WorldWideScience

Sample records for parotid gland sparing

  1. 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

  2. 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

  3. 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.

  4. 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

  5. Factors influencing the parotid function in nasopharyngeal carcinoma treated with parotid-sparing radiotherapy

    International Nuclear Information System (INIS)

    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)

  6. 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

  7. 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)

  8. The influence of parotid gland sparing on radiation damages of dental hard tissues.

    Science.gov (United States)

    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.

  9. 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

  10. 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.

  11. 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

  12. 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.

  13. 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

  14. Reducing Xerostomia After Chemo-IMRT for Head and Neck Cancer: Beyond Sparing the Parotid Glands

    Science.gov (United States)

    Little, Michael; Schipper, Matthew; Feng, Felix Y.; Vineberg, Karen; Cornwall, Craig; Murdoch-Kinch, Carol-Anne; Eisbruch, Avraham

    2011-01-01

    Purpose To assess whether in addition to sparing parotid glands (PGs), xerostomia after chemo-IMRT of head and neck cancer is affected by reducing doses to other salivary glands. Methods Prospective study: 78 patients with stages III/IV oropharynx/nasopharynx cancers received chemo-IMRT aiming to spare the parts outside the targets of bilateral PGs, oral cavity (OC) containing the minor salivary glands, and contralateral submandibular gland (SMG) (when contralateral level I was not a target). Pretherapy and periodically through 24 months, validated patient-reported xerostomia questionnaires (XQ) scores and observer-graded xerostomia were recorded, and stimulated and unstimulated saliva measured selectively from each of the PGs and SMGs. Mean OC doses served as surrogates of minor salivary glands dysfunction. Regression models assessed XQ and observer-graded xerostomia predictors. Results Statistically significant predictors of the XQ score in univariate analysis included OC, PG, and SMG mean doses, as well as baseline XQ score, time since RT, and both stimulated and unstimulated PG saliva flow rates. Similar factors were statistically significant predictors of observer-graded xerostomia. OC, PG and SMG mean doses were moderately inter-correlated (r=0.47–0.55). In multivariate analyses, after adjusting for PG and SMG doses, OC mean dose (p xerostomia. While scatter plots showed no thresholds, OC mean doses xerostomia at almost all post-therapy time points. Conclusion PG, SMG and OC mean doses were significant predictors of both patient-reported and observer-rated xerostomia after chemo-IMRT, with OC doses remaining significant after adjusting for PG and SMG doses. These results support efforts to spare all salivary glands by IMRT, beyond the PGs alone. PMID:22056067

  15. 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

  16. 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

  17. Large Parotid Gland Lipoblastoma in a Teenager.

    Science.gov (United States)

    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.

  18. Large Parotid Gland Lipoblastoma in a Teenager

    Directory of Open Access Journals (Sweden)

    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.

  19. Parotid gland-recovery after radiotherapy in the head and neck region - 36 months follow-up of a prospective clinical study

    Directory of Open Access Journals (Sweden)

    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.

  20. 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

  1. 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

  2. Reducing Xerostomia After Chemo-IMRT for Head-and-Neck Cancer: Beyond Sparing the Parotid Glands

    Energy Technology Data Exchange (ETDEWEB)

    Little, Michael [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Schipper, Matthew [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Cancer Center Biostatistics Core, University of Michigan, Ann Arbor, MI (United States); Feng, Felix Y.; Vineberg, Karen [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Cornwall, Craig; Murdoch-Kinch, Carol-Anne [Hospital Dentistry, University of Michigan, Ann Arbor, MI (United States); Eisbruch, Avraham, E-mail: eisbruch@umich.edu [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States)

    2012-07-01

    Purpose: To assess whether, in addition to sparing the parotid glands (PGs), xerostomia after chemotherapy plus intensity-modulated radiotherapy (chemo-IMRT) for head-and-neck cancer is affected by reducing the dose to the other salivary glands. Patients and Methods: In a prospective study, 78 patients with Stage III-IV oropharynx/nasopharynx cancer underwent chemo-IMRT, with the aim of sparing the parts of the bilateral PGs, oral cavity (OC) containing the minor salivary glands, and contralateral submandibular gland (SMG) outside the target (when contralateral level I was not a target). Before therapy and periodically for 24 months, validated patient-reported xerostomia questionnaire (XQ) scores and observer-graded xerostomia scores were recorded. Also, the stimulated and unstimulated saliva was measured selectively from each of the PGs and SMGs. The mean OC doses served as surrogates of minor salivary gland dysfunction. Regression models assessed the XQ and observer-graded xerostomia predictors. Results: Statistically significant predictors of the XQ score on univariate analysis included the OC, PG, and SMG mean doses and the baseline XQ score, time since RT, and both stimulated and unstimulated PG saliva flow rates. Similar factors were statistically significant predictors of observer-graded xerostomia. The OC, PG, and SMG mean doses were moderately intercorrelated (r = 0.47-0.55). On multivariate analyses, after adjusting for the PG and SMG doses, the OC mean dose (p < .0001), interval from RT (p < .0001), and stimulated PG saliva (p < .0025) were significant predictors of the XQ scores and the OC mean dose and time for observer-graded xerostomia. Although scatter plots showed no thresholds, an OC mean dose of <40 Gy and contralateral SMG mean dose of <50 Gy were each associated with low patient-reported and observer-rated xerostomia at almost all post-therapy points. Conclusion: The PG, SMG, and OC mean doses were significant predictors of both patient

  3. Reducing Xerostomia After Chemo-IMRT for Head-and-Neck Cancer: Beyond Sparing the Parotid Glands

    International Nuclear Information System (INIS)

    Little, Michael; Schipper, Matthew; Feng, Felix Y.; Vineberg, Karen; Cornwall, Craig; Murdoch-Kinch, Carol-Anne; Eisbruch, Avraham

    2012-01-01

    Purpose: To assess whether, in addition to sparing the parotid glands (PGs), xerostomia after chemotherapy plus intensity-modulated radiotherapy (chemo-IMRT) for head-and-neck cancer is affected by reducing the dose to the other salivary glands. Patients and Methods: In a prospective study, 78 patients with Stage III-IV oropharynx/nasopharynx cancer underwent chemo-IMRT, with the aim of sparing the parts of the bilateral PGs, oral cavity (OC) containing the minor salivary glands, and contralateral submandibular gland (SMG) outside the target (when contralateral level I was not a target). Before therapy and periodically for 24 months, validated patient-reported xerostomia questionnaire (XQ) scores and observer-graded xerostomia scores were recorded. Also, the stimulated and unstimulated saliva was measured selectively from each of the PGs and SMGs. The mean OC doses served as surrogates of minor salivary gland dysfunction. Regression models assessed the XQ and observer-graded xerostomia predictors. Results: Statistically significant predictors of the XQ score on univariate analysis included the OC, PG, and SMG mean doses and the baseline XQ score, time since RT, and both stimulated and unstimulated PG saliva flow rates. Similar factors were statistically significant predictors of observer-graded xerostomia. The OC, PG, and SMG mean doses were moderately intercorrelated (r = 0.47–0.55). On multivariate analyses, after adjusting for the PG and SMG doses, the OC mean dose (p < .0001), interval from RT (p < .0001), and stimulated PG saliva (p < .0025) were significant predictors of the XQ scores and the OC mean dose and time for observer-graded xerostomia. Although scatter plots showed no thresholds, an OC mean dose of <40 Gy and contralateral SMG mean dose of <50 Gy were each associated with low patient-reported and observer-rated xerostomia at almost all post-therapy points. Conclusion: The PG, SMG, and OC mean doses were significant predictors of both patient

  4. Parotid gland-recovery after radiotherapy in the head and neck region - 36 months follow-up of a prospective clinical study

    Science.gov (United States)

    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

  5. 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

  6. Dosimetric Verification and Evaluation of the 3-D Conformal Parotid Gland-Sparing Irradiation Technique for Bilateral Neck Treatment at University Hospital Centre Zagreb

    International Nuclear Information System (INIS)

    Kovacevic, N; Hrsak, H.; Bibic, J.

    2011-01-01

    3-D Conformal Parotid Gland-Sparing Irradiation Technique for Bilateral Neck (ConPas) is an alternative to Intensity-modulated radiotherapy (IMRT), and is in routine use at University Hospital Centre Rebro (KBC-Rebro), Zagreb. This technique includes highly asymmetric wedged conformal multi-leaf fields and demands very precise application. The aim of this paper is to present the dosimetric verification method of ConPas (and evaluation of ConPas applicability) as performed at KBC, taking into account the precision of the Treatment Planning System (TPS), possibilities of linear accelerator and patient set-up error. Results for two patients are shown in some details.ConPas is a rather sophisticated method and demands high precision in the whole radiotherapy process. Verification of ConPas using IMRT Verification Matrix Phantom shows good agreement between measured and predicted doses inside and outside PTV regions of the head and neck. Furthermore, a careful track of the positioning during the treatment shows that the overall set-up error is very small (practically negligible). When possible, one parotid gland may be partially spared, and therefore its function preserved at least to some extent. (author)

  7. 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

  8. 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

  9. 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)

  10. 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.

  11. Unilateral multiple tumorous lesions of the parotid gland

    International Nuclear Information System (INIS)

    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)

  12. 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

  13. 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.)

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  15. Patient- and therapy-related factors associated with the incidence of xerostomia in nasopharyngeal carcinoma patients receiving parotid-sparing helical tomotherapy.

    Science.gov (United States)

    Lee, Tsair-Fwu; Liou, Ming-Hsiang; Ting, Hui-Min; Chang, Liyun; Lee, Hsiao-Yi; Wan Leung, Stephen; Huang, Chih-Jen; Chao, Pei-Ju

    2015-08-20

    We investigated the incidence of moderate to severe patient-reported xerostomia among nasopharyngeal carcinoma (NPC) patients treated with helical tomotherapy (HT) and identified patient- and therapy-related factors associated with acute and chronic xerostomia toxicity. The least absolute shrinkage and selection operator (LASSO) normal tissue complication probability (NTCP) models were developed using quality-of-life questionnaire datasets from 67 patients with NPC. For acute toxicity, the dosimetric factors of the mean doses to the ipsilateral submandibular gland (Dis) and the contralateral submandibular gland (Dcs) were selected as the first two significant predictors. For chronic toxicity, four predictive factors were selected: age, mean dose to the oral cavity (Doc), education, and T stage. The substantial sparing data can be used to avoid xerostomia toxicity. We suggest that the tolerance values corresponded to a 20% incidence of complications (TD20) for Dis = 39.0 Gy, Dcs = 38.4 Gy, and Doc = 32.5 Gy, respectively, when mean doses to the parotid glands met the QUANTEC 25 Gy sparing guidelines. To avoid patient-reported xerostomia toxicity, the mean doses to the parotid gland, submandibular gland, and oral cavity have to meet the sparing tolerance, although there is also a need to take inherent patient characteristics into consideration.

  16. 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.)

  17. 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

  18. 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

  19. 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.

  20. 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)

  1. Using a Reduced Spot Size for Intensity-Modulated Proton Therapy Potentially Improves Salivary Gland-Sparing in Oropharyngeal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Water, Tara A. van de, E-mail: t.a.van.de.water@rt.umcg.nl [Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen (Netherlands); Lomax, Antony J. [Centre for Proton Therapy, Paul Scherrer Institute, Villigen-PSI (Switzerland); Bijl, Hendrik P.; Schilstra, Cornelis [Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen (Netherlands); Hug, Eugen B. [Centre for Proton Therapy, Paul Scherrer Institute, Villigen-PSI (Switzerland); Langendijk, Johannes A. [Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen (Netherlands)

    2012-02-01

    Purpose: To investigate whether intensity-modulated proton therapy with a reduced spot size (rsIMPT) could further reduce the parotid and submandibular gland dose compared with previously calculated IMPT plans with a larger spot size. In addition, it was investigated whether the obtained dose reductions would theoretically translate into a reduction of normal tissue complication probabilities (NTCPs). Methods: Ten patients with N0 oropharyngeal cancer were included in a comparative treatment planning study. Both IMPT plans delivered simultaneously 70 Gy to the boost planning target volume (PTV) and 54 Gy to the elective nodal PTV. IMPT and rsIMPT used identical three-field beam arrangements. In the IMPT plans, the parotid and submandibular salivary glands were spared as much as possible. rsIMPT plans used identical dose-volume objectives for the parotid glands as those used by the IMPT plans, whereas the objectives for the submandibular glands were tightened further. NTCPs were calculated for salivary dysfunction and xerostomia. Results: Target coverage was similar for both IMPT techniques, whereas rsIMPT clearly improved target conformity. The mean doses in the parotid glands and submandibular glands were significantly lower for three-field rsIMPT (14.7 Gy and 46.9 Gy, respectively) than for three-field IMPT (16.8 Gy and 54.6 Gy, respectively). Hence, rsIMPT significantly reduced the NTCP of patient-rated xerostomia and parotid and contralateral submandibular salivary flow dysfunction (27%, 17%, and 43% respectively) compared with IMPT (39%, 20%, and 79%, respectively). In addition, mean dose values in the sublingual glands, the soft palate and oral cavity were also decreased. Obtained dose and NTCP reductions varied per patient. Conclusions: rsIMPT improved sparing of the salivary glands and reduced NTCP for xerostomia and parotid and submandibular salivary dysfunction, while maintaining similar target coverage results. It is expected that rsIMPT improves quality

  2. Local Anatomic Changes in Parotid and Submandibular Glands During Radiotherapy for Oropharynx Cancer and Correlation With Dose, Studied in Detail With Nonrigid Registration

    International Nuclear Information System (INIS)

    Vasquez Osorio, Eliana M.; Hoogeman, Mischa S.; Al-Mamgani, Abrahim; Teguh, David N.; Levendag, Peter C.; Heijmen, Ben J.M.

    2008-01-01

    Purpose: To quantify the anatomic changes caused by external beam radiotherapy in head-and-neck cancer patients in full three dimensions and to relate the local anatomic changes to the planned mean dose. Methods and Materials: A nonrigid registration method was adapted for RT image registration. The method was applied in 10 head-and-neck cancer patients, who each underwent a planning and a repeat computed tomography scan. Contoured structures (parotid, submandibular glands, and tumor) were registered in a nonrigid manner. The accuracy of the transformation was determined. The transformation results were used to summarize the anatomic changes on a local scale for the irradiated and spared glands. The volume reduction of the glands was related to the planned mean dose. Results: Transformation was accurate with a mean error of 0.6 ± 0.5 mm. The volume of all glands and the primary tumor decreased. The lateral regions of the irradiated parotid glands moved inward (average, 3 mm), and the medial regions tended to remain in the same position. The irradiated submandibular glands shrank and moved upward. The spared glands showed only a small deformation (∼1 mm in most regions). Overall, the primary tumors shrank. The volume loss of the parotid glands correlated significantly with the planned mean dose (p <0.001). Conclusion: General shrinkage and deformation of irradiated glands was seen. The spared glands showed few changes. These changes were assessed by a nonrigid registration method, which effectively described the local changes occurring in the head-and-neck region after external beam radiotherapy

  3. 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.

  4. Xerostomia and its predictors following parotid-sparing irradiation of head-and-neck cancer

    International Nuclear Information System (INIS)

    Eisbruch, Avraham; Kim, Hyungjin M.; Terrell, Jeffrey E.; Marsh, Lon H.C.; Dawson, Laura A.; Ship, Jonathan A.

    2001-01-01

    Purpose: To assess long-term xerostomia in patients receiving parotid-sparing radiation therapy (RT) for head-and-neck cancer, and to find the patient and therapy-related factors that affect its severity. Patients and Methods: From March 1994 through January 2000, 84 patients received comprehensive bilateral neck RT using conformal and multisegmental intensity-modulated RT (IMRT) aiming to spare the major salivary glands. Before RT and periodically through 2 years after the completion of RT, salivary flow rates from each of the major salivary glands were selectively measured. At the same time intervals, each patient completed an 8-item self-reported xerostomia-specific questionnaire (XQ). To gain a relative measure of the effect of RT on the minor salivary glands, whose output could not be measured, the surfaces of the oral cavity (extending to include the surface of the base of tongue) were outlined in the planning CT scans. The mean doses to the new organ ('oral cavity') were recorded. Forty-eight patients receiving unilateral neck RT were similarly studied and served as a benchmark for comparison. Factors predicting the XQ scores were analyzed using a random-effects model. Results: The XQ was found to be reliable and valid in measuring patient-reported xerostomia. The spared salivary glands which had received moderate doses in the bilateral RT group recovered to their baseline salivary flow rates during the second year after RT, and the spared glands in the unilateral RT group, which had received very low doses, demonstrated increased salivary production beyond their pre-RT levels. The increase in the salivary flow rates during the second year after RT paralleled an improvement in xerostomia in both patient groups. The improvement in xerostomia was faster in the unilateral compared with the bilateral RT group, but the difference narrowed at 2 years. The major salivary gland flow rates had only a weak correlation with the xerostomia scores. Factors found to be

  5. 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

  6. Bilateral parotid gland tuberculosis: A rare occurrence

    Directory of Open Access Journals (Sweden)

    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.

  7. 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)

  8. 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

  9. 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)

  10. 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.

  11. Primary parotid gland lymphoma: a case report

    Directory of Open Access Journals (Sweden)

    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.

  12. 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

  13. 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.

  14. Sparing of the submandibular glands by intensity modulated radiotherapy in the treatment of head and neck cancer

    International Nuclear Information System (INIS)

    Saarilahti, Kauko; Kouri, Mauri; Collan, Juhani; Kangasmaeki, Aki; Atula, Timo; Joensuu, Heikki; Tenhunen, Mikko

    2006-01-01

    Background and purpose: The submandibular glands produce most of the unstimulated saliva output and are the key in prevention of radiation-related xerostomia. We investigated whether sparing of the submandibular function is feasible with intensity modulated radiotherapy (IMRT). Patients and methods: Thirty-six patients diagnosed with head and neck cancer were treated with IMRT and had at least one parotid gland excluded from the planning target volume. In a subset, of these patients (n=18) where the risk of cancer recurrence in the contralateral submandibular region was judged low, the contralateral submandibular gland was spared from full-dose irradiation. The total unstimulated and stimulated salivary flow rates and adverse effects were monitored. Results: Twelve months following IMRT mean unstimulated saliva flow was 60% of the baseline value among patients who had one submandibular gland spared and 25% among those who did not (P=0.006). Patients whose contralateral submandibular was spared reported less grade two or three xerostomia (4 vs. 11; P=0.018), and used less saliva substitutes. No cancer recurrences were detected at the vicinity of the spared glands during a median follow-up time of 31 months. Conclusions: Submandibular gland sparing with IMRT is safe in selected patients treated for head and neck cancer. It is effective in prevention of radiation-associated xerostomia

  15. Isolated Light Chain Amyloidosis Involving the Parotid Gland: A Case Report.

    Science.gov (United States)

    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.

