histograms to evaluate the dose to the contralateral parotid gland, the percentage of contralateral parotid volume receiving ≥30% of the prescribed dose was 100% for techniques [1], [8] and [9], and <5% for techniques [2] through [7]. Evaluating the 'hottest' 5 cc of the ipsilateral mandible and temporal lobes, the hot spots were: 152% and 150% for technique [2], 132% and 130% for technique [6]. Comparing the exit doses, techniques [1] and [8] contributed to ≥50% of the prescribed dose to the contralateral mandible and the temporal lobes. Only techniques [2] and [6] kept the highest point doses to both the brain stem and the spinal cord below 50% of the prescribed dose. Conclusion: The single photon lateral field [1] and the mixed
Rat parotid gland pathophysiology following 137Cs irradiation

International Nuclear Information System (INIS)

Rice, J.C.; Izutsu, K.T.; Truelove, E.L.; Menard, T.W.; Anderson, M.C.; Morton, T.H.; Siegel, I.A.

1982-01-01

Changes in rat parotid gland function were measured between 3 and 30 days following exposure to 1800 R of 137 Cs irradiation to the head. Glandular fluid secretion capability as indicated by volume of secretion, maximum rate of secretion, and duration of secretion following pilocarpine stimulation decreased concomitantly with gland weight following irradiation. Thus gland weight is probably indicative of residual glandular-potential for fluid secretion following irradiation. The relation between salivary sodium concentration and flow rate was assumed to be indicative of glandular electrolyte transport capability. Salivary sodium concentrations were not elevated over control values at any flow rate. Therefore, there is no evidence for an irradiation-induced defect in the ductal sodium resorption mechanism. Rather, the observed salivary sodium changes are consistent with a decrease in the relative glandular proportion of acini to ducts
Effects of glucose and sucrose variants of the caries-promoting Diet 2000 on the feeding patterns and parotid glands of prematurely weaned rats.

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Redman, Robert S

2015-03-01

The hypothesis of this study was that feeding glucose instead of sucrose in the cariogenic Diet 2000 to rats weaned at age 18 days would result in greater light/dark differences in feeding activity and secretion and storage of parotid salivary enzymes. Diet 2000 and a stock commercial diet (controls) were prepared in pelleted and powdered forms, as the increased mastication required by pellets has been shown to support circadian rhythms in rats. Food jars were weighed at lights on and just prior to lights off daily. Rats were euthanized at 25 days and their parotid glands removed, weighed, and analyzed for specific activities of the salivary enzymes α-amylase and deoxyribonuclease I. Light/dark differences in feeding activity were strong in the rats fed the pelleted stock diet and both powdered and pelleted glucose 2000 diets, moderate with the pelleted sucrose 2000 diet, and not significant with the powdered sucrose 2000 and stock diets. Light/dark differences in the parotid salivary enzymes were strong with the powdered glucose 2000 diet and the pelleted forms of the glucose and sucrose 2000 and stock diets, and not significant with the powdered stock and sucrose 2000 diets. Caries reportedly is higher in sucrose than glucose fed to rats in the standard powdered form of Diet 2000, mainly due to the colonizing advantage Streptococcus mutans gains with sucrose. These results suggest that additional factors are more feeding during lights on and less stimulation of parotid salivary secretion with the sucrose powder. Published by Elsevier Ltd.
Secondary radiation damage as the main cause for unexpected volume effects: A histopathologic study of the parotid gland

International Nuclear Information System (INIS)

Konings, Antonius W.T.; Faber, Hette; Cotteleer, Femmy; Vissink, Arjan; Coppes, Rob P.

2006-01-01

Purpose: To elucidate with a histopathological study the mechanism of region-dependent volume effects in the partly irradiated parotid gland of the rat. Methods and Materials: Wistar rats were locally X-irradiated with collimators with conformal radiation portals for 100% volume and 50% cranial/caudal partial volumes. Single doses up to 40 Gy were applied. Parotid saliva samples were collected, and the three lobes of the parotid gland were examined individually on the macro- and micromorphologic level up to 1 year after irradiation. Results: Dose-dependent loss of gland weight was observed 1 year after total or partial X-irradiation. Weight loss of the glands correlated very well with loss of secretory function. Irradiating the cranial 50% volume (implicating a shielded lateral lobe) resulted in substantially more damage in terms of weight loss and loss of secretory function than 50% caudal irradiation (shielding the ventral and dorsal lobe). Histologic examinations of the glands 1 year after irradiation revealed that the shielded lateral lobe was severely affected, in contrast to the shielded ventral and dorsal lobes. Time studies showed that irradiation of the cranial 50% volume caused late development of secondary damage in the shielded lateral lobe, becoming manifest between 240 and 360 days after irradiation. The possible clinical significance of this finding is discussed. Conclusion: It is concluded that the observed region-dependent volume effect for late function loss in the rat parotid gland after partial irradiation is mainly caused by secondary events in the shielded lateral lobe. The most probable first step (primary radiation event) in the development of this secondary damage is radiation exposure to the hilus region (located between the ventral and dorsal lobe). By injuring major excretory ducts and supply routes for blood and nerves in this area, the facility system necessary for proper functioning of the nonexposed lateral lobe is seriously affected

The feasibility of sugammadex for general anesthesia and facial nerve monitoring in patients undergoing parotid surgery

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I-Cheng Lu

2017-08-01

Fifty patients undergoing parotid surgery were randomized allocated into conventional anesthesia group (Group C, n = 25 and sugammadex group (Group S, n = 25. Group C did not receive any NMBA. Group S received rocuronium 0.6 mg/kg at anesthesia induction and sugammadex 2 mg/kg at skin incision. The intubating condition and influence on FNM evoked EMG results were compared between groups. The intubation condition showed significantly better in group S patients than C group patients (excellent in 96% v.s. 24%. In group S, rapid reverse of NMB was found and the twitch (% recovered from 0 to >90% within 10 min. Positive and high EMG signals were obtained in all patients at the time point of initial facial nerve stimulation in both groups. There was no significant difference as comparing the EMG amplitudes detected at the time point of initial and final facial nerve stimulation in both groups. Implementation of sugammadex in anesthesia protocol is feasible and reliable for successful FNM during parotid surgery.
Parotid gland pathophysiology after mixed gamma and neutron irradiation of cancer patients

International Nuclear Information System (INIS)

Anderson, M.W.; Izutsu, K.T.; Rice, J.C.

1981-01-01

Electrolyte and protein concentrations were measured in parotid saliva samples obtained from patients receiving localized, fractionated, neutron and gamma irradiation for the treatment of cancer. Salivary sodium chloride concentration increased transiently but then usually decreased to preirradiation values after 2 weeks of therapy. There were concurrent decreases in salivary flow rate, pH, and bicarbonate concentration. The decreases in sodium chloride concentration and flow rate are inconsistent with a previously suggested, irradiation-induced ductal sodium resorption defect. The findings contribute toward understanding how salivary gland physiology is altered in irradiation injury
Treatment and prognosis of primary parotid squamous cell carcinoma: study of 16 patients

International Nuclear Information System (INIS)

Ouyang Jinling; Gao Li; Yi Junlin; Huang Xiaodong; Luo Jingwei; Xu Guozhen

2007-01-01

Objective: To investigate the clinical characteristics and treatment of primary parotid squamous cell carcinoma through 16 patients. Methods: Sixteen such patients treated in our hospital from 1984 to 2005 were analyzed retrospectively. There were T1 2 patients, T2 and T3 5 patients each and T4 4. Ten patients had NO, and 6 N + lesions. Six patients were treated by monotherapy, ie-mono group (surgery alone or radiotherapy alone), the other 10 patients by surgery combined with postoperative radiotherapy. Results: The overall neck metastastic lymph nodes was observed in 12 patients (75%). The 3- and 5-year local control, overall survival and disease-free survival for the whole group was 45% and 30%, 58% and 58%; 36% and 27%, respectively. The 5-year survival for T1-T2 and T3-T4 patients was 100% and 29% (χ 2 =4.50, P=0.034), respectively. The 3-year overall survival of NO and N + patients was 80%, and 20% (χ 2 =8.70, P=0.003), with a disease-free survival of 54% and 0 (χ 2 =9.83, P=0.002), respectively. Conclusions: The choice of suitable treatment for locally advanced primary parotid squamous cell carcinoma is surgery plus postoperative radiotherapy. Prophylactic ipsilateral neck irradiation is necessary e- ven for N0 patients for the sake of high risk of neck node metastasis. (authors)
Salivary gland tumors of the parotid gland: CT and MR imaging findings with emphasis on intratumoral cystic components