  16. 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)

  17. Lymphoepithelial Carcinoma of Parotid Gland- A Case Report

    Directory of Open Access Journals (Sweden)

    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.

  18. Necrotizing sialometaplasia of the parotid gland associated with facial nerve paralysis.

    Science.gov (United States)

    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.

  19. 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.

  20. Impact of Salivary Gland Dosimetry on Post-IMRT Recovery of Saliva Output and Xerostomia Grade for Head-and-Neck Cancer Patients Treated With or Without Contralateral Submandibular Gland Sparing: A Longitudinal Study

    International Nuclear Information System (INIS)

    Wang Zhonghe; Yan Chao; Zhang Zhiyuan; Zhang Chenping; Hu Haisheng; Tu Wenyong; Kirwan, Jessica; Mendenhall, William M.

    2011-01-01

    Purpose: To observe the recovery of saliva output and effect on xerostomia grade after intensity-modulated radiotherapy (IMRT) with or without contralateral submandibular gland (cSMG) sparing and to assess the impact of salivary gland dosimetry on this recovery among patients with head-and-neck cancer. Methods and Materials: Between May 2007 and May 2008, 52 patients with head-and-neck cancer received definitive (n = 5 patients) and postoperative (n = 47 patients) IMRT at our institution, with at least one parotid gland spared. Of these patients, 26 patients with a low risk of recurrence in the cSMG region underwent IMRT and had their cSMGs spared (cSMG-sparing group). The remaining 26 high-risk patients had no cSMGs spared (cSMG-unspared group). Xerostomia grades and salivary flow rates were monitored at five time points (before IMRT and at 2, 6, 12, and 18 months after IMRT). Results: Average mean doses and mean volumes receiving 30 Gy (V30) of the cSMGs were lower in the cSMG-sparing group than in the cSMG-unspared group (mean dose, 20.4 Gy vs. 57.4 Gy; mean V30, 14.7% vs. 99.8%, respectively). Xerostomia grades at 2 and 6 months post-IMRT were also significantly lower among patients in the cSMG-sparing group than in the cSMG-unspared group, but differences were not significant at 12 and 18 months after IMRT. Patients in the cSMG-sparing group had significantly better mean unstimulated salivary flow rates at each time point post- IMRT as well as better mean stimulated salivary flow rates at 2 months post-IMRT. Conclusions: Recovery of saliva output and grade of xerostomia post-IMRT in patients whose cSMGs were spared were much better than in patients whose cSMGs were not spared. The influence of the mean doses to the cSMG and parotid gland on the recovery of saliva output was equivalent to that of the mean V30 to the glands.

  1. Impact of Salivary Gland Dosimetry on Post-IMRT Recovery of Saliva Output and Xerostomia Grade for Head-and-Neck Cancer Patients Treated With or Without Contralateral Submandibular Gland Sparing: A Longitudinal Study

    Energy Technology Data Exchange (ETDEWEB)

    Wang Zhonghe; Yan Chao [Division of Radiation Oncology, the Shanghai Ninth Peoples Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (China); Zhang Zhiyuan; Zhang Chenping [Department of Oral and Maxillofacial Surgery, the Shanghai Ninth Peoples Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (China); Hu Haisheng; Tu Wenyong [Division of Radiation Oncology, the Shanghai Ninth Peoples Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (China); Kirwan, Jessica [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida (United States); Mendenhall, William M., E-mail: mendwm@shands.ufl.edu [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida (United States)

    2011-12-01

    Purpose: To observe the recovery of saliva output and effect on xerostomia grade after intensity-modulated radiotherapy (IMRT) with or without contralateral submandibular gland (cSMG) sparing and to assess the impact of salivary gland dosimetry on this recovery among patients with head-and-neck cancer. Methods and Materials: Between May 2007 and May 2008, 52 patients with head-and-neck cancer received definitive (n = 5 patients) and postoperative (n = 47 patients) IMRT at our institution, with at least one parotid gland spared. Of these patients, 26 patients with a low risk of recurrence in the cSMG region underwent IMRT and had their cSMGs spared (cSMG-sparing group). The remaining 26 high-risk patients had no cSMGs spared (cSMG-unspared group). Xerostomia grades and salivary flow rates were monitored at five time points (before IMRT and at 2, 6, 12, and 18 months after IMRT). Results: Average mean doses and mean volumes receiving 30 Gy (V30) of the cSMGs were lower in the cSMG-sparing group than in the cSMG-unspared group (mean dose, 20.4 Gy vs. 57.4 Gy; mean V30, 14.7% vs. 99.8%, respectively). Xerostomia grades at 2 and 6 months post-IMRT were also significantly lower among patients in the cSMG-sparing group than in the cSMG-unspared group, but differences were not significant at 12 and 18 months after IMRT. Patients in the cSMG-sparing group had significantly better mean unstimulated salivary flow rates at each time point post- IMRT as well as better mean stimulated salivary flow rates at 2 months post-IMRT. Conclusions: Recovery of saliva output and grade of xerostomia post-IMRT in patients whose cSMGs were spared were much better than in patients whose cSMGs were not spared. The influence of the mean doses to the cSMG and parotid gland on the recovery of saliva output was equivalent to that of the mean V30 to the glands.

  2. 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.

  3. 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

  4. 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)

  5. Multifocal Adenomatous Oncocytic Hyperplasia of the Parotid Gland

    Science.gov (United States)

    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

  6. Multifocal Adenomatous Oncocytic Hyperplasia of the Parotid Gland

    Directory of Open Access Journals (Sweden)

    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.

  7. The effect of concomitant chemotherapy on parotid gland function following head and neck IMRT

    International Nuclear Information System (INIS)

    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

  8. 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.

  9. 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

  10. 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.

  11. 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.

  12. 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

  13. 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)

  14. 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

  15. 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

  16. 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

  17. 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.

  18. 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

  19. 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.

  20. 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.)

  1. 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.

  2. 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.

  3. 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.

  4. Benign Fibrous Tumour of the Parotid Gland

    Directory of Open Access Journals (Sweden)

    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.

  5. 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)

  6. 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

  7. 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.

  8. 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.

  9. The effect of setup uncertainty on normal tissue sparing with IMRT for head-and-neck cancer

    International Nuclear Information System (INIS)

    Manning, Matthew A.; Wu Quiwen; Cardinale, Robert M.; Mohan, Radhe; Lauve, Andrew D.; Kavanagh, Brian D.; Morris, Monica M.; Schmidt-Ullrich, Rupert K.

    2001-01-01

    Purpose: Intensity-modulated radiotherapy (IMRT) is being evaluated in the management of head-and-neck cancers at several institutions, and a Radiation Therapy Oncology Group study of its utility in parotid sparing is under development. There is an inherent risk that the sharper dose gradients generated by IMRT amplify the potentially detrimental impact of setup uncertainty. The International Commission on Radiation Units and Measurements Report 62 (ICRU-62) defined planning organ-at-risk volume (PRV) to account for positional uncertainties for normal tissues. The purpose of this study is to quantify the dosimetric effect of employing PRV for the parotid gland and to evaluate the use of PRV on normal-tissue sparing in the setting of small clinical setup errors. Methods and Materials: The optimized nine-beam IMRT plans for three head-and-neck cancer patients participating in an institutional review board approved parotid-sparing protocol were used as reference plans. A second optimized plan was generated for each patient by adding a PRV of 5 mm for the contralateral parotid gland. The effect of these additions on the quality of the plans was quantified, in terms of both target coverage and normal-tissue sparing. To test the value of PRV in a worst-case scenario, systematic translational setup uncertainties were simulated by shifting the treatment isocenter 5 mm superiorly, inferiorly, left, right, anteriorly, and posteriorly, without altering optimized beam profiles. At each shifted isocenter, dose distributions were recalculated, producing a total of six shifted plans without PRV and six shifted plans with PRV for each patient. The effect of setup uncertainty on parotid sparing and the value of PRV in compensating for the uncertainty were evaluated. Results: The addition of the PRV and reoptimization did not significantly affect the dose to gross tumor volume, spinal cord, or brainstem. In contrast, without any shift, the PRV did increase parotid sparing and reduce

  10. 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.

  11. 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.

  12. 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

  13. 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.

  14. Effect of ionizing radiation on rat parotid gland

    Energy Technology Data Exchange (ETDEWEB)

    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)

  15. 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.

  16. 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.

  17. Functional imaging of parotid glands: Diffusion-weighted echo-planar MRI before and after stimulation

    Energy Technology Data Exchange (ETDEWEB)

    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

  18. 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.

  19. Impact of head and neck cancer adaptive radiotherapy to spare the parotid glands and decrease the risk of xerostomia.

    Science.gov (United States)

    Castelli, Joel; Simon, Antoine; Louvel, Guillaume; Henry, Olivier; Chajon, Enrique; Nassef, Mohamed; Haigron, Pascal; Cazoulat, Guillaume; Ospina, Juan David; Jegoux, Franck; Benezery, Karen; de Crevoisier, Renaud

    2015-01-09

    Large anatomical variations occur during the course of intensity-modulated radiation therapy (IMRT) for locally advanced head and neck cancer (LAHNC). The risks are therefore a parotid glands (PG) overdose and a xerostomia increase. The purposes of the study were to estimate: - the PG overdose and the xerostomia risk increase during a "standard" IMRT (IMRTstd); - the benefits of an adaptive IMRT (ART) with weekly replanning to spare the PGs and limit the risk of xerostomia. Fifteen patients received radical IMRT (70 Gy) for LAHNC. Weekly CTs were used to estimate the dose distributions delivered during the treatment, corresponding either to the initial planning (IMRTstd) or to weekly replanning (ART). PGs dose were recalculated at the fraction, from the weekly CTs. PG cumulated doses were then estimated using deformable image registration. The following PG doses were compared: pre-treatment planned dose, per-treatment IMRTstd and ART. The corresponding estimated risks of xerostomia were also compared. Correlations between anatomical markers and dose differences were searched. Compared to the initial planning, a PG overdose was observed during IMRTstd for 59% of the PGs, with an average increase of 3.7 Gy (10.0 Gy maximum) for the mean dose, and of 8.2% (23.9% maximum) for the risk of xerostomia. Compared to the initial planning, weekly replanning reduced the PG mean dose for all the patients (pxerostomia by 11% (pxerostomia risk.

  20. 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.)

  1. 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.

  2. 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.

  3. 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....

  4. 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

  5. Evaluation of ultrasound in the diagnosis of parotid gland masses

    Directory of Open Access Journals (Sweden)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  7. 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.)

  8. 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%)

  9. 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...

  10. 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.

  11. 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.

  12. Metastatic Parotid Myoepithelial Carcinoma in a 7-Year-Old Boy

    Directory of Open Access Journals (Sweden)

    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.

  13. 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

  14. 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)

  15. 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

  16. 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.

  17. Pleomorphic adenoma of the parotid gland with cystic degeneration: A rare case report

    Directory of Open Access Journals (Sweden)

    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.

  18. 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

  19. 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.

  20. Predictive factors of local-regional recurrences following parotid sparing intensity modulated or 3D conformal radiotherapy for head and neck cancer

    International Nuclear Information System (INIS)

    Feng, Mary; Jabbari, Siavash; Lin, Alexander; Bradford, Carol R.; Chepeha, Douglas B.; Teknos, Theodoros N.; Worden, Francis P.; Tsien, Christina; Schipper, Matthew J.; Wolf, Gregory T.; Dawson, Laura A.; Eisbruch, Avraham

    2005-01-01

    Background and purpose: Predictive factors for local-regional (LR) failures after parotid-sparing, Intensity modulated (IMRT) or 3D conformal radiotherapy for head and neck (HN) cancers were assessed. Patients and methods: One hundred and fifty-eight patients with mostly stages III-IV HN squamous cell carcinoma underwent curative bilateral neck irradiation aimed at sparing the parotid glands. Patient, tumor, and treatment factors were analyzed as predictive factors for LR failure. Results: Twenty-three patients had LR recurrence (19 in-field and four marginal). No differences were found in the doses delivered to the PTVs of patients with or without in-field recurrences. In univariate analysis, tumor site was highly predictive for LR failure in both postoperative and definitive RT patients. In postoperative RT patients, pathologic tumor size, margin status, extracapsular extension (ECE) and number of lymph node metastases, were also significantly predictive. Multivariate analysis showed tumor site (oropharynx vs. other sites) to be a significant predictor in all patients, and involved margins and number of involved lymph nodes in postoperative patients. Conclusions: Clinical rather than dosimetric factors predicted for LR failures in this series, and were similar to those reported following standard RT. These factors may aid in the selection of patients for studies of treatment intensification using IMRT

  1. Salivary gland tumors of the parotid gland: CT and MR imaging findings with emphasis on intratumoral cystic components

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  2. Sci—Fri PM: Topics — 06: The influence of regional dose sensitivity on salivary loss and recovery in the parotid gland

    Energy Technology Data Exchange (ETDEWEB)

    Clark, H [University of British Columbia, Vancouver, B.C. (Canada); BC Cancer Agency, Surrey, B.C. (Canada); BC Cancer Agency, Vancouver, B.C. (Canada); Thomas, S [BC Cancer Agency, Surrey, B.C. (Canada); Moiseenko, V [University of California San Diego, La Jolla, Ca (United States); Hovan, A; Wu, J [BC Cancer Agency, Vancouver, B.C. (Canada)

    2014-08-15

    Purpose: The Quantitative Analyses of Normal Tissue Effects in the Clinic (QUANTEC 2010) survey of radiation dose-volume effects on salivary gland function has called for improved understanding of intragland dose sensitivity and the effectiveness of partial sparing in salivary glands. Regional dose susceptibility of sagittally- and coronally-sub-segmented parotid gland has been studied. Specifically, we examine whether individual consideration of sub-segments leads to improved prediction of xerostomia compared with whole parotid mean dose. Methods: Data from 102 patients treated for head-and-neck cancers at the BC Cancer Agency were used in this study. Whole mouth stimulated saliva was collected before (baseline), three months, and one year after cessation of radiotherapy. Organ volumes were contoured using treatment planning CT images and sub-segmented into regional portions. Both non-parametric (local regression) and parametric (mean dose exponential fitting) methods were employed. A bootstrap technique was used for reliability estimation and cross-comparison. Results: Salivary loss is described well using non-parametric and mean dose models. Parametric fits suggest a significant distinction in dose response between medial-lateral and anterior-posterior aspects of the parotid (p<0.01). Least-squares and least-median squares estimates differ significantly (p<0.00001), indicating fits may be skewed by noise or outliers. Salivary recovery exhibits a weakly arched dose response: the highest recovery is seen at intermediate doses. Conclusions: Salivary function loss is strongly dose dependent. In contrast no useful dose dependence was observed for function recovery. Regional dose dependence was observed, but may have resulted from a bias in dose distributions.

  3. 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)

  4. 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

  5. Oncocytic carcinoma of parotid gland: a case report with clinical, immunohistochemical and ultrastructural features

    Directory of Open Access Journals (Sweden)

    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

  6. 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)

  7. 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

  8. Ultrasonic Nakagami-parameter characterization of parotid-gland injury following head-and-neck radiotherapy: A feasibility study of late toxicity

    Energy Technology Data Exchange (ETDEWEB)

    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.

  9. 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

  10. 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.

  11. Perfusion imaging of parotid gland tumours: usefulness of arterial spin labeling for differentiating Warthin's tumours

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  12. 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)

  13. The accuracy of fine-needle aspiration cytology for diagnosis of parotid gland masses: a clinicopathological study of 114 patients

    Directory of Open Access Journals (Sweden)

    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.

  14. 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.

  15. Cutaneous Carcinosarcoma with Metastasis to the Parotid Gland

    Directory of Open Access Journals (Sweden)

    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.

  16. Cutaneous Carcinosarcoma with Metastasis to the Parotid Gland

    OpenAIRE

    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.

  17. 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)

  18. CT findings of parotid gland tumors: benign versus malignant tumors

    International Nuclear Information System (INIS)

    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

  19. 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)

  20. 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.

  1. 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)

  2. 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.

  3. 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)

  4. 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)

  5. Mucoepidermoid carcinoma in a salivary duct cyst of the parotid gland. Contribution to the development of tumours in salivary gland cysts.

    Science.gov (United States)

    Seifert, G

    1996-12-01

    Concerning the hypothesis that distinct types of salivary gland cysts may be the starting point of a salivary gland tumour, a histological examination of 1,661 salivary gland cysts was performed in order to analyse the cell types and their proliferative activity. Epithelial alterations were found especially in salivary duct cysts of parotid gland and in mucous retention cysts of minor salivary glands. Characteristic cellular changes were epithelial metaplasias (goblet cells, clear cells, squamous cells) and focal epithelial proliferations with plump or papillary plaques projecting into the cyst lumen. Only in one case had a mucoepidermoid carcinoma developed in the wall of a parotid duct cyst. The epithelial metaplasia and focal proliferative activity in salivary duct cysts is comparable to similar alterations in odontogenic cysts as possible early manifestation of a tumour, especially of an ameloblastoma or mucoepidermoid carcinoma. The differential diagnosis of salivary duct cysts must take primarily cystadenomas and cystic mucoepidermoid carcinomas of well-differentiated type into account.

  6. 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

  7. Sparing of contralateral major salivary glands has a significant effect on oral health in patients treated with radical radiotherapy of head and neck tumors

    International Nuclear Information System (INIS)

    Beer, K.T.; Greiner, R.H.; Zehnder, D.; Lussi, A.