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Kato, Hiroki; Watanabe, Haruo [Gifu University School of Medicine, Department of Radiology, Gifu (Japan); Kanematsu, Masayuki [Gifu University School of Medicine, Department of Radiology, Gifu (Japan); Gifu University Hospital, High-Level Imaging Diagnosis Center, Gifu (Japan); Mizuta, Keisuke; Aoki, Mitsuhiro [Gifu University School of Medicine, Department of Otolaryngology, Gifu (Japan)

2014-09-15

The purpose of this study was to assess computed tomography (CT) and magnetic resonance (MR) imaging findings of salivary gland tumors of the parotid gland with emphasis on intratumoral cystic components. Seventy-two histopathologically confirmed salivary gland tumors of the parotid gland (44 benign and 28 malignant), which underwent both CT and MR imaging including contrast-enhanced study, were included in this study. We retrospectively reviewed images for the presence, number, occupying rate, margin characteristics, distribution, and predominant MR signal intensity of intratumoral cystic components. The prevalence of cystic components was greater in malignant than benign tumors (79 vs. 50 %, p < 0.05). The number and occupying rate were similar between benign and malignant tumors. The irregular margins were more frequent in malignant than benign tumors (73 vs. 27 %, p < 0.01). The frequency of eccentric location was greater in benign than malignant tumors (91 vs. 55 %, p < 0.01), whereas the frequency of centric location was greater in malignant than benign tumors (32 vs. 0 %, p < 0.01). On T1-weighted images, the frequency of hyperintensity was greater in benign than malignant tumors (50 vs. 9 %, p < 0.01), whereas that of isointensity was greater in malignant than benign tumors (50 vs. 0 %, p < 0.01). Multiple logistic regression analysis showed that the absence of irregular margins of cystic components only was significantly correlated with the presence of benign salivary gland tumors (p < 0.01). Imaging features of intratumoral cystic components may help to differentiate benign from malignant tumors of the parotid salivary gland. (orig.)
Tfficacy to efficacy of thyroid/parotid ratio in the diagnosis of hyperthyroidism in different environmental conditions: a multi-centric study

International Nuclear Information System (INIS)

Das, B.K.; Pradhan, P.K.; Senthilnathan, M.S.

2010-01-01

Full text: Thyroid to parotid ratio (TPR) as a simple and cost effective diagnostic test in the evaluation of thyroid disorders was first reported by the author in 1997. Since then several centers have used this procedure for the diagnosis of high uptake thyroid disorders. The purpose of this multi centric study is to prove the validity of this simple technique in different environmental conditions and ethnic populations. Materials and Method: Prospective study which includes following patients: 578 hyperthyroid patients (212 males and 366 females) from northern part of India (endemic goiter region) between Jan. 1996 and Dec. 2002, 43 consecutive hyperthyroid patients (26 males and 17 females) from eastern Malaysia (high dietary iodine) sent for radio iodine therapy between May 2005 and Dec. 2006, 19 consecutive patients (8 males and 11 females) from south India (non-endemic goiter region) clinically and bio chemically hyperthyroid referred between June 2005 and Dec. 2006 and 56 consecutive hyperthyroid patients (16 males and 40 females) from eastern part of India (non-endemic goiter region) between Nov. 2008 and Feb. 2010. All patients were subjected to a standard 99m Tc thyroid scan. Thyroid to Parotid Ratio (TPR) was calculated after drawing ROIs over the thyroid and parotid glands in anterior projection. Blood samples were taken on the same day for estimation of T3, T4 and TSH. The TPR values were compared with the biochemical parameters. Results: The individual comparison of clinical and biochemical parameters with TPR in hyperthyroid patients showed concordance in over 90% in all the four centers (Lucknow 93.7%, Kelantan 91%, Madurai 96.5% and Bhubaneswar 93.6%). Conclusions: Calculation of TPR is extremely simple without the requirement of syringe counts or adhering to any specific time period after injection. It is highly sensitive and specific in the diagnosis of hyperthyroidism. TPR appears to hold good irrespective of different environmental conditions
Early radiation effects on muscarinic receptor-induced secretory responsiveness of the parotid gland in the freely moving rat

NARCIS (Netherlands)

Coppes, RP; Roffel, AF; Zeilstra, LJW; Vissink, A; Konings, AWT

Although the salivary glands have a low rate of cell turnover, they are relatively radiosensitive. To study the possible mechanism behind this inherent radiosensitivity, a rat model was developed in which saliva can be collected after local irradiation of the parotid gland without the use of
The ability to identify the intraparotid facial nerve for locating parotid gland lesions in comparison to other indirect landmark methods: evaluation by 3.0 T MR imaging with surface coils