    2002-01-01

    Background: Has a conscious exclusion of the contralateral major salivary glands (parotid, submandibular, and sublingual glands) a significant impact on the milieu of the oral cavity (saliva flow, pH, buffer capacity, and colonisation with Streptococcus mutans) in patients with ENT tumors receiving radical radiotherapy? Patients and Methods: 20 consecutive consentient patients with ENT tumors were evaluated once before, weekly during, and 6 weeks after the end of treatment in regard to saliva flow, pH, buffer capacity, and colonisation with Streptococcus mutans. In 13 patients the major salivary glands on both sides were included in the treated volume, in seven patients the treatment portals excluded consciously the contralateral major salivary glands. Results: The stimulated saliva flow decreases already during the 1st week of radiotherapy, the decrease follows the dose exponentially; the saliva flow is further reduced in the weeks after the end of treatment. The effect is less pronounced in patients with sparing of contralateral major salivary glands. The majority of patients with unilateral sparing of the major salivary glands retain the baseline value of buffer capacity, whereas buffer capacity of all patients with inclusion of all major salivary glands is markedly reduced with 20 Gy already, without signs of recovery when treatment has stopped. With unilateral salivary gland sparing the pH always remains basic, in bilaterally irradiated patients the pH changes from a mean of 7.3 to 5.8 during treatment. The colonisation with Streptococcus mutans varies little in both groups during the radiotherapy; after the end of therapy, it is higher in bilaterally irradiated patients. Conclusions: The conscious arrangement of irradiation portals in order to spare contralateral major salivary glands in patients with radical radiotherapy of ENT tumors has a significant influence on the oral environment: the stimulated saliva flow is higher, the buffer capacity retains the

  8. Multiple Myopericytoma of the Face and Parotid Gland

    Directory of Open Access Journals (Sweden)

    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.

  9. Primary unclassified sarcoma of the parotid gland: a case of diagnostic and therapeutic challenge.

    Science.gov (United States)

    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.

  10. Giant lipoma arising from deep lobe of the parotid gland

    Directory of Open Access Journals (Sweden)

    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.

  11. 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

  12. Noninvasive carcinoma ex pleomorphic adenoma of the parotid gland: A difficult diagnosis on fine needle aspiration

    Directory of Open Access Journals (Sweden)

    Theresa Scognamiglio

    2015-01-01

    Full Text Available Carcinoma ex pleomorphic adenoma (CXPA is a rare epithelial malignancy that arises from a primary or recurrent pleomorphic adenoma (PA. It may be noninvasive (NI or invasive. NI CXPA is extremely rare. Preoperative diagnosis on fine needle aspiration (FNA of CXPA may be difficult and poses a diagnostic challenge to clinicians and pathologists. Herein, we describe the FNA findings of a case of NI-CXPA. A 69-year-old woman presented with rapid enlargement of a stable parotid mass of 25 years. Cytologically, malignant cells were focally associated with metachromatic fibromyxoid matrix that was homogeneous and dense with a vague fibrillary quality. There were cell groups, papillary-like clusters and single malignant cells. The nuclei were pleomorphic with irregularly dispersed chromatin, and the cytoplasm was ill-defined and granular. Nucleoli were small to inconspicuous. Mitoses and necrosis were not seen. Cytological features were not specific for any type of salivary gland carcinoma. The FNA diagnosis was primary high-grade adenocarcinoma of the parotid gland, not otherwise specified. Facial nerve-sparing total parotidectomy was performed, which histologically showed PA interspersed with ducts and nests composed of pleomorphic atypical nuclei surrounded by extensive hyalinization. Single cells were also noted. No capsular infiltration was seen in the entirely sampled tumor. Immunohistochemistry for Ki-67 showed a higher proliferation rate in the malignant ducts and p63 positive cells focally surrounded some of the malignant ducts. Histological diagnosis was NI-CXPA. Accurate diagnosis is important for proper surgical management; however, the preoperative diagnosis of NI-CXPA is difficult to make on FNA.

  13. Noninvasive carcinoma ex pleomorphic adenoma of the parotid gland: A difficult diagnosis on fine needle aspiration

    Science.gov (United States)

    Scognamiglio, Theresa; Joshi, Rohan; Kuhel, William I.; Tabbara, Sana O.; Rezaei, M. Katayoon; Hoda, Rana S.

    2015-01-01

    Carcinoma ex pleomorphic adenoma (CXPA) is a rare epithelial malignancy that arises from a primary or recurrent pleomorphic adenoma (PA). It may be noninvasive (NI) or invasive. NI CXPA is extremely rare. Preoperative diagnosis on fine needle aspiration (FNA) of CXPA may be difficult and poses a diagnostic challenge to clinicians and pathologists. Herein, we describe the FNA findings of a case of NI-CXPA. A 69-year-old woman presented with rapid enlargement of a stable parotid mass of 25 years. Cytologically, malignant cells were focally associated with metachromatic fibromyxoid matrix that was homogeneous and dense with a vague fibrillary quality. There were cell groups, papillary-like clusters and single malignant cells. The nuclei were pleomorphic with irregularly dispersed chromatin, and the cytoplasm was ill-defined and granular. Nucleoli were small to inconspicuous. Mitoses and necrosis were not seen. Cytological features were not specific for any type of salivary gland carcinoma. The FNA diagnosis was primary high-grade adenocarcinoma of the parotid gland, not otherwise specified. Facial nerve-sparing total parotidectomy was performed, which histologically showed PA interspersed with ducts and nests composed of pleomorphic atypical nuclei surrounded by extensive hyalinization. Single cells were also noted. No capsular infiltration was seen in the entirely sampled tumor. Immunohistochemistry for Ki-67 showed a higher proliferation rate in the malignant ducts and p63 positive cells focally surrounded some of the malignant ducts. Histological diagnosis was NI-CXPA. Accurate diagnosis is important for proper surgical management; however, the preoperative diagnosis of NI-CXPA is difficult to make on FNA. PMID:25972908

  14. 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.

  15. 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)

  16. 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

  17. [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.

  18. 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

  19. 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)

  20. 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

  1. Correlation between intravoxel incoherent motion MR parameters and MR nodular grade of parotid glands in patients with Sjögren’s syndrome: A pilot study

    Energy Technology Data Exchange (ETDEWEB)

    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

  2. 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.

  3. Patterns of local-regional recurrence following parotid-sparing conformal and segmental intensity-modulated radiotherapy for head and neck cancer

    International Nuclear Information System (INIS)

    Dawson, Laura A.; Anzai, Yoshimi; Marsh, Lon; Martel, Mary K.; Paulino, Augusto; Ship, Jonathan A.; Eisbruch, Avraham

    2000-01-01

    Purpose: To analyze the patterns of local-regional recurrence in patients with head and neck cancer treated with parotid-sparing conformal and segmental intensity-modulated radiotherapy (IMRT). Methods and Materials: Fifty-eight patients with head and neck cancer were treated with bilateral neck radiation (RT) using conformal or segmental IMRT techniques, while sparing a substantial portion of one parotid gland. The targets for CT-based RT planning included the gross tumor volume (GTV) (primary tumor and lymph node metastases) and the clinical target volume (CTV) (postoperative tumor bed, expansions of the GTVs and lymph node groups at risk of subclinical disease). Lymph node targets at risk of subclinical disease included the bilateral jugulodigastric and lower jugular lymph nodes, bilateral retropharyngeal lymph nodes at risk, and high jugular nodes at the base of skull in the side of the neck at highest risk (containing clinical neck metastases and/or ipsilateral to the primary tumor). The CTVs were expanded by 5 mm to yield planning target volumes (PTVs). Planning goals included coverage of all PTVs (with a minimum of 95% of the prescribed dose) and sparing of a substantial portion of the parotid gland in the side of the neck at less risk. The median RT doses to the gross tumor, the operative bed, and the subclinical disease PTVs were 70.4 Gy, 61.2 Gy, and 50.4 Gy respectively. All recurrences were defined on CT scans obtained at the time of recurrence, transferred to the pretreatment CT dataset used for RT planning, and analyzed using dose-volume histograms. The recurrences were classified as 1) 'in-field', in which 95% or more of the recurrence volume (V recur ) was within the 95% isodose; 2) 'marginal', in which 20% to 95% of V recur was within the 95% isodose; or 3) 'outside', in which less than 20% of V recur was within the 95% isodose. Results: With a median follow-up of 27 months (range 6 to 60 months), 10 regional recurrences, 5 local recurrences

  4. Patterns of local-regional recurrence following parotid-sparing conformal and segmental intensity-modulated radiotherapy for head and neck cancer.

    Science.gov (United States)

    Dawson, L A; Anzai, Y; Marsh, L; Martel, M K; Paulino, A; Ship, J A; Eisbruch, A

    2000-03-15

    To analyze the patterns of local-regional recurrence in patients with head and neck cancer treated with parotid-sparing conformal and segmental intensity-modulated radiotherapy (IMRT). Fifty-eight patients with head and neck cancer were treated with bilateral neck radiation (RT) using conformal or segmental IMRT techniques, while sparing a substantial portion of one parotid gland. The targets for CT-based RT planning included the gross tumor volume (GTV) (primary tumor and lymph node metastases) and the clinical target volume (CTV) (postoperative tumor bed, expansions of the GTVs and lymph node groups at risk of subclinical disease). Lymph node targets at risk of subclinical disease included the bilateral jugulodigastric and lower jugular lymph nodes, bilateral retropharyngeal lymph nodes at risk, and high jugular nodes at the base of skull in the side of the neck at highest risk (containing clinical neck metastases and/or ipsilateral to the primary tumor). The CTVs were expanded by 5 mm to yield planning target volumes (PTVs). Planning goals included coverage of all PTVs (with a minimum of 95% of the prescribed dose) and sparing of a substantial portion of the parotid gland in the side of the neck at less risk. The median RT doses to the gross tumor, the operative bed, and the subclinical disease PTVs were 70.4 Gy, 61.2 Gy, and 50.4 Gy respectively. All recurrences were defined on CT scans obtained at the time of recurrence, transferred to the pretreatment CT dataset used for RT planning, and analyzed using dose-volume histograms. The recurrences were classified as 1) "in-field," in which 95% or more of the recurrence volume (V(recur)) was within the 95% isodose; 2) "marginal," in which 20% to 95% of V(recur) was within the 95% isodose; or 3) "outside," in which less than 20% of V(recur) was within the 95% isodose. With a median follow-up of 27 months (range 6 to 60 months), 10 regional recurrences, 5 local recurrences (including one noninvasive recurrence) and 1

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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.

  10. 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.

  11. 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.

  12. 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)

  13. Parotid hybrid tumor

    International Nuclear Information System (INIS)

    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

  14. Magnetic Resonance of Parotid and Submandibular Salivary Glands

    Directory of Open Access Journals (Sweden)

    María Cristina HERNÁNDEZ-RODRÍGUEZ

    2017-05-01

    Full Text Available Introduction and objective: Salivary glands are divided in major and minor, including tissue distributed by the upper airway. There are numerous entities which can affect these structures conditioning various types of pathology. Given the greater importance of the submandibular and parotid gland, this article focuses on their study. Method: A retrospective review of patients underwent MRI studies with known or suspected pathology of salivary glands was made, over five years (2011-2015, assuming a total of 123 patients. Results: Magnetic resonance imaging (MRI identified pathology in most patients, including inflammatory and infectious disorders, benign and malignant neoplasms and even autoimmune disease. Conclusions: Through these studies performed in our Hospital it was possible to get a complete vision of the glandular anatomy and pathology in most cases, including long-term monitoring of patients with known disease, optimizing scans by using fat saturation sequences and dynamic contrast-enhanced imaging, with the added advantage of the absence of ionizing radiation. However, in some cases it was not possible to reach an accurate diagnostic imaging and biopsy was necessary.

  15. 11C-methionine PET, a novel method for measuring regional salivary gland function after radiotherapy of head and neck cancer

    International Nuclear Information System (INIS)

    Buus, Simon; Grau, Cai; Munk, Ole Lajord; Bender, Dirk; Jensen, Kenneth; Keiding, Susanne

    2004-01-01

    Background and purpose: Loss of salivary gland function is a distressing side-effect of radiotherapy (RT) for head and neck cancer. The aim of this study was to develop a positron emission tomography (PET) method for measuring regional salivary gland function in the major salivary glands irradiated during RT. Patients and methods: Eight head and neck cancer patients were included; two were examined before RT and six after parotid sparing RT. Patients were examined by dynamic 11 C-methionine PET of the major salivary glands and parotid gland salivary flow measurements. PET data were analysed using a kinetic model of salivary gland 11 C-methionine metabolism, in which salivary gland function was quantified by the net metabolic clearance of 11 C-methionine, K. Functional voxel-wise images of K were calculated and matched with the CT-dose-plan for comparing regional salivary gland function with the regional radiation dose. Results: Parotid gland K correlated positively with parotid gland salivary flow, indicating that K can be used as an index of salivary gland function. K of parotid and submandibular glands was reduced dependent on the median radiation dose. In one patient, receiving a heterogeneous radiation dose to the parotid glands, regional salivary gland function was inversely correlated to the regional radiation dose. Conclusions: Salivary gland function can be measured by dynamic 11 C-methionine PET. The net metabolic clearance of 11 C-methionine of salivary glands was reduced dependent on the radiation dose. Dynamic 11 C-methionine PET offers a method for studying the individual response of the major salivary glands to irradiation

  16. Unique cellular structures in the parotid gland of an Old world fruit bat, Pteropus lylei (Lyle's flying fox).

    Science.gov (United States)

    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.

  17. Impact of head and neck cancer adaptive radiotherapy to spare the parotid glands and decrease the risk of xerostomia

    International Nuclear Information System (INIS)

    Castelli, Joel; Simon, Antoine; Louvel, Guillaume; Henry, Olivier; Chajon, Enrique; Nassef, Mohamed; Haigron, Pascal; Cazoulat, Guillaume; Ospina, Juan David; Jegoux, Franck; Benezery, Karen; Crevoisier, Renaud de

    2015-01-01

    Large anatomical variations occur during the course of intensity-modulated radiation therapy (IMRT) for locally advanced head and neck cancer (LAHNC). The risks are therefore a parotid glands (PG) overdose and a xerostomia increase. The purposes of the study were to estimate: - the PG overdose and the xerostomia risk increase during a “standard” IMRT (IMRT std ); - the benefits of an adaptive IMRT (ART) with weekly replanning to spare the PGs and limit the risk of xerostomia. Fifteen patients received radical IMRT (70 Gy) for LAHNC. Weekly CTs were used to estimate the dose distributions delivered during the treatment, corresponding either to the initial planning (IMRT std ) or to weekly replanning (ART). PGs dose were recalculated at the fraction, from the weekly CTs. PG cumulated doses were then estimated using deformable image registration. The following PG doses were compared: pre-treatment planned dose, per-treatment IMRT std and ART. The corresponding estimated risks of xerostomia were also compared. Correlations between anatomical markers and dose differences were searched. Compared to the initial planning, a PG overdose was observed during IMRT std for 59% of the PGs, with an average increase of 3.7 Gy (10.0 Gy maximum) for the mean dose, and of 8.2% (23.9% maximum) for the risk of xerostomia. Compared to the initial planning, weekly replanning reduced the PG mean dose for all the patients (p < 0.05). In the overirradiated PG group, weekly replanning reduced the mean dose by 5.1 Gy (12.2 Gy maximum) and the absolute risk of xerostomia by 11% (p < 0.01) (30% maximum). The PG overdose and the dosimetric benefit of replanning increased with the tumor shrinkage and the neck thickness reduction (p < 0.001). During the course of LAHNC IMRT, around 60% of the PGs are overdosed of 4 Gy. Weekly replanning decreased the PG mean dose by 5 Gy, and therefore by 11% the xerostomia risk

  18. {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.)

  19. 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)

  20. Dose-Effect Relationships for the Submandibular Salivary Glands and Implications for Their Sparing by Intensity Modulated Radiotherapy

    International Nuclear Information System (INIS)

    Murdoch-Kinch, Carol-Anne; Kim, Hyugnjin M.; Vineberg, Karen A.; Ship, Jonathan; Eisbruch, Avraham

    2008-01-01

    Purpose: Submandibular salivary glands (SMGs) dysfunction contributes to xerostomia after radiotherapy (RT) of head-and-neck (HN) cancer. We assessed SMG dose-response relationships and their implications for sparing these glands by intensity-modulated radiotherapy (IMRT). Methods and Materials: A total of 148 HN cancer patients underwent unstimulated and stimulated SMG salivary flow rate measurements selectively from Wharton's duct orifices, before RT and periodically through 24 months after RT. Correlations of flow rates and mean SMG doses were modeled throughout all time points. IMRT replanning in 8 patients whose contralateral level I was not a target incorporated the results in a new cost function aiming to spare contralateral SMGs. Results: Stimulated SMG flow rates decreased exponentially by (1.2%) Gy as mean doses increased up to 39 Gy threshold, and then plateaued near zero. At mean doses ≤39 Gy, but not higher, flow rates recovered over time at 2.2%/month. Similarly, the unstimulated salivary flow rates decreased exponentially by (3%) Gy as mean dose increased and recovered over time if mean dose was <39 Gy. IMRT replanning reduced mean contralateral SMG dose by average 12 Gy, achieving ≤39 Gy in 5 of 8 patients, without target underdosing, increasing the mean doses to the parotid glands and swallowing structures by average 2-3 Gy. Conclusions: SMG salivary flow rates depended on mean dose with recovery over time up to a threshold of 39 Gy. Substantial SMG dose reduction to below this threshold and without target underdosing is feasible in some patients, at the expense of modestly higher doses to some other organs

  1. Does cell phone use increase the chances of parotid gland tumor development? A systematic review and meta-analysis.

    Science.gov (United States)

    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.

  2. 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

  3. Automated Segmentation of the Parotid Gland Based on Atlas Registration and Machine Learning: A Longitudinal MRI Study in Head-and-Neck Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    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

  4. 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.

  5. Function of the parotid gland in juvenile recurrent parotitis: a case series.

    Science.gov (United States)

    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.

  6. 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

  7. The QUANTEC criteria for parotid gland dose and their efficacy to prevent moderate to severe patient-rated xerostomia.

    Science.gov (United States)

    Beetz, Ivo; Steenbakkers, Roel J H M; Chouvalova, Olga; Leemans, Charles R; Doornaert, Patricia; van der Laan, Bernard F A M; Christianen, Miranda E M C; Vissink, Arjan; Bijl, Henk P; van Luijk, Peter; Langendijk, Johannes A

    2014-05-01

    Recently, the Quantitative Analysis of Normal Tissue Effect in the Clinic (QUANTEC) Group defined dose-volume constraints for the parotid glands to avoid severe xerostomia. The aim of this study was to determine if application of these QUANTEC criteria also protected against moderate-to-severe patient-rated xerostomia. The study population consisted of 307 head and neck cancer patients treated with primary (chemo)radiotherapy, either with 3D-CRT (56%) or with IMRT (44%). All patients participated in a standard follow-up program in which radiation-induced toxicity and quality of life were prospectively assessed. Patients who met the QUANTEC criteria were classified as low risk and otherwise as high risk. In total, 41% of the patients (treated with 3D-CRT and IMRT) were classified as low risk patients. In the group treated with 3D-CRT and IMRT, it was possible to meet the QUANTEC criteria in 47% and 32% of the patients, respectively. Sparing the parotid glands with IMRT was considerably more difficult in patients with lymph node metastases and in patients with nasopharyngeal and oropharyngeal tumours. Low risk patients reported significantly less moderate-to-severe xerostomia than high risk patients. However, the predicted risk of elderly patients and patients with pre-existing minor patient-rated xerostomia at baseline was > 20%, even when the QUANTEC criteria were met. Significantly lower rates of radiation-induced patient-rated xerostomia were found among low risk patients treated according to the QUANTEC criteria, but these criteria do not completely protect against xerostomia. Particularly in elderly patients and patients already suffering from minor xerostomia at baseline, the QUANTEC criteria do not sufficiently protect against persistent, moderate-to-severe patient-rated xerostomia.

  8. 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

  9. Target cell and mode of radiation injury in rhesus salivary glands

    International Nuclear Information System (INIS)

    Stephens, L.C.; Kian Ang, K.; Schultheiss, T.E.; King, G.K.; Brock, W.A.; Peters, L.J.

    1986-01-01

    Morphological alterations of parotid and submandibular salivary glands of rhesus monkeys were studied 1-72 h and 16-40 weeks postirradiation (PI) with single photon doses of 2.5-15.0 Gy, or 10.2 Gy given in 6 fractions. Acute degeneration and necrosis of serous cells in both parotid and submandibular glands were clearly expressed by 24 h PI and occurred in a dose-related fashion. In submandibular glands, doses of 12.5 or 15.0 Gy damaged mucous cells, but to a considerably lesser extent than the serous cells in the same glands. No significant sparing was evident with dose fractionation. These observations demonstrate the unique sensitivity of serous cells which appear to undergo interphase cell death after irradiation. The results also show that late atrophy was the direct result of acute loss of serous acini and reflects a lack of regeneration of acinar cells receiving acute injury. (Auth.)

  10. Prognostic value of proliferating cell nuclear antigen in parotid gland cancer.

    Science.gov (United States)

    Stenner, Markus; Demgensky, Ariane; Molls, Christoph; Hardt, Aline; Luers, Jan C; Grosheva, Maria; Huebbers, Christian U; Klussmann, Jens P

    2012-04-01

    Although cell proliferation is related to tumour aggressiveness and prognosis, there are few studies describing the expression of proliferative markers in salivary gland cancer. Our aim was to assess the long-term prognostic value of the proliferating cell nuclear antigen (PCNA) in a large group of histologically different salivary gland cancers. We analysed the expression of PCNA in 159 patients with parotid gland cancer by means of immunohistochemistry. The mean follow-up time was 56.6 months. A high expression of PCNA showed a significant correlation to the patients' pathological lymph node stage (p = 0.004). A high PCNA expression significantly indicated a poor 5-year disease-free (p = 0.046) and overall survival rate (p = 0.018). The PCNA expression was the only prognostic factor for a worse 5-year disease-free and overall survival in acinic cell carcinomas (p = 0.004, p = 0.022). The correlation between PCNA expression and survival probabilities of salivary gland cancer might make proliferation markers helpful tools in patient follow-up, prognosis and targeted therapy in salivary gland cancer in future.

  11. Monitoring Dosimetric Impact of Weight Loss With Kilovoltage (KV) Cone Beam CT (CBCT) During Parotid-Sparing IMRT and Concurrent Chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    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

  12. Unilateral Duplication Of Parotid Duct. A Rare Anatomical Variation

    Directory of Open Access Journals (Sweden)

    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.

  13. 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

  14. 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.)

  15. Effects of large pressure amplitude low frequency noise in the parotid gland perivasculo-ductal connective tissue.

    Science.gov (United States)

    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.

  16. 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

  17. The effects of antidepressants and pilocarpine on rat parotid glands: an immunohistochemical study

    Directory of Open Access Journals (Sweden)

    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.

  18. 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

  19. 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

  20. 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.

  1. 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.

  2. Allometric and radioautographic study on developing parotid gland of the golden hamster at early postnatat period

    Energy Technology Data Exchange (ETDEWEB)

    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.).

  3. Parotid Glands Dose–Effect Relationships Based on Their Actually Delivered Doses: Implications for Adaptive Replanning in Radiation Therapy of Head-and-Neck Cancer

    Energy Technology Data Exchange (ETDEWEB)

    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

  4. 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

  5. Renal Cell Carcinoma Metastasis to Ipsilateral Parotid and Submandibular Glands: Report of a Case with Sonoelastographic Findings

    International Nuclear Information System (INIS)

    Balaban, Mehtap; Dogruyol, Sureyya Vudali; Idilman, Ilkay S.; Unal, Ozlem; Ipek, Ali

    2016-01-01

    Renal cell carcinoma (RCC) – also known as hypernephroma or grawitz tumor – accounts for 3% of the adulthood malignancies. Approximately 30–40% of the patients have metastasis at the time of the diagnosis and most common sites for metastasis are lung, regional lymph nodes, bone and liver. A total of 8–14% of the patients with RCC has head and neck metastasis. However, metastasis to major salivary glands is rarely seen. In this paper, we aimed to report a RCC case with metastasis to parotid and submandibular glands that has the same sonographic and sonoelastographic findings with the primary tumor. 66-year old woman with RCC history was referred to our radiology department for neck ultrasound (US) with painful swelling in the right parotid gland region. A well-defined, 37×21 mm sized hypoechoic heterogeneous solid mass was detected in the superficial-deep lobe of the right parotid gland. The mass was prominently hypervascular in color Doppler ultrasonography scan. Coincidentally, a 13×13 mm hypoechoic lobulated solid mass was detected in the right submandibular gland with similar sonographic findings. Real-time sonoelastography (SEL) was performed to the masses and both of them were blue-green colored that indicates hard tissue. An US and SEL evaluation was also performed to the renal mass (RCC) of the patient. The primary mass was also similar in sonographic and SEL appearance as salivary gland masses. In the patient history, she revealed chemotherapy-radiotherapy treatment 1.5 years ago due to inoperable mass in the mid-lower pole of the left kidney diagnosed as clear cell RCC with vascular invasion, liver, lung and brain metastasis. Because of known primary tumor, the masses in the salivary glands were suspected to be metastatic and a tru-cut biopsy was performed. Pathological result was reported as clear cell RCC metastasis. The etiology of RCC is still unknown and metastatic involvement can be seen at unexpected tissue and organs. Metastatic disease

  6. 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

  7. 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.

    Science.gov (United States)

    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.

  8. Potential Benefits of Scanned Intensity-Modulated Proton Therapy Versus Advanced Photon Therapy With Regard to Sparing of the Salivary Glands in Oropharyngeal Cancer

    International Nuclear Information System (INIS)

    Water, Tara A. van de; Lomax, Antony J.; Bijl, Hendrik P.; Jong, Marije E. de; Schilstra, Cornelis; Hug, Eugen B.; Langendijk, Johannes A.

    2011-01-01

    Purpose: To test the hypothesis that scanned intensity-modulated proton therapy (IMPT) results in a significant dose reduction to the parotid and submandibular glands as compared with intensity-modulated radiotherapy with photons (IMRT) and three-dimensional conformal radiotherapy (3D-CRT) for oropharyngeal cancer. In addition, we investigated whether the achieved dose reductions would theoretically translate into a reduction of salivary dysfunction and xerostomia. Methods and Materials: Ten patients with N0 oropharyngeal carcinoma were used. The intensity-modulated plans delivered simultaneously 70 Gy to the boost planning target volume (PTV2) and 54 Gy to the elective nodal areas (PTV1). The 3D-CRT technique delivered sequentially 70 Gy and 46 Gy to PTV2 and PTV1, respectively. Normal tissue complication probabilities were calculated for salivary dysfunction and xerostomia. Results: Planning target volume coverage results were similar for IMPT and IMRT. Intensity-modulated proton therapy clearly improved the conformity. The 3D-CRT results were inferior to these results. The mean dose to the parotid glands by 3D-CRT (50.8 Gy), IMRT (25.5 Gy), and IMPT (16.8 Gy) differed significantly. For the submandibular glands no significant differences between IMRT and IMPT were found. The dose reductions obtained with IMPT theoretically translated into a significant reduction in normal tissue complication probability. Conclusion: Compared with IMRT and 3D-CRT, IMPT improved sparing of the organs at risk, while keeping similar target coverage results. The dose reductions obtained with IMPT vs. IMRT and 3D-CRT varied widely per individual patient. Intensity-modulated proton therapy theoretically translated into a clinical benefit for most cases, but this requires clinical validation.

  9. 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

  10. 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)

  11. Benign lymphoepithelial lesion of the parotid gland in AIDS patients: CT characteristics

    International Nuclear Information System (INIS)

    Holiday, R.A.; Cohen, W.A.; Schinella, R.A.; Rothstein, S.G.; Persky, M.S.; Jacobs, J.M.

    1987-01-01

    Contrast agent-enhanced CT scans in nine male patients with histologically proved benign lymphoepithelial lesions of the perotid gland were reviewed. All scans showed cystic-appearing masses with peripheral rim enhancement corresponding to the macroscopic appearance of the lesion. Five patients were seropositive for human immunodeficiency virus (HIV) infection or had infections seen in acquired immunodeficiency syndrome. Three patients were members of high-risk groups. Only one patient had symptoms of the SICCA syndrome. Once a rare cause of parotid gland enlargement, benign lymphoepithelial lesions have recently been seen with increasing frequency in patients with HIV infection. Although the CT appearance is not pathognomic, correlation results of aspiration cytology and with clinical history can lead to a preoperative diagnosis of a benign lymphoepithelial lesion

  12. Influence of Handheld Mobiles on Parotid: A Cohort Study

    Directory of Open Access Journals (Sweden)

    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.

  13. Discovery and prevalidation of salivary extracellular microRNA biomarkers panel for the noninvasive detection of benign and malignant parotid gland tumors

    NARCIS (Netherlands)

    Matse, J.H.; Yoshizawa, J.; Wang, X.; Elashoff, D.; Bolscher, J.G.M.; Veerman, E.C.I.; Bloemena, E.; Wong, D.T.W.

    2013-01-01

    Purpose: This study was conducted to explore the differences in salivary microRNA (miRNA) profiles between patients with malignant or benign parotid gland tumors as a potential preoperative diagnostic tool of tumors in the salivary glands. Experimental Design: Whole saliva samples from patients with

  14. 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

    Directory of Open Access Journals (Sweden)

    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.

  15. Comparison of doses received in the mandibular condyle, cochlea, and parotid gland in neuroaxial treatment

    Energy Technology Data Exchange (ETDEWEB)

    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)

  16. 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

  17. 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)

  18. 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.

  19. Leiomyosarcoma Ex Pleomorphic Adenoma of the Parotid Gland: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    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.

  20. 3D-conformal-intensity modulated radiotherapy with compensators for head and neck cancer: clinical results of normal tissue sparing

    Directory of Open Access Journals (Sweden)

    Koscielny Sven

    2006-06-01

    Full Text Available Abstract Background To investigate the potential of parotic gland sparing of intensity modulated radiotherapy (3D-c-IMRT performed with metallic compensators for head and neck cancer in a clinical series by analysis of dose distributions and clinical measures. Materials and methods 39 patients with squamous cell cancer of the head and neck irradiated using 3D-c-IMRT were evaluable for dose distribution within PTVs and at one parotid gland and 38 patients for toxicity analysis. 10 patients were treated primarily, 29 postoperatively, 19 received concomittant cis-platin based chemotherapy, 20 3D-c-IMRT alone. Initially the dose distribution was calculated with Helax ® and photon fluence was modulated using metallic compensators made of tin-granulate (n = 22. Later the dose distribution was calculated with KonRad ® and fluence was modified by MCP 96 alloy compensators (n = 17. Gross tumor/tumor bed (PTV 1 was irradiated up to 60–70 Gy, [5 fractions/week, single fraction dose: 2.0–2.2 (simultaneously integrated boost], adjuvantly irradiated bilateral cervical lymph nodes (PTV 2 with 48–54 Gy [single dose: 1.5–1.8]. Toxicity was scored according the RTOG scale and patient-reported xerostomia questionnaire (XQ. Results Mean of the median doses at the parotid glands to be spared was 25.9 (16.3–46.8 Gy, for tin graulate 26 Gy, for MCP alloy 24.2 Gy. Tin-granulate compensators resulted in a median parotid dose above 26 Gy in 10/22, MCP 96 alloy in 0/17 patients. Following acute toxicities were seen (°0–2/3: xerostomia: 87%/13%, dysphagia: 84%/16%, mucositis: 89%/11%, dermatitis: 100%/0%. No grade 4 reaction was encountered. During therapy the XQ forms showed °0–2/3: 88%/12%. 6 months postRT chronic xerostomia °0–2/3 was observed in 85%/15% of patients, none with °4 xerostomia. Conclusion 3D-c-IMRT using metallic compensators along with inverse calculation algorithm achieves sufficient parotid gland sparing in virtually all advanced

  1. Measurement by means of sup(99m)Tc-pertechnetate of the function of salivary glands before and after stimulation with pilocarpine in cases of sicca-syndrome of the parotidic glands

    International Nuclear Information System (INIS)

    Gelinsky, P.

    1979-01-01

    Judgement on xerostomia in systemic diseases of the salivary glands and on the sicca-syndrome as a side-effect of radiation therapy or of a treatment with psychopharmaca has been improved by the function test of the parotidic glands for each side individually with sup(99m)Tc-pertechnetate, particularly in view of the detection of lateral differences. Measurements of the salivation volume and activity are completive of the function test, yielding knowledge of the total excretory power of all the salivary glands. Functional remainders and reserves can be visualized objectively by additional utilization of the pilocarpine stimulation test (today performed with carbachol). The findings will be still more precise if the parotide salivation is collected and measured for each side separately. This exploration method is appropriate for frequent controls in the course of a disease and for the forming of an opinion upon therapeutic effects of sialogogic agents. (orig.) [de

  2. 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.

  3. 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

  4. Major salivary glands

    International Nuclear Information System (INIS)

    Mancuso, A.A.

    1985-01-01

    This chapter deals with two important features of treatment of malignant tumors of the parotid and submandibular gland: the lack of a satisfactory means of staging these lesions, and the all-important treatment considerations relative to the facial nerve in parotid gland malignancies. The imaging physician and the clinician should also consider that many suspected parotid mass lesions turn out to arise from structures extrinsic to the gland. The authors discuss in detail the sources of such mass lesions as well as how CT can be used to differentiate these from intrinsic lesions in the parotid and submandibular glands. Computed tomography and, perhaps in the near future, magnetic resonance imaging (MRI) will provide us with a means to diagnose these tumors earlier. This is especially true when studies are used in situations such as unexplained peripheral seventh nerve paralysis or in the early screening of patients with parotid or periparotid masses. Unfortunately, it is usually patient delay that leads to late diagnosis of palpable mass lesions in this region, and there is little that any imaging study can do to reduce this factor

  5. 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

    Energy Technology Data Exchange (ETDEWEB)

    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)

  6. 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.)

  7. Prognostic relevance of epithelial-mesenchymal transition and proliferation in surgically treated primary parotid gland cancer.

    Science.gov (United States)

    Busch, Alina; Bauer, Larissa; Wardelmann, Eva; Rudack, Claudia; Grünewald, Inga; Stenner, Markus

    2017-05-01

    Cancer of the major salivary glands comprises a morphologically diverse group of rare tumours of largely unknown cause. Epithelial-mesenchymal transition (EMT) has been shown to play a significant prognostic role in various human cancers. The aim was to assess the expression of EMT markers in different histological subtypes of parotid gland cancer (PGC) and analyse their prognostic value. We examined 94 PGC samples (13 histological subtypes) for the expression of MIB-1, epithelial cadherin (E-cadherin), β-catenin, vimentin and cytokeratin 8/18 (CK8/18) by means of immunohistochemistry. The experimental findings were correlated with clinicopathological and survival parameters. We detected all analysed EMT and proliferation markers in specifically different constellations within the examined histological subtypes of PGC. We found high epithelial marker expressions (CK8/18, E-cadherin, membranous β-catenin) only in a distinct variety of carcinomas. A high proliferation rate (high MIB-1 expression) as well as a combination of high CK8/18 and low vimentin expression was associated with a significantly worse survival. Our findings indicate that activation of the EMT pathway is a relevant explanation for tumour progression in individual histological subtypes of malignant parotid gland lesions, but by far not in all. Evidence of EMT activation in PGC cannot be seen as an isolated prognostic factor. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  8. VALIDITY OF CORE NEEDLE BIOPSY IN THE HISTOPATHOLOGICAL VERIFICATION OF PAROTID GLAND LESIONS

    Directory of Open Access Journals (Sweden)

    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.

  9. 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.