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Ishibashi, Mana; Fujii, Shinya; Nishihara, Keisuke; Matsusue, Eiji; Kodani, Kazuhiko; Kaminou, Toshio; Ogawa, Toshihide [Tottori University, Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori (Japan); Kawamoto, Katsuyuki [Tottori University, Division of Otolaryngology, Head and Neck Surgery, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, Tottori (Japan)

2010-11-15

It is important to know whether a parotid gland lesion is in the superficial or deep lobe for preoperative planning. We aimed to investigate the ability of 3.0 T magnetic resonance (MR) imaging with surface coils to identify the intraparotid facial nerve and locate parotid gland lesions, in comparison to other indirect landmark methods. We retrospectively evaluated 50 consecutive patients with primary parotid gland lesions. The position of the facial nerve was determined by tracing the nerve in the stylomastoid foramen and then following it on sequential MR sections through the parotid gland. The retromandibular vein and the facial nerve line (FN line) were also identified. For each radiologist and each method, we determined the diagnostic ability for deep lobe lesions and superficial lobe lesions, as well as accuracy. These abilities were compared among the three methods using the Chi-square test with Yates' correction. Mean diagnostic ability for deep lobe lesions, the diagnostic ability for superficial lobe lesions, and accuracy were 92%, 86%, 87%, respectively, for the direct identification method; 67%, 89%, 86%, respectively, for the retromandibular vein method; and 25%, 99%, 90%, respectively, for the FN line method. The direct identification method had significantly higher diagnostic ability for deep lesions than the FN line method (P < 0.01), but significantly lower diagnostic ability for superficial lobe lesions than the FN line method (P < 0.01). Direct identification of the intraparotid facial nerve enables parotid gland lesions to be correctly located, particularly those in the deep lobes. (orig.)
Prospective assessment of the salivary function by parotid scintigraphy after radiotherapy of 27 nasopharyngeal cancers

International Nuclear Information System (INIS)

Mnejja, W.; Ghorbal, L.; Daoud, J.; Kallel, F.; Guermazi, F.; Frikha, M.

2011-01-01

As xerostomia is the main complication after radiotherapy of nasopharyngeal carcinomas, and affects life quality, this study aims at objectively assess the salivary function after radiotherapy of a nasopharyngeal cancer by parotid scintigraphy. 27 seven patients have been treated by radiotherapy with or without chemotherapy. Results are analyzed in terms of salivary toxicity, change of secretion function. No correlation was found between the xerostomia severity and scintigraphy results. Short communication
Dose Measurements of Parotid Glands and Spinal Cord in Conventional Treatment of Nasopharyngeal Carcinoma Using RANDO Phantom and Thermoluminescent Dosimeters

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Mohammad Taghi Bahreyni Toossi

2015-07-01

Full Text Available Introduction Radiotherapy is regarded as the first treatment of choice for nasopharyngeal carcinoma. Despite the advantages of radiotherapy, patients may suffer from a wide range of side-effects due to the presence of many sensitive normal tissues in these regions. If the absorbed dose exceeds the tolerance level in parotid glands and the spinal cord, myelopathy, Lhermitte's sign and xerostomia cannot be avoided. Materials and Methods The head and neck of a RANDO phantom (reference man, which was regarded as a hypothetical patient with nasopharyngeal carcinoma was evaluated. The full course of treatment consisted of three phases. At the beginning of each phase, an oncologist marked conventional fields on the RANDO phantom using a simulator. For measuring the absorbed dose, Thermoluminescent Dosimeters(TLD chips (TLD-100 were utilized.The absorbed dose by TLDs was read by Harshaw 3500 TLD reader. Results The total absorbed dose was calculated by measuring the absorbed dose in each phase, multiplied by the fraction numbers of each phase; the obtained values were summed up. The results showed that the received doses by spinal cord ranged from 15.24 to 54.56 Gy. Also, the absorbed dose of parotid glands was approximately 39.23 Gy. Conclusion Considering the minimum tolerance dose the absorbed doses in the spinal cord and parotid glands were above the tolerance level. The incidence rate of xerostomia and myelopathy were higher in patients, treated by conventional methods.
Acinic cell carcinoma of the parotid in children

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Jones, A.O.; Lam, A.H. [Saint Vincent`s Hospital, Darlinghurst, NSW (Australia); Martin, H.C.O. [Royal Alexandria Hospital, Westmead, NSW (Australia). Depts of Radiology and Surgery