  10. Targeted next generation sequencing of parotid gland cancer uncovers genetic heterogeneity.

    Science.gov (United States)

    Grünewald, Inga; Vollbrecht, Claudia; Meinrath, Jeannine; Meyer, Moritz F; Heukamp, Lukas C; Drebber, Uta; Quaas, Alexander; Beutner, Dirk; Hüttenbrink, Karl-Bernd; Wardelmann, Eva; Hartmann, Wolfgang; Büttner, Reinhard; Odenthal, Margarete; Stenner, Markus

    2015-07-20

    Salivary gland cancer represents a heterogeneous group of malignant tumors. Due to their low incidence and the existence of multiple morphologically defined subtypes, these tumors are still poorly understood with regard to their molecular pathogenesis and therapeutically relevant genetic alterations.Performing a systematic and comprehensive study covering 13 subtypes of salivary gland cancer, next generation sequencing was done on 84 tissue samples of parotid gland cancer using multiplex PCR for enrichment of cancer related gene loci covering hotspots of 46 cancer genes.Mutations were identified in 22 different genes. The most frequent alterations affected TP53, followed by RAS genes, PIK3CA, SMAD4 and members of the ERB family. HRAS mutations accounted for more than 90% of RAS mutations, occurring especially in epithelial-myoepithelial carcinomas and salivary duct carcinomas. Additional mutations in PIK3CA also affected particularly epithelial-myoepithelial carcinomas and salivary duct carcinomas, occurring simultaneously with HRAS mutations in almost all cases, pointing to an unknown and therapeutically relevant molecular constellation. Interestingly, 14% of tumors revealed mutations in surface growth factor receptor genes including ALK, HER2, ERBB4, FGFR, cMET and RET, which might prove to be targetable by new therapeutic agents. 6% of tumors revealed mutations in SMAD4.In summary, our data provide novel insight into the fundamental molecular heterogeneity of salivary gland cancer, relevant in terms of tumor classification and the establishment of targeted therapeutic concepts.

  11. 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...

  12. 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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  13. Oxidative and antioxidative responses in submandibular and parotid glands of rats exposed to long-term extremely low frequency magnetic field

    Directory of Open Access Journals (Sweden)

    Mehmet Akdağ

    2014-06-01

    Full Text Available Background: Some epidemiologic and laboratory studies have suggested a possible associations between exposure to extremely low frequency magnetic field (ELF-MF and cancer. However, it is not known underlying mechanisms of this interaction. The aim of the study was to investigate the possible oxidative damage induced by long-term ELF-MF exposure on submandibular and parotis glands of rats. Methods: Rats in the experimental group were exposed to 100 and 500 µT ELF-MF (2 h/day, 7 days/week, for 10 months corresponding to exposure levels that are considered safe for humans. The same experimental procedures were applied to the sham group, but the ELF generator was turned off. The levels of catalase (CAT, malondialdehyde (MDA, myeloperoxidase (MPO, total antioxidative capacity (TAC, total oxidant status (TOS, and oxidative stress index (OSI were measured in rat submandibular and parotis gland. Results: Although some oxidative and antioxidative parameters of submandibular gland were altered by ELF-100 and ELF-500 exposure groups, these changes were not statistically significant ( p >0.05. However, a decrease observed in CAT levels of parotid gland in both the ELF-100 and ELF-500 exposure groups (p0.05. Conclusions: Our results showed that long-term ELF-MF exposure did not alter oxidative, antioxidative processes and lipid peroxidation in submandibular gland of rats. However, 100 µT and 500 µT ELF-MF exposure decreased CAT activity in parotid gland. J Clin Exp Invest 2014; 5 (2: 219-225

  14. Dose Measurements of Parotid Glands and Spinal Cord in Conventional Treatment of Nasopharyngeal Carcinoma Using RANDO Phantom and Thermoluminescent Dosimeters

    Directory of Open Access Journals (Sweden)

    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.

  15. 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

  16. Parotid Salivary Gland Basal Cell Adenocarcinoma in a Big-eared Opossum (Didelphis aurita).

    Science.gov (United States)

    Díaz-Delgado, J; Coimbra, A A C; Dos Santos-Cirqueira, C; Sanches, T C; Guerra, J M; de Oliveira, A S; Di Loretto, C; Zwarg, T; Ressio, R; Rivas, L; Sansone, M; Nagamori, F O; Kanamura, C; Gonçalves, P S; Fernandes, N C C A; Groch, K R; Catão-Dias, J L

    2018-02-01

    The opossum (family Didelphidae) is a marsupial endemic to the Americas. Apart from the South American short-tailed opossum (Monodelphis domestica) and the Virginia opossum (Didelphis virginiana), there is considerable lack of knowledge about the health and diseases of most opossum species. Among these, the big-eared opossum (Didelphis aurita) is found in Argentina, Brazil and Paraguay. Natural and experimental studies have shown this species to be susceptible to infectious agents with zoonotic potential and the animals may play a role in transmission of such agents. However, neoplasia appears to be uncommon in this species. We describe the gross, microscopical and immunohistochemical features of a parotid salivary gland basal cell adenocarcinoma in a free-living big-eared opossum. This case represents the first report of salivary gland neoplasia in opossums. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Parotid gland function during and following radiotherapy of malignancies in the head and neck

    International Nuclear Information System (INIS)

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

    1992-01-01

    Radiotherapy of tumours in the head and neck region usually involves the salivary glands in the treatment volume with ensuing dryness and discomfort. A prospective evaluation of the same patients was performed before, during radiotherapy and 6, 12 and 18 months after the end of treatment. All but one of the patients receiving doses less than 52 Gy showed a recovery of secretion beginning after 2 months with a continuous improvement of the salivary flow up to 18 months. Doses exceeding 64 Gy caused irreversibly depressed parotid function in the vast majority of glands. The subjective experience of discomfort with dry mouth was not at all correlated to the initial flow rate. Treatment with unilateral technique and doses below 52 Gy caused just no or slight dryness and 3 out of 4 patients with bilateral involvement of the glands displayed problem with subjective dryness even after 18 months. Doses over 64 Gy with one gland involved had only slight dryness, however, patients with both glands affected showed severe problems with dryness. There were relatively large interindividual differences with respect to salivary flow and discomfort of dryness. These patients need a careful dose planning and a close follow up with co-operation between radiotherapeutists and dentists. (author)

  18. Acinic cell carcinoma of parotid gland metastasis to left cavernous sinus: a case report and review of literature

    Directory of Open Access Journals (Sweden)

    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

  19. Treatment of eccrine porocarcinoma with metastasis to the parotid gland using intensity-modulated radiation therapy: a case report

    Directory of Open Access Journals (Sweden)

    Lentsch Eric J

    2010-05-01

    Full Text Available Abstract Introduction Cutaneous eccrine porocarcinomas are uncommon malignant tumors of the sweat gland. Case Presentation A 76-year-old Caucasian man presented to our hospital with a left temporal mass. We describe a case of eccrine porocarcinoma with metastasis to the parotid gland with special emphasis on the role of surgical resection and adjuvant radiation therapy. Conclusion Besides surgical resection, little is known about the role of adjuvant therapy in managing eccrine porocarcinomas. Radiation therapy should be considered within a multidisciplinary approach in patients with primary or recurrent eccrine porocarcinomas.

  20. 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.

  1. Clinical, histopathological and immunohistological study of lymphoid disorders in the parotid gland of patients with Sjögren's syndrome

    Directory of Open Access Journals (Sweden)

    Trenkić-Božinović Marija

    2009-01-01

    Full Text Available Bacground/Aim. Sjögren's syndrome is a chronic autoimmune systemic disease characterized by polyglandular tissue destruction, leading to keratoconjunctivitis sicca and xerostomia. These patients have 44-fold increased risk of developing salivary gland lymphoma, of which 80% are marginal zone (MALT type. Having in mind that criteria for distinguishing benign lymphoepithelial lesions from MALT lymphoma are obscure, the aim of this study was to provide practical information that could be integrated into diagnostic practice. Methods. Among 32 parotidectomies, 27 cases were identified as having benign lymphoepithelial disorders and 5 cases low grade MALT lymphoma. Histological sections were stained routinely with hematoxylin and eosin (H&E and special stains. Immunohistochemical study was performed by LSAB2 method, by using primary antibodies for CD20, CD3, Kappa and Lambda light chains and Cytokeratin (Dako Denmark. Results. The 27 patients with Sjögren's sialoadenitis (22 women and 5 men, and 5 patients with MALT lymphoma (only women were included in this analysis. According to the Ann Harbor Classification, all patients with MALT lymphoma had stage IE. Both groups of patients had an indolent clinical course, except permanent, rapid parotid enlargement in the patients with MALT lymphoma. Histologically, the periductal lymphoid infiltrate, gradually extended to the acini, completely replacing them by a sea of polyclonal lymphocytes, immunoblasts, germinal centers and plasma cells (confirmed immunohistochemically, but sparing the ducts and preserving lobular appearance. The histological feature of salivary gland MALT lymphoma included heterogeneous B-cell infiltrate that totally or subtotally had effaced the normal glandular structure. Malign lymphoepithelial lesions, representing infiltration of the ductal and epithelial structures by monoclonal neoplastic Bcells, positive for CD20, were highlighted by antibody to cytokeratin. Conclusion. The

  2. 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

  3. Comparison of different deep learning approaches for parotid gland segmentation from CT images

    Science.gov (United States)

    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.

  4. 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

  5. Dose–response analysis of parotid gland function: What is the best measure of xerostomia?

    International Nuclear Information System (INIS)

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

    2013-01-01

    Purpose: To describe the dose–response relationships for the different measures of salivary gland recovery following radical radiotherapy for locally advanced head and neck squamous cell cancers (LA-HNSCC). Methods and materials: Dosimetric analysis of data from the PARSPORT trial, a Phase III study of conventional RT (RT) and intensity modulated radiotherapy (IMRT) for LA-HNSCC was undertaken to determine the relationship between parotid gland mean dose and toxicity endpoints: high-grade subjective and objective xerostomia and xerostomia-related quality of life scores. LKB-NTCP parameters (TD50, m and n) were generated and tolerance doses (D50) reported using non-linear logistic regression analysis. Results: Data were available on 63 patients from the PARSPORT trial. Parotid saliva flow rate provided the strongest association between mean dose and recovery, D50 = 23.4 Gy (20.6–26.2) and k = 3.2 (1.9–4.5), R 2 = 0.85. Corresponding LKB parameters were TD50 = 26.3 Gy (95% CI: 24.0–30.1), m = 0.25 (0.18–1.0 and n = 1). LENTSOMA subjective xerostomia also demonstrated a strong association D50 = 33.3 Gy (26.7–39.8), k = 2.8 (91.4–4.4), R 2 = 0.77). Conclusion: We recommend using the LENT SOMA subjective xerostomia score to predict recovery of salivation due to its strong association with dosimetry and ease of recording

  6. Dose-response analysis of parotid gland function: what is the best measure of xerostomia?

    Science.gov (United States)

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

    2013-03-01

    To describe the dose-response relationships for the different measures of salivary gland recovery following radical radiotherapy for locally advanced head and neck squamous cell cancers (LA-HNSCC). Dosimetric analysis of data from the PARSPORT trial, a Phase III study of conventional RT (RT) and intensity modulated radiotherapy (IMRT) for LA-HNSCC was undertaken to determine the relationship between parotid gland mean dose and toxicity endpoints: high-grade subjective and objective xerostomia and xerostomia-related quality of life scores. LKB-NTCP parameters (TD50, m and n) were generated and tolerance doses (D50) reported using non-linear logistic regression analysis. Data were available on 63 patients from the PARSPORT trial. Parotid saliva flow rate provided the strongest association between mean dose and recovery, D50=23.4 Gy (20.6-26.2) and k=3.2 (1.9-4.5), R(2)=0.85. Corresponding LKB parameters were TD50=26.3 Gy (95% CI: 24.0-30.1), m=0.25 (0.18-1.0 and n=1). LENTSOMA subjective xerostomia also demonstrated a strong association D50=33.3 Gy (26.7-39.8), k=2.8 (91.4-4.4), R(2)=0.77). We recommend using the LENT SOMA subjective xerostomia score to predict recovery of salivation due to its strong association with dosimetry and ease of recording. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  7. Parotid gland tumors: a comparison of postoperative radiotherapy techniques using three dimensional (3-D) dose distributions and dose-volume histograms (DVH)

    International Nuclear Information System (INIS)

    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

  8. Conventional megavoltage radiotherapy in the management of malignant epithelial tumours of the parotid gland

    International Nuclear Information System (INIS)

    Piedbois, P.; Bataini, J.P.; Colin, P.; Jaulerry, C.; Brunin, F.; Pontvert, D.; Durand, J.C.

    1989-01-01

    This is an evaluation of definitive conventional megavoltage radiotherapy in a consecutive series of 35 patients presenting malignant epithelial tumours of the parotid gland. In this series, the 5-year actuarial locoregional control rate was 41% with a 5-year crude survival rate of 36%. The results are analyzed according to tumour presentation and tumour doses. Six of 15 patients with tumours larger than 6 cm have had a lasting locoregional control. During the same period 43 other patients received radiotherapy as a post-operative modality. Results obtained in this group confirm the previously published data. While recent studies tend to demonstrate the specific efficacy of high LET radiation in the management of locally advanced salivary gland tumours, radical conventional radiotherapy can still be employed with a curative intent when neutron facilities are not available. (author). 34 refs.; 1 fig.; 5 tabs

  9. Acute parotiditis after cesarean section; case report

    Directory of Open Access Journals (Sweden)

    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.

  10. 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

  11. 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

  12. Sialolipoma of parotid gland in a 1-year-old male child: A case report and review of literature.

    Science.gov (United States)

    Arakeri, Surekha Ulhas; Banga, Shilpi

    2018-01-01

    Sialolipoma is a recently described rare histological variant of lipoma, characterized by well-demarcated proliferation of mature adipocytes with secondary entrapment of salivary gland elements. Less than forty cases of sialolipoma have been reported in English literature. This tumor has been reported both in major and minor salivary glands, with the parotid gland being the most common site. Age incidence in this tumor varies from 0 month to 84 years. However, the occurrence of this tumor in an infant is very rare. In the published literature, the size of this tumor varied from 1 to 7 cm. In the present case, the tumor size was >7 cm. To the best of our knowledge, congenital sialolipoma >7 cm has been rarely reported earlier. Hence, this case is presented because of its rarity and unusual gross appearance.

  13. 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

  14. 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.

  15. [Epidemic parotiditis, a reportable disease].

    Science.gov (United States)

    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.

  16. 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.

  17. Differential Diagnosis of Parotid Lipoma in a Breast Ca Patient

    Directory of Open Access Journals (Sweden)

    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.

  18. Submandibular gland-sparing radiation therapy for locally advanced oropharyngeal squamous cell carcinoma: patterns of failure and xerostomia outcomes

    International Nuclear Information System (INIS)

    Gensheimer, Michael F; Liao, Jay J; Garden, Adam S; Laramore, George E; Parvathaneni, Upendra

    2014-01-01

    Saliva from submandibular glands (SMG) is necessary to minimize xerostomia. It is unclear whether SMG can be safely spared in patients undergoing bilateral neck radiotherapy for locally advanced oropharyngeal cancer without increasing the risk of marginal recurrence. We evaluated the outcomes of contralateral submandibular gland (cSMG) sparing intensity-modulated radiation therapy (IMRT). All patients with stage III/IV oropharyngeal squamous cell carcinoma treated with bilateral neck IMRT from 2006–2012 at our institution were included. Appropriately selected patients with favorable primary tumor characteristics and no definite contralateral neck disease were treated with cSMG-sparing IMRT. Patterns of failure and xerostomia outcomes were retrospectively analyzed. 114 patients were treated. 89% had stage IV disease and 89% received definitive radiation therapy. 76 patients (67%) received cSMG sparing IMRT. With a median follow-up of 30 months, there were 10 local, 9 regional, and 10 distant recurrences. 2-year overall survival was 86% and 2-year loco-regional control was 87%. In cSMG spared patients, the mean cSMG dose was 30.7 Gy. Late grade 2+ xerostomia was significantly reduced in the cSMG spared group compared to those without SMG sparing (6 months: 23% vs. 72%, 12 months: 6% vs. 41%, 24 months: 3% vs. 36%, all p < 0.0007). There were no peri-SMG marginal recurrences in the cSMG-spared cohort. cSMG sparing IMRT did not increase marginal failures in this series of locally advanced oropharyngeal SCC patients. Xerostomia was significantly reduced in cSMG spared patients

  19. 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

  20. Image analysis of microsialograms of the mouse parotid gland using digital image processing

    International Nuclear Information System (INIS)

    Yoshiura, K.; Ohki, M.; Yamada, N.

    1991-01-01

    The authors compared two digital-image feature-extraction methods for the analysis of microsialograms of the mouse parotid gland following either overfilling, experimentally induced acute sialoadenitis or irradiation. Microsialograms were digitized using a drum-scanning microdensitometer. The grey levels were then partitioned into four bands representing soft tissue, peripheral minor, middle-sized and major ducts, and run-length and histogram analysis of the digital images performed. Serial analysis of microsialograms during progressive filling showed that both methods depicted the structural characteristics of the ducts at each grey level. However, in the experimental groups, run-length analysis showed slight changes in the peripheral duct system more clearly. This method was therefore considered more effective than histogram analysis

  1. Expression of VEGF₁₆₅b, VEGFR1, VEGFR2 and CD34 in benign and malignant tumors of parotid glands.

    Science.gov (United States)

    Błochowiak, Katarzyna J; Sokalski, Jerzy; Bodnar, Magdalena B; Trzybulska, Dorota; Marszałek, Andrzej K; Witmanowski, Henryk

    2018-01-01

    Vascular endothelial growth factor (VEGF) is an angiogenic factor and could be involved in the pathogenesis of salivary gland tumors. VEGF exerts its biological function by binding to its receptors, VEGFR1 and VEGFR2. An alternative splice variant of VEGF (VEGFxxxb) is an anti-angiogenic factor. Binding VEGF165b with VEGFR2 results in an impaired angiogenic response. The imbalance of VEGFxxx and VEGFxxxb isoforms can underpin pathological angiogenesis. The purpose of this study was to evaluate and compare the expression of VEGF165b, VEGFR1, VEGFR2, and CD34 in benign and malignant parotid gland tumors and to explore the possible correlations between their expression and clinicopathological features of tumors. The study was performed on archived paraffin-embedded tissue samples derived from 70 patients with benign and malignant parotid gland tumors (25 with malignant tumors, 23 with pleomorphic adenoma and 22 with Warthin's tumor). Immunohistochemical staining of selected tissue sections was performed using monoclonal antibodies. Immunohistochemical staining of selected molecules was used for evaluation of their expression in tissue sections. There were no statistically significant differences in the expression of the selected proteins localized in the tumor and surgical margin taken from the same patient. Expression of VEGFR2 correlated with VEGF165b in mixed tumors. There was a statistically significant difference in the expression of VEGFR1 in malignant tumors between females and males, and between the expression of VEGFR1 and the score of T classification in malignant tumors. VEGF165b cannot be treated as a prognostic factor. VEGF receptors correlated with selected clinicopathological data of malignant tumors, indicating their possible role as a prognostic marker. The balance of VEGF isoforms have a limited influence on the development of parotid glands tumors. The correlation between VEGF165b and VEGFR2 in mixed tumors suggests the existence of an additional

  2. Exploratory study of long-term health-related quality of life in patients with surgically treated primary parotid gland cancer.