1997-02-01

The imaging findings of two children with acinic cell carcinoma of the parotid gland are presented. Ultrasonic and computed tomography features are emphasized. One of these children, a 6 year old boy, suffers from the oculocerebrorenal syndrome of Lowe, a rare congenital, inherited condition manifested by defects of the nervous system (mental retardation, hypotonia), eyes (cataracts, glaucoma) and kidneys. To date, no known association exists between these two rare entities. The other child, a 10 year old girl, was otherwise well. The ultrasound findings of both cases demonstrate features more classic for a benign intraparotid mass than for a potentially malignant lesion. The possibility of acinic cell carcinoma should be considered if a well-defined, relatively homogeneously hypo-echoic intraparotid mass is encountered in a child, especially if cystic spaces are present. It was estimated that computed tomography findings reflected features already demonstrated by ultrasound and added little to characterization of the primary mass in this case. 12 refs.,5 figs.
Treatment of mandibular condyle fractures using a modified transparotid approach via the parotid mini-incision: experience with 31 cases.

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Jun Shi

Full Text Available Surgery for mandibular condyle fractures must allow direct vision of the fracture, reduce surgical trauma and achieve reduction and fixation while avoiding facial nerve injury. This prospective study was conducted to introduce a new surgical approach for open reduction and internal fixation of mandibular condyle fractures using a modified transparotid approach via the parotid mini-incision, and surgical outcomes were evaluated. The modified transparotid approach via the parotid mini-incision was applied and rigid internal fixation using a small titanium plate was carried out for 36 mandibular condyle fractures in 31 cases. Postoperative follow-up of patients ranged from 3 to 26 months; in the first 3 months after surgery, outcomes for all patients were analyzed by evaluating the degree of mouth opening, occlusal relationship, facial nerve function and results of imaging studies. The occlusal relationships were excellent in all patients and none had symptoms of intraoperative ipsilateral facial nerve injury. The mean degree of mouth opening was 4.0 (maximum 4.8 cm, minimum 3.0 cm. No mandibular deviations were noted in any patient during mouth opening. CT showed complete anatomical reduction of the mandibular condyle fracture in all patients. The modified transparotid approach via the smaller, easily concealed parotid mini-incision is minimally invasive and achieves anatomical reduction and rigid internal fixation with a simplified procedure that directly exposes the fracture site. Study results showed that this procedure is safe and feasible for treating mandibular condyle fracture, and offers a short operative path, protection of the facial nerve and satisfactory aesthetic outcomes.
The effect of 2100 MHz radiofrequency radiation of a 3G mobile phone on the parotid gland of rats.

Science.gov (United States)

Aydogan, Filiz; Unlu, Ilhan; Aydin, Emine; Yumusak, Nihat; Devrim, Erdinc; Samim, Ethem Erdal; Ozgur, Elcin; Unsal, Velid; Tomruk, Arin; Ozturk, Goknur Guler; Seyhan, Nesrin

2015-01-01

We aimed to evaluate the effect of 2100 MHz radiofrequency radiation on the parotid gland of rats in short and relatively long terms. Thirty Wistar albino rats were divided into four groups. Groups A and B served as the control groups (for 10 days and 40 days, respectively), and each group included six rats. Groups C and D were composed of nine rats each, and they were the exposure groups. The rats were exposed to 2100 MHz radiofrequency radiation emitted by a generator, simulating a third generation mobile phone for 6 hours/day, 5 days/week, for 10 or 40 days. Following exposure, the rats were sacrificed and parotid glands were removed. Histopathological and biochemical examinations were performed. Although there were no histopathological changes in the control groups except for two animals in group A and three animals in group B, the exposure groups C (10 days) and D (40 days) showed numerous histopathological changes regarding salivary gland damage including acinar epithelial cells, interstitial space, ductal system, vascular system, nucleus, amount of cytoplasm and variations in cell size. The histopathological changes were more prominent in group D compared to group C. There was statistically significant different parameter regarding variation in cell size between the groups B and D (p=0.036). The parotid gland of rats showed numerous histopathological changes after exposure to 2100 MHz radiofrequency radiation, both in the short and relatively long terms. Increased exposure duration led to an increase in the histopathological changes. Copyright © 2015 Elsevier Inc. All rights reserved.
Non tuberculous mycobacterial lesion of the parotid gland and facial skin in a 4year old girl: A proposed treatment strategy.

Science.gov (United States)

Berkovic, Juraj; Vanchiere, John A; Gungor, Anil

2016-01-01

We report a case of a parotid-facial caseating granulomatous infection caused by atypical mycobacteria (Mycobacterium avium) in an immuno-competent child. The size and depth of the lesion and its proximity to the facial nerve present a challenge for a purely surgical treatment strategy. An alternative treatment strategy is developed to avoid severe disfigurement. Atypical mycobacterial infection of the parotid region in a 5 year old girl: timeline and definition of a planned combined treatment strategy with antibiotics and surgical excision. Cervicofacial infections caused by non-tuberculous mycobacteria (NTM) may present surgical challenges due to the size and depth of the lesion and its proximity to the facial nerve and major vascular structures. Even minor scars are highly visible and poorly tolerated. Close clinical monitoring combined with judicious treatment strategies is necessary for successful treatment and good cosmesis. Recent literature provides insufficient guidance in formulating the best treatment strategy for the individual patient. Comparisons of antibiotic therapy with variations of surgical excision are abundant but poorly formulated. Our case presented with a lesion involving skin, superficial and deep lobe of the parotid gland. Lesion was in immediate proximity to the distribution of the facial nerve through the parotid gland. The risk of surgical damage to the facial nerve in the acute phase of the inflammation and the required extent of skin excision were significant. We decided to start treatment with combination antimycobacterial antibiotics in close cooperation with the pediatric infectious disease specialists. We observed and documented the regress and executed a delayed surgical excision when the lesion was reduced to skin only. In our opinion this was the best treatment strategy that helped us avoid extensive dissection in the vicinity of the facial nerve as well as a parotidectomy. Excision of the involved skin with the deep portion
Intensity Modulated Radiotherapy Improves Target Coverage and Parotid Gland Sparing When Delivering Total Mucosal Irradiation in Patients With Squamous Cell Carcinoma of Head and Neck of Unknown Primary Site

International Nuclear Information System (INIS)

Bhide, Shreerang; Clark, Catherine; Harrington, Kevin; Nutting, Christopher M.

2007-01-01

Head and neck squamous cell carcinoma with occult primary site represents a controversial clinical problem. Conventional total mucosal irradiation (TMI) maximizes local control, but at the expense of xerostomia. IMRT has been shown to spare salivary tissue in head and cancer patients. This study has been performed to investigate the potential of IMRT to perform nodal and TMI and also allow parotid gland sparing in this patient group. Conventional radiotherapy (CRT) and IMRT plans were produced for six patients to treat the ipsilateral (involved) post-operative neck (PTV1) and the un-operated contralateral neck and mucosal axis (PTV2). Plans were produced with and without the inclusion of nasopharynx in the PTV2. The potential to improve target coverage and spare the parotid glands was investigated for the IMRT plans. There was no significant difference in the mean doses to the PTV1 using CRT and IMRT (59.7 and 60.0 respectively, p = 0.5). The maximum doses to PTV1 and PTV2 were lower for the IMRT technique as compared to CRT (P = 0.008 and P < 0.0001), respectively, and the minimum doses to PTV1 and PTV2 were significantly higher for IMRT as compared to CRT (P = 0.001 and P = 0.001), respectively, illustrating better dose homogeneity with IMRT. The mean dose to the parotid gland contralateral to PTV1 was significantly lower for IMRT (23.21 ± 0.7) as compared to CRT (50.5 ± 5.8) (P < 0.0001). There was a significant difference in parotid dose between plans with and without the inclusion of the nasopharynx. IMRT offers improved dose homogeneity in PTV1 and PTV2 and allows for parotid sparing
SU-E-T-208: Incidence Cancer Risk From the Radiation Treatment for Acoustic Neuroma Patient

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Kim, D [Kyung Hee University International Med. Serv., Seoul (Korea, Republic of); Chung, W [Kyung Hee University Hospital at Gangdong, Seoul, Seoul (Korea, Republic of); Shin, D [Kyung Hee University Hospital, Seoul, Seoul (Korea, Republic of); Yoon, M [Korea University, Seoul (Korea, Republic of)