    Science.gov (United States)

    Stenner, Markus; Beenen, Franziska; Hahn, Moritz; Koopmann, Mario; Weiss, Daniel; Hüttenbrink, Karl-Bernd

    2016-01-01

    Health-related quality of life (HRQOL) has received more and more attention as an outcome in cancer therapy. In this exploratory study, we assessed the long-term HRQOL among 77 surgically treated patients with parotid gland cancer. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30-questions (EORTC-QLQ-C30) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 Head and Neck 35-questions (EORTC-QLQ-C30-H&N35) questionnaires were used in a cross-sectional design. The mean time-lag between initial diagnosis and completion of the questionnaire was 89.7 months. The HRQOL significantly increased with the time-lag to surgery and decreased with the patients' age. Factors with clinically significant effects in several areas of long-term HRQOL (ie, more than 4 scores) were age, type of neck dissection, preoperative facial nerve palsy, and postoperative radiation therapy. In parotid gland cancer surgery, factors, such as sex, age, type of surgery, facial nerve palsy, and radiation therapy, seem to be associated with clinically meaningful differences in long-term HRQOL scores. © 2015 Wiley Periodicals, Inc.

  3. 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.

  4. Sparing of contralateral major salivary glands has a significant effect on oral health in patients treated with radical radiotherapy of head and neck tumors

    Energy Technology Data Exchange (ETDEWEB)

    Beer, K.T.; Greiner, R.H. [Klinik fuer Radio-Onkologie, Univ. Bern, Inselspital (Switzerland); Zehnder, D.; Lussi, A. [Klinik fuer Zahnerhaltung, Kinder- und Praeventivmedizin, Univ. Bern, Inselspital (Switzerland)

    2002-12-01

    Background: Has a conscious exclusion of the contralateral major salivary glands (parotid, submandibular, and sublingual glands) a significant impact on the milieu of the oral cavity (saliva flow, pH, buffer capacity, and colonisation with Streptococcus mutans) in patients with ENT tumors receiving radical radiotherapy? Patients and Methods: 20 consecutive consentient patients with ENT tumors were evaluated once before, weekly during, and 6 weeks after the end of treatment in regard to saliva flow, pH, buffer capacity, and colonisation with Streptococcus mutans. In 13 patients the major salivary glands on both sides were included in the treated volume, in seven patients the treatment portals excluded consciously the contralateral major salivary glands. Results: The stimulated saliva flow decreases already during the 1st week of radiotherapy, the decrease follows the dose exponentially; the saliva flow is further reduced in the weeks after the end of treatment. The effect is less pronounced in patients with sparing of contralateral major salivary glands. The majority of patients with unilateral sparing of the major salivary glands retain the baseline value of buffer capacity, whereas buffer capacity of all patients with inclusion of all major salivary glands is markedly reduced with 20 Gy already, without signs of recovery when treatment has stopped. With unilateral salivary gland sparing the pH always remains basic, in bilaterally irradiated patients the pH changes from a mean of 7.3 to 5.8 during treatment. The colonisation with Streptococcus mutans varies little in both groups during the radiotherapy; after the end of therapy, it is higher in bilaterally irradiated patients. Conclusions: The conscious arrangement of irradiation portals in order to spare contralateral major salivary glands in patients with radical radiotherapy of ENT tumors has a significant influence on the oral environment: the stimulated saliva flow is higher, the buffer capacity retains the

  5. 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.)

  6. Effects of gender, age, and body mass index on fat contents and apparent diffusion coefficients in healthy parotid glands: an MRI evaluation

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  7. 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

  8. 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.

  9. Self-induced parapharyngeal and parotid emphysema: A case of pneumoparotitis

    Directory of Open Access Journals (Sweden)

    Javier González 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 Stensen’s 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 1–3 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

  10. 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)

  11. 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

  12. Linfoma tipo MALT de la glándula parótida Lymphoma type MALT of the parotid gland

    Directory of Open Access Journals (Sweden)

    Carlos Frómeta Neira

    2010-09-01

    Full Text Available Los linfomas tipo MALT (tejido linfoideo asociado a mucosa, constituyen la variedad más recientemente descubierta de los linfomas no Hodgkin, tienen lugar fundamentalmente en la mucosa gástrica asociados a infección por Helycobacter pylori, y en la glándula tiroides en relación con la tiroiditis de Hashimoto. Sin embargo, internacionalmente se han descrito casos en glándulas salivales asociados a linfoadenitis. La naturaleza de la lesión a menudo no puede ser determinada solo por el estudio citológico; se hace necesario el análisis histopatológico para el diagnóstico definitivo en la mayoría de los casos. El presente estudio muestra un paciente masculino con aumento de volumen bilateral de ambas glándulas parótidas y diagnóstico citohistopatológico de un proceso linfoepitelial benigno, el cual desarrolló un linfoma tipo MALT en relación con la glándula parótida derecha.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.

  13. 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)

  14. 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

  15. 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)

  16. [The pathology of salivary glands. Tumors of the salivary glands].

    Science.gov (United States)

    Mahy, P; Reychler, H

    2006-01-01

    The management of benign and malignant neoplasms of the salivary glands requires precise knowledge of tumor histogenesis and classification as well as surgical skills. Pleomorphic adenoma and Whartin's tumor are the most frequent tumors in parotid glands while the probability for malignant tumors is higher in other glands, especially in sublingual and minor salivary glands. Those malignant salivary glands tumors are rare and necessitate multidisciplinar staging and management in close collaboration with the pathologist and the radiation oncologist.

  17. Current concepts in diagnosis of unusual salivary gland tumors

    Directory of Open Access Journals (Sweden)

    Ajay Kumar Bansal

    2012-01-01

    Full Text Available Salivary gland tumors are relatively uncommon and account for approximately 3-6% of all neoplasms of the head and neck. Tumors mostly involve the major salivary glands, 42.9-90% of which occur in the parotid glands and 8-19.5% in the sub-mandibular glands; tumors in the sub-lingual glands being uncommon. Despite the plethora of different malignant salivary gland tumor presented to pathologists for diagnosis, there is consensus on a limited number of pathologic observations that determine treatment and outcome. There are few absolutes in salivary gland tumor diagnosis given the marked spectrum and overlap of differentiated cell types that participate in the numerous benign and malignant tumors. Thus, there are enumerating antibodies that may be helpful in resolving difficult differential diagnoses when applied with astute morphologic correlation. In general, immunohistochemistry as an ancillary diagnostic tool should be used sparingly and wisely as a morphologic adjunct because of the lack of specificity of many markers for specific histologic tumor types. The aim of this review is to discuss the molecular profiling of salivary gland neoplasms and correlate this with histogenesis of salivary gland neoplasms. We have elected to discuss and illustrate some of the unusual salivary gland tumors that the practicing pathologist find difficult to diagnose. These have been selected because they readily simulate each other but have very different clinical therapies and, therefore, should be included routinely in differential diagnosis.

  18. Xerostomia: A day and night difference

    International Nuclear Information System (INIS)

    Dijkema, Tim; Raaijmakers, Cornelis P.J.; Braam, Pètra M.; Roesink, Judith M.; Monninkhof, Evelyn M.; Terhaard, Chris H.J.

    2012-01-01

    Purpose: To compare patient-reported xerostomia during daytime and during nighttime with objectively measured parotid and submandibular gland function in a cohort of head-and-neck cancer (HNC) patients treated with RT. Materials and methods: A cohort of 138 HNC patients underwent objective measurements of parotid (PF) and submandibular (SMF) gland function and completed a xerostomia questionnaire (XQ) before RT, at 6 weeks, 6 months and 1 year after RT. No attempt was made to spare the submandibular gland(s). The XQ contained specific questions concerning the sensation of dry mouth during day- (XD) and nighttime (XN), scored on a 5-point Likert scale. Patients with no or mild (grade 1–3) xerostomia and patients with more severe (grade 4–5) complaints were grouped together. Results: Before RT, no association existed between dry mouth complaints and PF or SMF. At 6 weeks, 6 months and 1 year after RT; 37%, 51% and 36% had grade 4–5 XD and 65%, 64% and 56% had grade 4–5 XN, respectively. Patients with grade 4–5 XD and XN had significantly worse SMF at all time points after RT compared to patients with grade 1–3 XD and XN, while PF was significantly worse only at 6 weeks after RT. In multivariate analyses, SMF was consistently the most important factor related to XN after treatment. PF significantly influenced XD at 6 weeks and 1 year after RT. Conclusions: Differentiating between complaints during day- and nighttime in xerostomia research is necessary. Dry mouth at night is a frequent problem after (parotid-sparing) RT for HNC and is explained by submandibular gland dysfunction. Sparing of the contralateral submandibular gland, in addition to parotid gland sparing, may result in improved patient-reported xerostomia.

  19. Brooke-Spiegler syndrome presenting multiple concurrent cutaneous and parotid gland neoplasms: cytologic findings on fine-needle sample and description of a novel mutation of the CYLD gene.

    Science.gov (United States)

    Malzone, Maria Gabriella; Campanile, Anna Cipolletta; Losito, Nunzia Simona; Longo, Francesco; Perri, Francesco; Caponigro, Francesco; Schiavone, Concetta; Ionna, Franco; Maiello, Francesco; Martinuzzi, Claudia; Nasti, Sabina; Botti, Gerardo; Fulciniti, Franco

    2015-08-01

    Multiple dermal cylindromas and membranous basal cell adenoma of parotid gland in a 67-year-old woman with Brooke-Spiegler syndrome (BSS) were examined by fine-needle cytology. Histology, immunochemistry, and CYLD germline mutation testing were also performed. Cytomorphology and immunochemistry of the two lesions showed basaloid neoplasms, remarkably similar, composed by proliferating epithelial cells of basal type accompanied by a smaller proportion of myoepithelial cells. CYLD gene showed a novel germline splice acceptor site mutation (c.2042-1G>C) with skipping of the entire exon 15. The occurrence of analogous tumors, dermal cylindromas, and membranous basal cell adenoma of the parotid gland, in the same patient may result from the action of a single gene on ontogenetically similar stem cells. Therefore, patients with BSS should be offered a genetic counselling for an early and correct diagnosis. © 2015 Wiley Periodicals, Inc.

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

    Directory of Open Access Journals (Sweden)

    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.

  1. 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

  2. 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.

  3. 3DCRT for posterior fossa: Sparing of surrounding organs at risk

    African Journals Online (AJOL)

    Azza Helal

    2013-06-25

    Jun 25, 2013 ... spinal cord, thyroid gland, pharynx, parotid glands and mandible using three different 3DCRT ... Methods: Ten patients underwent CT simulation for treatment .... structures such as the developing brain, bone, thyroid gland,.

  4. Sjoegren's syndrome of the parotid gland: value of diffusion-weighted echo-planar MRI for diagnosis at an early stage based on MR sialography grading in comparison with healthy volunteers

    International Nuclear Information System (INIS)

    Regier, Marc; Ries, T.; Arndt, C.; Cramer, M.C.; Adam, G.; Habermann, C.R.; Graessner, J.; Reitmeier, F.; Jaehne, M.

    2009-01-01

    To investigate the value of diffusion-weighted echo-planar imaging (DW-EPI) for quantifying functional changes of the parotid gland in Sjoegren's disease and to evaluate whether ADC mapping allows for early diagnosis based on MR sialography grading. Using a DW-EPI sequence at 1.5T (b-factors: 0, 500 and 1000 sec/mm 2 ), the parotid glands of 52 healthy volunteers and 13 patients with histologically verified affection of Sjoegren's disease were examined. All scans were performed prior to and following gustatory stimulation with 5 ml of lemon juice. ADC maps were evaluated by placing an inordinate region-of-interest (ROI) enclosing the entire parotid gland. Sjoegren's disease was graded based on MR sialography findings using a 4-point grading-scale. Statistics included student t-test and kappa-analysis. In healthy volunteers mean ADCs of 1.14 x 10 -3 mm 2 /sec before and 1.2 x 10 -3 mm 2 /sec after stimulation were observed. Higher ADCs were determined for early-stage Sjoegren's disease, averaging 1.22 x 10 -3 mm 2 /sec before and 1.29 x 10 -3 mm 2 /sec after stimulation. Advanced disease revealed significantly lower ADCs (0.97 x 10 -3 mm 2 /sec (p = 0.002) before and 1.01 x 10 -3 mm 2 /sec (p < 0.001) after stimulation). (orig.)

  5. 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)

  6. 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.

  7. A functional test of the salivary gland using sup(99m)Tc-pertechnetate

    International Nuclear Information System (INIS)

    Kiuchi, Sousuke; Oshima, Motoo

    1981-01-01

    The function of the parotid glands were studied in 45 patients with parotid gland diseases, with the salivary glands affection systemic diseases, and with radiation injury of the parotid glands. As a control, the studies were done on 13 patients with no history of salivary gland disease. The method is consisted of sequential scientigraphy using a gamma scintillation camera and simultaneous recordings of the time-activity curves for the regions over the parotid glands and Stensen's orifices. The examination was commenced immediately after intravenous injection of sup(99m)Tc, and was continued up to 30 minutes. Salivation was stimulated with oral administration of tartaric acid at 20 minutes after injection. According to whether the uptake, concentration and excretion of sup(99m)Tc were diminished or increased, the time-activity curves could be grouped four different patterns. Using this method, a clinician can determine the exact stage of glandular dysfunction. (author)

  8. 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

  9. [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.

  10. 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

  11. Salivary gland ultrastructure and cyclic AMP-dependent reactions in Spacelab 3 rats

    International Nuclear Information System (INIS)

    Mednieks, M.I.; Hand, A.R.

    1987-01-01

    Environmental stimuli influencing catecholamine levels induce changes in cyclic AMP-dependent reactions and cell morphology in the rat parotid. Responses of salivary glands to spaceflight were determined by measurement of cyclic AMP-mediated reactions in fresh-frozen salivary glands and by microscopic evaluation of ultrastructure in fixed parotid glands. Decreased cell-free protein phosphorylation, determined by autoradiography, occurred in parotid glands in three of five flight animals. Protein kinase activity ratios were decreased in the soluble and increased in the particulate fractions of Spacelab 3 (SL-3) rat sublingual glands, compared with ground controls. Biochemical analyses show that effects of space flight on salivary glands are similar to those induced experimentally by physiological manipulation or alteration of catecholamine levels. Morphological evaluation of three SL-3 rat parotid glands showed increased numbers of lysosomes, autophagic vacuoles containing degenerating secretory product, and accumulation of lipid droplets. Since these animals lost weight, consistent with disruption of food and water consumption, morphological changes may in part be due to decreased masticatory stimulation, as occurs with reduced food intake or a liquid diet. The observed changes may reflect physiological responses of the gastrointestinal and autonomic systems to effects of spaceflight

  12. 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

  13. 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.)

  14. Imaging of the major salivary glands

    DEFF Research Database (Denmark)

    Afzelius, Pia; Nielsen, Ming-Yuan; Ewertsen, Caroline

    2016-01-01

    The major salivary glands, submandibular, parotid and sublingual glands play an important role in preserving the oral cavity and dental health. Patients with problems of the major salivary glands may present with symptoms such as dry mouth, dysphagia and obstruction of duct, inflammation, severe...

  15. Protection of Salivary Function by Concomitant Pilocarpine During Radiotherapy: A Double-Blind, Randomized, Placebo-Controlled Study

    International Nuclear Information System (INIS)

    Burlage, Fred R.; Roesink, Judith M.; Kampinga, Harm H.; Coppes, Rob P.; Terhaard, Chris; Langendijk, Johannes A.; Luijk, Peter van; Stokman, Monique A.; Vissink, Arjan

    2008-01-01

    Purpose: To investigate the effect of concomitant administration of pilocarpine during radiotherapy for head-and-neck squamous cell carcinoma (HNSCC) on postradiotherapy xerostomia. Methods and Materials: A prospective, double blind, placebo-controlled randomized trial including 170 patients with HNSCC was executed to study the protective effect of pilocarpine on radiotherapy-induced parotid gland dysfunction. The primary objective endpoint was parotid flow rate complication probability (PFCP) scored 6 weeks, 6 months, and 12 months after radiotherapy. Secondary endpoints included Late Effects of Normal Tissue/Somatic Objective Management Analytic scale (LENT SOMA) and patient-rated xerostomia scores. For all parotid glands, dose-volume histograms were assessed because the dose distribution in the parotid glands is considered the most important prognostic factor with regard to radiation-induced salivary dysfunction. Results: Although no significant differences in PFCP were found for the two treatments arms, a significant (p = 0.03) reduced loss of parotid flow 1 year after radiotherapy was observed in those patients who received pilocarpine and a mean parotid dose above 40 Gy. The LENT SOMA and patient-rated xerostomia scores showed similar trends toward less dryness-related complaints for the pilocarpine group. Conclusions: Concomitant administration of pilocarpine during radiotherapy did not improve the PFCP or LENT SOMA and patient-rated xerostomia scores. In a subgroup of patients with a mean dose above 40 Gy, pilocarpine administration resulted in sparing of parotid gland function. Therefore, pilocarpine could be provided to patients in whom sufficient sparing of the parotid is not achievable

  16. Prognostic value of survivin expression in parotid gland cancer in consideration of different histological subtypes.

    Science.gov (United States)

    Stenner, Markus; Demgensky, Ariane; Molls, Christoph; Hardt, Aline; Luers, Jan C; Grosheva, Maria; Huebbers, Christian U; Klussmann, Jens P

    2011-05-01

    Cancer of the major salivary glands comprises a morphological diverse group of rare tumours of largely unknown cause. Survivin, an inhibitor of apoptosis has shown to be a significant prognostic indicator in various human cancers. The aim of this study was to assess the long-term prognostic value of survivin in a large group of histological different salivary gland cancers. We analysed the survivin expression in 143 patients with parotid gland cancer by means of immunohistochemistry and tissue micro array. Survivin expression was categorised into a low and a high expressing group. The experimental findings were correlated with clinicopathological and survival parameters. The mean follow-up time was 54.8 months. A positive cytoplasmic expression of survivin was found in 61.5%, a high expression in 25.9% of all specimens. In the whole group, high cytoplasmic survivin expression significantly indicated a poor 5-year disease-free and overall survival rate (p < 0.0001, p = 0.003). This applied for all adeno-, adenoid cystic and undifferentiated carcinomas whereas in mucoepidermoid carcinomas an analogical non-significant trend could be observed. A high cytoplasmic survivin expression significantly indicated a poor survival in high grade but not in low grade tumours. A multivariate analysis revealed that high cytoplasmic survivin expression was the only significant negative prognostic indicator for a poor 5-year disease-free survival rate in all patients (p = 0.042). The correlation between cytoplasmic survivin expression and survival probabilities of salivary gland cancer might make this an effective tool in patient follow-up, prognosis and targeted therapy in future. Copyright © 2011 Elsevier Ltd. All rights reserved.