2014-06-01

Purpose: The present study aimed to compare the incidence risk of a secondary cancer from therapeutic doses in patients receiving intensitymodulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT), and stereotactic radiosurgery (SRS). Methods: Four acoustic neuroma patients were treated with IMRT, VMAT, or SRS. Their incidnece excess relative risk (ERR), excess absolute risk (EAR), and lifetime attributable risk (LAR) were estimated using the corresponding therapeutic doses measured at various organs by radio-photoluminescence glass dosimeters (RPLGD) placed inside a humanoid phantom. Results: When a prescription dose was delivered in the planning target volume of the 4 patients, the average organ equivalent doses (OED) at the thyroid, lung, normal liver, colon, bladder, prostate (or ovary), and rectum were measured. The OED decreased as the distance from the primary beam increased. The thyroid received the highest OED compared to other organs. A LAR were estimated that more than 0.03% of AN patients would get radiation-induced cancer. Conclusion: The tyroid was highest radiation-induced cancer risk after radiation treatment for AN. We found that LAR can be increased by the transmitted dose from the primary beam. No modality-specific difference in radiation-induced cancer risk was observed in our study.
Survival Outcomes of Patients Treated with Hypofractionated Stereotactic Body Radiation Therapy for Parotid Gland Tumors: a Retrospective Analysis

International Nuclear Information System (INIS)

Karam, Sana D.; Snider, James W.; Wang, Hongkun; Wooster, Margaux; Lominska, Christopher; Deeken, John; Newkirk, Kenneth; Davidson, Bruce; Harter, K. William

2012-01-01

Background: to review a single-institution experience with the management of parotid malignancies treated by fractionated stereotactic body radiosurgery (SBRT). Findings: Between 2003 and 2011, 13 patients diagnosed with parotid malignancies were treated with adjuvant or definitive SBRT to a median dose of 33 Gy (range 25–40 Gy). There were 11 male and two female patients with a median age of 80. Ten patients declined conventional radiation treatment and three patients had received prior unrelated radiation therapy to neighboring structures with unavailable radiation records. Six patients were treated with definitive intent while seven patients were treated adjuvantly for adverse surgical or pathologic features. Five patients had clinical or pathologic evidence of lymph node disease. Conclusion: at a median follow-up of 14 months only one patient failed locally, and four failed distantly. The actuarial 2-year overall survival, progression-free survival, and local-regional control rates were 46, 84, and 47%, respectively. Statistical analysis revealed surgery as a positive predictor of overall survival while presence of gross disease was a negatively correlated factor (p < 0.05).
Distal anterior inferior cerebellar artery syndrome after acoustic neuroma surgery.

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Hegarty, Joseph L; Jackler, Robert K; Rigby, Peter L; Pitts, Lawrence H; Cheung, Steven W

2002-07-01

To define a clinicopathologic syndrome associated with persistent cerebellar dysfunction after acoustic neuroma (AN) excision. Case series derived from radiographic and clinical chart review. Tertiary referral center. In 12 patients with AN, persistent cerebellar dysfunction developed after AN removal. Each case demonstrated abnormality in the ipsilateral cerebellar peduncle on postoperative magnetic resonance imaging. Cerebellar function and ambulatory status over the first postoperative year. On magnetic resonance imaging scans, the extent of cerebellar peduncle infarcts was variable. It ranged from focal brain injury (2 cm) spanning the full thickness of the peduncle. Peduncular infarcts were associated with large tumor size (average 3.8 cm, range 2.0-5.5 cm diameter). The long-term functional outcomes (>1 yr) varied. Dysmetria was unchanged or improved in over half of the patients (6 of 11 patients). Gait recovered to normal or to preoperative levels in 5 patients. In the 6 patients with persistent impaired mobility, 2 had mild gait disturbance, 3 required regular use of a cane, and 1 has been dependent on a walker. One patient had sustained mild motor weakness. Three of 11 patients remained dependent on others for activities of daily living. Peduncle injury most likely stems from interruption of distal branches of the anterior inferior cerebellar artery (AICA). These small vessels are intimately related to the capsule of the tumor and may supply both the neoplasm and the brain parenchyma. It has long been recognized that interruption of the proximal segment of the AICA results in severe injury to the pons, with devastating neurologic sequelae. A limited AICA syndrome caused by loss of its distal ramifications seems a more plausible explanation for peduncular infarction than either venous insufficiency or direct surgical trauma.
Observations at the CNS-PNS border of ventral roots connected to a neuroma