  17. [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.

  18. 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)

  19. Polymorphous Low Grade Adenocarcinoma of the Parotid in a Teenager

    Directory of Open Access Journals (Sweden)

    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.

  20. Oxidative Damage to the Salivary Glands of Rats with Streptozotocin-Induced Diabetes-Temporal Study: Oxidative Stress and Diabetic Salivary Glands.

    Science.gov (United States)

    Knaś, M; Maciejczyk, M; Daniszewska, I; Klimiuk, A; Matczuk, J; Kołodziej, U; Waszkiel, D; Ładny, J R; Żendzian-Piotrowska, M; Zalewska, A

    2016-01-01

    Objective. This study evaluated oxidative damage caused to the salivary glands in streptozotocin-induced diabetes (DM). Materials and Methods. Rats were divided into 4 groups: groups 1 and 2, control rats, and groups 3 and 4, DM rats. 8-Hydroxy-2'-deoxyguanosine (8-OHdG), protein carbonyl (PC), 4-hydroxynonenal protein adduct (4-HNE), oxidized and/or MDA-modified LDL-cholesterol (oxy-LDL/MDA), 8-isoprostanes (8-isoP), and oxidative stress index (OSI) were measured at 7 (groups 1 and 3) and 14 (groups 2 and 4) days of experiment. Results. The unstimulated salivary flow in DM rats was reduced in the 2nd week, while the stimulated flow was decreased throughout the duration of the experiment versus control. OSI was elevated in both diabetic glands in the 1st and 2nd week, whereas 8-isoP and 8-OHdG were higher only in the parotid gland in the second week. PC and 4-HNE were increased in the 1st and 2nd week, whereas oxy-LDL/MDA was increased in the 2nd week in the diabetic parotid glands. Conclusions. Diabetes induces oxidative damage of the salivary glands, which seems to be caused by processes taking place in the salivary glands, independently of general oxidative stress. The parotid glands are more vulnerable to oxidative damage in these conditions.

  1. Oxidative Damage to the Salivary Glands of Rats with Streptozotocin-Induced Diabetes-Temporal Study: Oxidative Stress and Diabetic Salivary Glands

    Directory of Open Access Journals (Sweden)

    M. Knaś

    2016-01-01

    Full Text Available Objective. This study evaluated oxidative damage caused to the salivary glands in streptozotocin-induced diabetes (DM. Materials and Methods. Rats were divided into 4 groups: groups 1 and 2, control rats, and groups 3 and 4, DM rats. 8-Hydroxy-2′-deoxyguanosine (8-OHdG, protein carbonyl (PC, 4-hydroxynonenal protein adduct (4-HNE, oxidized and/or MDA-modified LDL-cholesterol (oxy-LDL/MDA, 8-isoprostanes (8-isoP, and oxidative stress index (OSI were measured at 7 (groups 1 and 3 and 14 (groups 2 and 4 days of experiment. Results. The unstimulated salivary flow in DM rats was reduced in the 2nd week, while the stimulated flow was decreased throughout the duration of the experiment versus control. OSI was elevated in both diabetic glands in the 1st and 2nd week, whereas 8-isoP and 8-OHdG were higher only in the parotid gland in the second week. PC and 4-HNE were increased in the 1st and 2nd week, whereas oxy-LDL/MDA was increased in the 2nd week in the diabetic parotid glands. Conclusions. Diabetes induces oxidative damage of the salivary glands, which seems to be caused by processes taking place in the salivary glands, independently of general oxidative stress. The parotid glands are more vulnerable to oxidative damage in these conditions.

  2. Effect of Capsaicin Cream on the Secretion of the Submandibular and Parotid Gland in the General Population with Different Chilli-eating Habits.

    Science.gov (United States)

    Wang, Yang; Wang, Zhen; Yu, Guang Yan; Tang, Zhan Gui; Hu, Ji An

    2016-06-01

    To investigate the effect of capsaicin cream on the secretion of the submandibular gland (SMG) and the parotid gland (PG) in the general population, with different chilli-eating habits. In two groups with different chilli-eating habits, the salivary flow rate of the SMG and the PG was detected at statics and different times, after application of capsaicin cream. In both groups, the topical application of capsaicin cream could significantly increase the salivary secretion of SMG (P 0.05). On the other hand, although the salivary flow rate of PG also increased after stimulation, the increase had no statistical difference (P > 0.05). The application of capsaicin cream can effectively promote the secretion of the SMG and the PG, and its effect is independent of chilli-eating habits, which indicates that topical application of capsaicin cream can be considered as a potential treatment for the hypofunction of the salivary gland.

  3. A RARE CASE OF PAROTID CYST

    Directory of Open Access Journals (Sweden)

    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

  4. Sjoegren's syndrome of the parotid gland: value of diffusion-weighted echo-planar MRI for diagnosis at an early stage based on MR sialography grading in comparison with healthy volunteers

    Energy Technology Data Exchange (ETDEWEB)

    Regier, Marc; Ries, T.; Arndt, C.; Cramer, M.C.; Adam, G.; Habermann, C.R. [Universitaetsklinikum Hamburg-Eppendorf (Germany). Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie; Graessner, J. [Siemens AG, Hamburg (Germany). Medical Solutions; Reitmeier, F.; Jaehne, M. [Universitaetsklinikum Hamburg-Eppendorf (Germany). Klinik und Poliklinik fuer Hals-, Nasen- und Ohrenheilkunde

    2009-03-15

    To investigate the value of diffusion-weighted echo-planar imaging (DW-EPI) for quantifying functional changes of the parotid gland in Sjoegren's disease and to evaluate whether ADC mapping allows for early diagnosis based on MR sialography grading. Using a DW-EPI sequence at 1.5T (b-factors: 0, 500 and 1000 sec/mm{sup 2}), the parotid glands of 52 healthy volunteers and 13 patients with histologically verified affection of Sjoegren's disease were examined. All scans were performed prior to and following gustatory stimulation with 5 ml of lemon juice. ADC maps were evaluated by placing an inordinate region-of-interest (ROI) enclosing the entire parotid gland. Sjoegren's disease was graded based on MR sialography findings using a 4-point grading-scale. Statistics included student t-test and kappa-analysis. In healthy volunteers mean ADCs of 1.14 x 10{sup -3} mm{sup 2} /sec before and 1.2 x 10{sup -3} mm{sup 2} /sec after stimulation were observed. Higher ADCs were determined for early-stage Sjoegren's disease, averaging 1.22 x 10{sup -3} mm{sup 2} /sec before and 1.29 x 10{sup -3} mm{sup 2} /sec after stimulation. Advanced disease revealed significantly lower ADCs (0.97 x 10{sup -3} mm{sup 2} /sec (p = 0.002) before and 1.01 x 10{sup -3} mm{sup 2} /sec (p < 0.001) after stimulation). (orig.)

  5. Intensity-modulated radiotherapy vs. parotid-sparing 3D conformal radiotherapy. Effect on outcome and toxicity in locally advanced head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lambrecht, M.; Nevens, D.; Nuyts, S. [University Hospitals Leuven (Belgium). Dept. of Radiation Oncology

    2013-03-15

    Background and purpose: Intensity-modulated radiotherapy (IMRT) has rapidly become standard of care in the management of locally advanced head and neck squamous cell carcinoma (HNSCC). In this study, our aim was to retrospectively investigate the effect of the introducing IMRT on outcome and treatment-related toxicity compared to parotid-sparing 3D conformal radiotherapy (3DCRT). Material and methods: A total of 245 patients with stage III and IV HNSCC treated with primary radiotherapy between January 2003 and December 2010 were included in this analysis: 135 patients were treated with 3DCRT, 110 patients with IMRT. Groups were compared for acute and late toxicity, locoregional control (LRC), and overall survival (OS). Oncologic outcomes were estimated using Kaplan-Meier analysis and compared using a log-rank test. Acute toxicity was analyzed according to the Common Terminology Criteria for Adverse Events v3.0 and late toxicity was scored using the RTOG/EORTC late toxicity scoring system. Results: Median follow-up was 35 months in the IMRT group and 68 months in the 3DCRT group. No significant differences were found in 3-year LRC and OS rates between the IMRT group and 3DCRT group. Significantly less acute mucositis {>=} grade 3 was observed in the IMRT group (32% vs. 44%, p = 0.03). There was significantly less late xerostomia {>=} grade 2 in the IMRT group than in the 3DCRT group (23% vs. 68%, p < 0.001). After 24 months, there was less dysphagia {>=} grade 2 in the IMRT group although differences failed to reach statistical significance. Conclusion: The introduction of IMRT in the radiotherapeutic management of locally advanced head and neck cancer significantly improved late toxicity without compromising tumor control compared to a parotid-sparing 3D conformal radiotherapy technique. (orig.)

  6. Dynamic scintigraphy of salivary glands in patients suffering from Sycca Syndrome

    International Nuclear Information System (INIS)

    Mijatovic, J.M.; Rajkovaca Zvezdana, Z.R.

    2002-01-01

    Aim: The objective of the study was to analyse the obtained results and evaluate the dynamic scintigraphy value in appraising the functional condition of salivary glands in patient suffering from Sycca Syndrome. Materials: Fifty-three patients (5 men and 48 women), aged l8-80, were referred to specialist for rheumatic diseases in the period March 2000 - March 2002. The patients had some of the following symptoms: dryness of oral cavity, dryness of conjunctivas with or without a chronic polyarthritis symptom. Methodology: Upon intravenous injection of 142-222MBq 99mTc pertechnetate, acquisition (matrix 64x64, 25 frems of 60 seconds, l5 minutes, vitamin C tablet under tongue). Generating of dynamic curves above both parotid and both submandibular salivary glands and semi-quantitative analysis of curves. Results: Four (4) out fifty-three (53) patients had a normal (regular) finding. Forty-nine (49) out of 53 patients had deviating dynamic curvec generated above the mentioned glands. Nineteen (19) out of those 49 patients had deviated all 4 dynamic curves, 22 out of 49 patients had deviated curves only above submandibular salivary glands, 1 patient had deviated curves only above parotid glands, 1 patient had deviated curves above both parotid and one submandibular salivary glands and the other 6 out of 49 patients had deviated curve only above one of the mentioned glands. Conclusion: In the diagnosis of Sycca syndrome, simple and non-invasive method for observing functional condition of parotid and submandibular salivary glands may help in clinical management of patients for diagnosing of heterogenic group of immunosialoadenitis

  7. An automatic contour propagation method to follow parotid gland deformation during head-and-neck cancer tomotherapy

    International Nuclear Information System (INIS)

    Faggiano, E; Scalco, E; Rizzo, G; Fiorino, C; Broggi, S; Cattaneo, M; Maggiulli, E; Calandrino, R; Dell'Oca, I; Di Muzio, N

    2011-01-01

    We developed an efficient technique to auto-propagate parotid gland contours from planning kVCT to daily MVCT images of head-and-neck cancer patients treated with helical tomotherapy. The method deformed a 3D surface mesh constructed from manual kVCT contours by B-spline free-form deformation to generate optimal and smooth contours. Deformation was calculated by elastic image registration between kVCT and MVCT images. Data from ten head-and-neck cancer patients were considered and manual contours by three observers were included in both kVCT and MVCT images. A preliminary inter-observer variability analysis demonstrated the importance of contour propagation in tomotherapy application: a high variability was reported in MVCT parotid volume estimation (p = 0.0176, ANOVA test) and a larger uncertainty of MVCT contouring compared with kVCT was demonstrated by DICE and volume variability indices (Wilcoxon signed rank test, p -4 for both indices). The performance analysis of our method showed no significant differences between automatic and manual contours in terms of volumes (p > 0.05, in a multiple comparison Tukey test), center-of-mass distances (p = 0.3043, ANOVA test), DICE values (p = 0.1672, Wilcoxon signed rank test) and average and maximum symmetric distances (p = 0.2043, p = 0.8228 Wilcoxon signed rank tests). Results suggested that our contour propagation method could successfully substitute human contouring on MVCT images.

  8. An automatic contour propagation method to follow parotid gland deformation during head-and-neck cancer tomotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Faggiano, E; Scalco, E; Rizzo, G [Istituto di Bioimmagini e Fisiologia Molecolare (IBFM), CNR, Milan (Italy); Fiorino, C; Broggi, S; Cattaneo, M; Maggiulli, E; Calandrino, R [Department of Medical Physics, San Raffaele Scientific Institute, Milan (Italy); Dell' Oca, I; Di Muzio, N, E-mail: fiorino.claudio@hsr.it [Department of Radiotherapy, San Raffaele Scientific Institute, Milan (Italy)

    2011-02-07

    We developed an efficient technique to auto-propagate parotid gland contours from planning kVCT to daily MVCT images of head-and-neck cancer patients treated with helical tomotherapy. The method deformed a 3D surface mesh constructed from manual kVCT contours by B-spline free-form deformation to generate optimal and smooth contours. Deformation was calculated by elastic image registration between kVCT and MVCT images. Data from ten head-and-neck cancer patients were considered and manual contours by three observers were included in both kVCT and MVCT images. A preliminary inter-observer variability analysis demonstrated the importance of contour propagation in tomotherapy application: a high variability was reported in MVCT parotid volume estimation (p = 0.0176, ANOVA test) and a larger uncertainty of MVCT contouring compared with kVCT was demonstrated by DICE and volume variability indices (Wilcoxon signed rank test, p < 10{sup -4} for both indices). The performance analysis of our method showed no significant differences between automatic and manual contours in terms of volumes (p > 0.05, in a multiple comparison Tukey test), center-of-mass distances (p = 0.3043, ANOVA test), DICE values (p = 0.1672, Wilcoxon signed rank test) and average and maximum symmetric distances (p = 0.2043, p = 0.8228 Wilcoxon signed rank tests). Results suggested that our contour propagation method could successfully substitute human contouring on MVCT images.

  9. 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

  10. Primary hydatid disease of the infratemporal fossa and the parotid gland

    Energy Technology Data Exchange (ETDEWEB)

    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.

  11. Transcriptional profiling reveals gland-specific differential expression in the three major salivary glands of the adult mouse.

    Science.gov (United States)

    Gao, Xin; Oei, Maria S; Ovitt, Catherine E; Sincan, Murat; Melvin, James E

    2018-04-01

    RNA-Seq was used to better understand the molecular nature of the biological differences among the three major exocrine salivary glands in mammals. Transcriptional profiling found that the adult murine parotid, submandibular, and sublingual salivary glands express greater than 14,300 protein-coding genes, and nearly 2,000 of these genes were differentially expressed. Principle component analysis of the differentially expressed genes revealed three distinct clusters according to gland type. The three salivary gland transcriptomes were dominated by a relatively few number of highly expressed genes (6.3%) that accounted for more than 90% of transcriptional output. Of the 912 transcription factors expressed in the major salivary glands, greater than 90% of them were detected in all three glands, while expression for ~2% of them was enriched in an individual gland. Expression of these unique transcription factors correlated with sublingual and parotid specific subsets of both highly expressed and differentially expressed genes. Gene ontology analyses revealed that the highly expressed genes common to all glands were associated with global functions, while many of the genes expressed in a single gland play a major role in the function of that gland. In summary, transcriptional profiling of the three murine major salivary glands identified a limited number of highly expressed genes, differentially expressed genes, and unique transcription factors that represent the transcriptional signatures underlying gland-specific biological properties.

  12. Histopathological audit of salivary gland neoplasms

    International Nuclear Information System (INIS)

    Memon, J.M.; Sheikh, B.

    2014-01-01

    Salivary gland neoplasms are uncommon but important presentation to general surgeons. Objective: To analyze the relative frequency and distribution of Salivary gland neoplasms in our division. Setting: Department of surgery and pathology, Peoples Medical University hospital and GMMMC hospital Sukkur. Study design: Descriptive (case series) Subjects and methods: A total of 40 patients registered for salivary gland tumors from oct 2008 to 0ct 2013 were included in the study. A thorough history, clinical examination, routine haematological and biochemical studies were done in all patients. FNAC was done in all cases. All patients were subjected to surgical intervention on standard rules. Each resected specimen was sent for histopathology. Information about age, gender and tumor location was obtained from clinical record and frequency of different neoplasms was studied from histopathological report. All data was collected on especially designed proforma. Data analysis was done using spss version 17. Results: A total of 40 patients were registered for salivary gland neoplasms. 28 patients (70%) had parotid lesions, 10 patients (25%) had submandibular gland involvement and 2 patients ( 5%) had minor salivary gland tumors. Patients were between 15 - 80 years of age( mean age =34.7 years) 24 patients(60%) were male and 16 (40%) were female,with male to female ratio of 1.5:1.32 . 22 (80%) had benign lesions and 8 patients (20%) had malignant lesions. Pleomorphic adenoma was the most common benign tumor affecting the parotid gland. Adenocarcinoma represented as the most prevelant parotid malignancy. Benign neoplasms occurred in third and fourth decades of life and malignant neoplasms were diagnosed in sixth and seventh decades of life. Conclusion:Salivary gland neoplasms are uncommon but they have occasioned much interest and debate because of broad histological spectrum. The data presented in this study is corroborated with most of the studied literature worldwide. (author)

  13. The Role of Fine Needle Aspiration in the Diagnosis of Parotid Gland Tumors: Correlation With Preoperative Computerized Tomography Tumor Size.