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Sten Remahl

2010-10-01

Full Text Available Previous studies have shown that numerous sprouts originating from a neuroma, after nerve injury in neonatal animals, can invade spinal nerve roots. In this study the border between the central and peripheral nervous system (CNS-PNS border of ventral roots in kittens was examined with both light and electron microscopy after early postnatal sciatic nerve resection. A transient ingrowth of substance P positive axons was observed into the CNS, but no spouts remained 6 weeks after the injury. Using serial sections and electron microscopy it was possible to identify small bundles of unmyelinated axons that penetrated from the root fascicles for a short distance into the CNS. These axons ended blindly, sometimes with a growth cone-like terminal swelling filled with vesicles. The axon bundles were accompanied by p75 positive cells in both the root fascicles and the pia mater, but not in the CNS. It may thus be suggested that neurotrophin presenting p75 positive cells could facilitate axonal growth into the pia mater and that the lack of such cells in the CNS compartment might contribute to the failure of growth into the CNS. A maldevelopment of myelin sheaths at the CNS-PNS border of motor axons was observed and it seems possible that this could have consequences for the propagation of action potential across this region after neonatal nerve injury.
Comparison of different deep learning approaches for parotid gland segmentation from CT images

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Hänsch, Annika; Schwier, Michael; Gass, Tobias; Morgas, Tomasz; Haas, Benjamin; Klein, Jan; Hahn, Horst K.

2018-02-01

The segmentation of target structures and organs at risk is a crucial and very time-consuming step in radiotherapy planning. Good automatic methods can significantly reduce the time clinicians have to spend on this task. Due to its variability in shape and often low contrast to surrounding structures, segmentation of the parotid gland is especially challenging. Motivated by the recent success of deep learning, we study different deep learning approaches for parotid gland segmentation. Particularly, we compare 2D, 2D ensemble and 3D U-Net approaches and find that the 2D U-Net ensemble yields the best results with a mean Dice score of 0.817 on our test data. The ensemble approach reduces false positives without the need for an automatic region of interest detection. We also apply our trained 2D U-Net ensemble to segment the test data of the 2015 MICCAI head and neck auto-segmentation challenge. With a mean Dice score of 0.861, our classifier exceeds the highest mean score in the challenge. This shows that the method generalizes well onto data from independent sites. Since appropriate reference annotations are essential for training but often difficult and expensive to obtain, it is important to know how many samples are needed to properly train a neural network. We evaluate the classifier performance after training with differently sized training sets (50-450) and find that 250 cases (without using extensive data augmentation) are sufficient to obtain good results with the 2D ensemble. Adding more samples does not significantly improve the Dice score of the segmentations.
SU-F-T-611: Critical Analysis and Efficacy of Linac Based (Beam Modulator) and Cyberknife Treatment Plans for Acoustic Neuroma/schwannoma

International Nuclear Information System (INIS)

KP, Karrthick; Kataria, T; Thiyagarajan, R; Selvan, T; Abhishek, A

2016-01-01

Purpose: To study the critical analysis and efficacy of Linac and Cyberknife (CK) treatment plans for acoustic neuroma/schwannoma. Methods: Twelve of acoustic neuroma/schwannoma patients were taken for these study that. Treatment plans were generated in Multiplan treatment planning system (TPS) for CK using 5,7.5 and 10mm diameter collimators. Target volumes were in the range of 0.280 cc to 9.256 cc. Prescription dose (Rx) ranges from 1150cGy to 1950cGy delivered over 1 to 3 Fractions. For same patients stereotactic Volumetric modulated arc plans were generated using Elekta Linac with MLC thickness of 4mm in Monaco TPS. Appropriate calculation algorithms and grid size were used with same Rx and organ at risk (OAR) constrains for both Linac and CK plans. Treatment plans were developed to achieve at least 95% of the target volume to receive the Rx. The dosimetric indices such as conformity index (CI), coverage, OAR dose and volume receiving 50% of Rx (V50%) were used to evaluate the plans. Results: Target volumes ranges from 0.280 cc to 3.5cc shows the CI of 1.16±0.109 and 1.53±0.360 for cyberknife and Linac plans respectively. For small volume targets, the OARs were well spared in CK plans. There are no significant differences in CI and OAR doses were observed between CK and Linac plans that have the target volume >3.5 cc. Perhaps the V50% were lesser in CK plans, and found to be 12.8± 8.4 and 22.8 ± 15.0 for CK and Linac respectively. Conclusion: The analysis shows the importance of collimator size for small volume targets. The target volumes >3.5 cc can be treated in Linac as comparable with CK. For targets <3.5cc CK plans showed superior plan quality with better CI and OAR sparing than the Linac based plans. Further studies may require evaluating the clinical advantage of CK robotic system.

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