    Science.gov (United States)

    Ghantous, Yasmine; Naddaf, Raja; Barak, Michal; Abd-Elraziq, Murad; Abu Eln-Naaj, Imad

    2016-03-01

    The role of fine needle aspiration cytology (FNAC) in the diagnosis of parotid gland masses is still controversial, regarding its sensitivity and specificity that vary between 41% and 100% and between 86% and 100% respectively.The aim of this study was to identify the specificity and sensitivity of FNAC of parotid gland tumors in relation to the tumor size as characterized preoperatively by computer tomography. The medical files of 79 patients whom were referred to the MaxilloFacila Surgery Department, Rambam medical center, over a 10.5-year period (2000-2010) were analyzed retrospectively.The extensity of the operation was determined by the location of the tumor as presented in computed tomography (CT) radiography, and preoperative FNAC examination.The majority of the masses were located in the superficial lobe (88.52%), and only 11.48% of the patients were located in the deep lobe (8:1 ratio). FNAC results were nondiagnostic in 7 patients (8.86%), 62 patients were diagnosed as inflammatory and benign lesion in (78.48%), malignant tumors were diagnosed in 10 patients (12.65%).The sensitivity in our study was 90%, the specificity was 98%, positive predictive value was 90%, negative predictive value was 98%, and diagnostic accuracy was 88%. The positive predictive value was 90%, the negative predictive value was 98%.Analyzing the effect of the preoperative CT size upon the accuracy of the FNAC diagnosis, we found that lesion with preoperative CT size greater than 24 mm has a more accurate FNAC result (P = 0.034).

  14. [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.

  15. 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...

  16. A STUDY ON PAROTID SWELLINGS

    Directory of Open Access Journals (Sweden)

    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

  17. 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.

  18. Pre-trial quality assurance processes for an intensity-modulated radiation therapy (IMRT) trial: PARSPORT, a UK multicentre Phase III trial comparing conventional radiotherapy and parotid-sparing IMRT for locally advanced head and neck cancer.

    Science.gov (United States)

    Clark, C H; Miles, E A; Urbano, M T Guerrero; Bhide, S A; Bidmead, A M; Harrington, K J; Nutting, C M

    2009-07-01

    The purpose of this study was to compare conventional radiotherapy with parotid gland-sparing intensity-modulated radiation therapy (IMRT) using the PARSPORT trial. The validity of such a trial depends on the radiotherapy planning and delivery meeting a defined standard across all centres. At the outset, many of the centres had little or no experience of delivering IMRT; therefore, quality assurance processes were devised to ensure consistency and standardisation of all processes for comparison within the trial. The pre-trial quality assurance (QA) programme and results are described. Each centre undertook exercises in target volume definition and treatment planning, completed a resource questionnaire and produced a process document. Additionally, the QA team visited each participating centre. Each exercise had to be accepted before patients could be recruited into the trial. 10 centres successfully completed the quality assurance exercises. A range of treatment planning systems, linear accelerators and delivery methods were used for the planning exercises, and all the plans created reached the standard required for participation in this multicentre trial. All 10 participating centres achieved implementation of a comprehensive and robust IMRT programme for treatment of head and neck cancer.

  19. Clinical evaluation of salivary gland imaging with technetium-99m pertechnetate 43 cases

    International Nuclear Information System (INIS)

    Huang Daming

    1989-01-01

    Salivary gland imaging in 36 patients with benign or malignant tumor all showed the size, extent and location of tumor in parotid glands. There was no pseudonegative diagnosis in salivary gland imaging, but in sailography there were three cases with pseudo-negative diagnosis. The authors believe salivary gland imaging with Technetium-99m pertechnetate although is nonspecific for Warthin's tumor of parotid gland, and is also not able to differentiate malignant tumor from benign tumor of salivary gland, but radionuclide examination is a safe and simple diagnostic technnique and proves to have greater sensitivity in demonstrating abnormalities of salivary gland than that of routine sailography. Contrast salivarry gland imaging with sailography one can differentiate inflammation from tumor and benign from malignant tumor

  20. 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)

  1. Giant Parotid Pleomorphic Adenoma Involving Parapharyngeal Space

    Directory of Open Access Journals (Sweden)

    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

  2. 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.

  3. 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)

  4. Effects of glucose and sucrose variants of the caries-promoting Diet 2000 on the feeding patterns and parotid glands of prematurely weaned rats.

    Science.gov (United States)

    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.

  5. Characteristic Magnetic Resonance Imaging Findings in Rheumatoid Arthritis of the Temporomandibular Joint: Focus on Abnormal Bone Marrow Signal of the Mandibular Condyle, Pannus, and Lymph Node Swelling in the Parotid Glands.

    Science.gov (United States)

    Hirahara, Naohisa; Kaneda, Takashi; Muraoka, Hirotaka; Fukuda, Taiga; Ito, Kotaro; Kawashima, Yusuke

    2017-04-01

    The purpose of this study was to determine the characteristic magnetic resonance imaging (MRI) findings indicating bone and soft tissue involvement in patients with rheumatoid arthritis (RA) of the temporomandibular joints (TMJs). Twenty-one patients with RA and TMJ pain who underwent MRI examination of the TMJs at the authors' hospital from August 2006 to December 2014 were included in this study. Twenty-two patients with normal TMJs who underwent MRI examination at the authors' hospital from November to December 2014 were included as controls. MRI findings were compared between the 2 groups. MRI findings of RA in the TMJ included 1) abnormal disc position (95.2%), 2) abnormal disc morphology (83.3%), 3) joint effusion (30.9%), 4) osseous changes in the mandibular condyle (83.3%), 5) synovial proliferation (pannus; 85.7%), 6) erosion of the articular eminence and glenoid fossa (9.52%), 7) deformity of the articular eminence and glenoid fossa (16.6%), 8) abnormal bone marrow signal in the mandibular condyle (83.3%), and 9) swelling of lymph nodes in the parotid glands (78.5%). The abnormal bone marrow signal and pannus in the mandibular condyle and lymph node swelling in the parotid glands were markedly more common in patients with RA than in controls. MRI findings of RA of the TMJs were characterized by bone and soft tissue involvement, including abnormal bone marrow signal of the mandibular condyle, pannus, and swelling of lymph nodes in the parotid glands. These characteristic MRI findings could be useful in detecting RA in the TMJ in a clinical situation. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  6. A safe transoral surgical approach to parapharyngeal tumor arising from deep lobe of parotid gland

    Directory of Open Access Journals (Sweden)

    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.

  7. Comparative study of four advanced 3d-conformal radiation therapy treatment planning techniques for head and neck cancer

    International Nuclear Information System (INIS)

    Herrassi, Mohamed Yassine; Bentayeb, Farida; Malisan, Maria Rosa

    2013-01-01

    For the head-and-neck cancer bilateral irradiation, intensity-modulated radiation therapy (IMRT) is the most reported technique as it enables both target dose coverage and organ-at-risk (OAR) sparing. However, during the last 20 years, three-dimensional conformal radiotherapy (3DCRT) techniques have been introduced, which are tailored to improve the classic shrinking field technique, as regards both planning target volume (PTV) dose conformality and sparing of OARs, such as parotid glands and spinal cord. In this study, we tested experimentally in a sample of 13 patients, four of these advanced 3DCRT techniques, all using photon beams only and a unique isocentre, namely Bellinzona, Forward-Planned Multisegments (FPMS), ConPas, and field-in-field (FIF) techniques. Statistical analysis of the main dosimetric parameters of PTV and OARs DVHs as well as of homogeneity and conformity indexes was carried out in order to compare the performance of each technique. The results show that the PTV dose coverage is adequate for all the techniques, with the FPMS techniques providing the highest value for D95%; on the other hand, the best sparing of parotid glands is achieved using the FIF and ConPas techniques, with a mean dose of 26 Gy to parotid glands for a PTV prescription dose of 54 Gy. After taking into account both PTV coverage and parotid sparing, the best global performance was achieved by the FIF technique with results comparable to that of IMRT plans. This technique can be proposed as a valid alternative when IMRT equipment is not available or patient is not suitable for IMRT treatment. (author)

  8. 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.)

  9. 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

  10. 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.

  11. 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...

  12. Therapeutic effect of intraductal irrigation of the salivary gland: A technical report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Chena [Dept. of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul (Korea, Republic of); Kim, Jo Eun; Huh, Kyoung Hoe; Yi, Won Jin; Lee, Sam Sun; Choi, Soon Chul [Dept. of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    2017-06-15

    Obstructive and inflammatory disease often occurs in the major salivary glands, and no predictive treatment has yet been developed for this condition. The aim of this report was to introduce an intraductal irrigation procedure and to illustrate its application to practical patient cases. Two patients complaining of pain and swelling in the parotid gland during meals who underwent sialography were diagnosed as having sialodochitis with sialadenitis. Intraductal irrigation was then performed on the parotid gland on the side of the complaint. The irrigation procedure was conducted in the same manner as the sialography procedure, except that saline was used as the filling solution. Symptom severity was evaluated with a numerical rating scale (NRS) at the initial visit and a month after the irrigation. The initial NRS value of patient 1 was 10. The value decreased to 6 and then to 0 after 2 irrigation procedures. The NRS value of patient 2 regarding the symptoms involving the left parotid gland decreased from 4-5 to 1 after 4 irrigation procedures performed at 1-month intervals. Intraductal irrigation of the salivary gland may be a simple, safe, and effective treatment option for patients with obstructive and inflammatory disease of the salivary gland that is capable of resolving their symptoms.

  13. Therapeutic effect of intraductal irrigation of the salivary gland: A technical report.

    Science.gov (United States)

    Lee, Chena; Kim, Jo-Eun; Huh, Kyoung-Hoe; Yi, Won-Jin; Heo, Min-Suk; Lee, Sam-Sun; Choi, Soon-Chul

    2017-06-01

    Obstructive and inflammatory disease often occurs in the major salivary glands, and no predictive treatment has yet been developed for this condition. The aim of this report was to introduce an intraductal irrigation procedure and to illustrate its application to practical patient cases. Two patients complaining of pain and swelling in the parotid gland during meals who underwent sialography were diagnosed as having sialodochitis with sialadenitis. Intraductal irrigation was then performed on the parotid gland on the side of the complaint. The irrigation procedure was conducted in the same manner as the sialography procedure, except that saline was used as the filling solution. Symptom severity was evaluated with a numerical rating scale (NRS) at the initial visit and a month after the irrigation. The initial NRS value of patient 1 was 10. The value decreased to 6 and then to 0 after 2 irrigation procedures. The NRS value of patient 2 regarding the symptoms involving the left parotid gland decreased from 4-5 to 1 after 4 irrigation procedures performed at 1-month intervals. Intraductal irrigation of the salivary gland may be a simple, safe, and effective treatment option for patients with obstructive and inflammatory disease of the salivary gland that is capable of resolving their symptoms.

  14. Unilateral versus bilateral irradiation in squamous cell head and neck cancer in relation to patient-rated xerostomia and sticky saliva

    International Nuclear Information System (INIS)

    Jellema, Anke Petra; Slotman, Ben J.; Doornaert, Patricia; Leemans, C. Rene; Langendijk, Johannes A.

    2007-01-01

    Background and purpose: To investigate the association between radiation technique with patient-rated moderate and severe xerostomia and sticky saliva. Materials and methods: One hundred and fifty patients treated with bilateral or unilateral irradiation for head and neck cancer were included. The salivary glands and the oral cavity were delineated on plannings-CT scans. Xerostomia and sticky saliva were assessed using the EORTC QLQ-H and N35 questionnaire at baseline and 6 and 12 months. Results: At 6 months a significant association between radiation technique and the mean parotid dose (MD parb ) and xerostomia was observed (Odds ratio (OR)-technique: 2.55; p = 0.04 and OR-MD parb : 1.04; p = 0.009). Considering the individual salivary glands, only the mean dose in the contralateral parotid gland (MD parcl ) is associated with xerostomia (OR: 1.04; p parb influence the risk of xerostomia in irradiated patients. Of all individual salivary glands, only MD parcl is of utmost importance for xerostomia. The shift in the P50 observed for xerostomia suggests that sparing of the contralateral parotid gland is compensated by hyperfunction of the contralateral parotid gland

  15. Metabolic Imaging Biomarkers of Postradiotherapy Xerostomia

    International Nuclear Information System (INIS)

    Cannon, Blake; Schwartz, David L.; Dong Lei

    2012-01-01

    Purpose: Xerostomia is a major complication of head and neck radiotherapy (RT). Available xerostomia measures remain flawed. [ 18 F]fluorodeoxyglucose-labeled positron emission tomography-computed tomography (FDG-PET-CT) is routinely used for staging and response assessment of head and neck cancer. We investigated quantitative measurement of parotid gland FDG uptake as a potential biomarker for post-RT xerostomia. Methods and Materials: Ninety-eight locally advanced head and neck cancer patients receiving definitive RT underwent baseline and post-RT FDG-PET-CT on a prospective imaging trial. A separate validation cohort of 14 patients underwent identical imaging while prospectively enrolled in a second trial collecting sialometry and patient-reported outcomes. Radiation dose and pre- and post-RT standard uptake values (SUVs) for all voxels contained within parotid gland ROI were deformably registered. Results: Average whole-gland or voxel-by-voxel models incorporating parotid D Met (defined as the pretreatment parotid SUV weighted by dose) accurately predicted posttreatment changes in parotid FDG uptake (e.g., fractional parotid SUV). Fractional loss of parotid FDG uptake closely paralleled early parotid toxicity defined by posttreatment salivary output (p Met may potentially be used to guide function-sparing treatment planning. Prospective validation of FDG-PET-CT as a convenient, quantifiable imaging biomarker of parotid function is warranted and ongoing.

  16. A forgotten facial nerve tumour: granular cell tumour of the parotid and its implications for treatment.

    Science.gov (United States)

    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.

  17. 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)

  18. Epithelioid Myoepithelioma of the Accessory Parotid Gland: Pathological and Magnetic Resonance Imaging Findings

    Directory of Open Access Journals (Sweden)

    Hiroyoshi Iguchi

    2014-05-01

    Full Text Available Tumors of the accessory parotid gland (APG are rare, and pleomorphic adenoma (PA is the most common benign APG tumor subtype. Myoepithelioma of the APG is much rarer than PA, and to date, only 5 cases have been sporadically reported in the English literature. We describe the clinicopathological and MRI findings of an epithelioid myoepithelioma of the APG that was treated in our hospital. The patient's only clinical symptom was a slow-growing and painless mid-cheek mass. The tumor was suspected to be PA before surgery based on the following MRI findings: (1 a well-circumscribed and lobulated contour, (2 isointensity and hyperintensity relative to the muscle on T1- and T2-weighted images (WIs, respectively, (3 good enhancement on contrast-enhanced T1-WIs, (4 peripheral hypointensity on T2-WIs, and (5 a gradual time-signal intensity curve enhancement pattern on gadolinium-enhanced dynamic MRI. The tumor was completely resected via a standard parotidectomy approach, and the postoperative pathological examination of the tumor, including immunohistochemistry, confirmed the diagnosis of epithelioid myoepithelioma. As it is hardly possible to distinguish myoepithelioma from PA and low-grade malignant tumors preoperatively, a pathological examination using frozen sections is helpful for surgical strategy-related decisions.

  19. Histology of parotoid gland of Anuran species Rhinella schneideri (Amphibia: Bufonidae

    Directory of Open Access Journals (Sweden)

    Juliana Costa Sousa

    2015-02-01

    Full Text Available We performed histologic evaluation of the parotid glands of 10 (male and female Rhinella schneideri. Animals were manually captured during nocturnal collections in Bom Jesus, Piauí, and euthanized by administering a lethal dose of anesthetic thiopental. The parotid glands were then collected and embedded in paraffin, and sectioned to 4 µm blocks using a manual rotary microtome. Considering the lack of general information concerning anatomical and histological conditions of Rhinella scheneideri, we sought to address key characteristics of macro glands found in the species with the goal of a better understanding of the operation of this type of defense mechanism. Histological analysis revealed the presence of macrogland alveoli with ducts encircled with differentiated mucous cells, known as "accessory glands", as well as granular glands. We also discovered glandular ducts on the glands which communicate with the outside of the body. These ducts are internally lined by duct glandular epithelial cells, forming a plug which promotes total obstruction of the duct. There were no histological differences in macro gland anatomy in this species compared to other species in Bufonidae.

  20. Comprehensive irradiation of head and neck cancer using conformal multisegmental fields: assessment of target coverage and noninvolved tissue sparing

    International Nuclear Information System (INIS)

    Eisbruch, Avraham; Marsh, Lon H.; Martel, Mary K.; Ship, Jonathan A.; Haken, Randall ten; Pu, Anthony T.; Fraass, Benedick A.; Lichter, Allen S.

    1998-01-01

    Purpose: Conformal treatment using static multisegmental intensity modulation was developed for patients requiring comprehensive irradiation for head and neck cancer. The major aim is sparing major salivary gland function while adequately treating the targets. To assess the adequacy of the conformal plans regarding target coverage and dose homogeneity, they were compared with standard irradiation plans. Methods and Materials: Fifteen patients with stage III/IV head and neck cancer requiring comprehensive, bilateral neck irradiation participated in this study. CT-based treatment plans included five to six nonopposed fields, each having two to four in-field segments. Fields and segments were devised using beam's eye views of the planning target volumes (PTVs), noninvolved organs, and isodose surfaces, to achieve homogeneous dose distribution that encompassed the targets and spared major salivary gland tissue. For comparison, standard three-field radiation plans were devised retrospectively for each patient, with the same CT-derived targets used for the clinical (conformal) plans. Saliva flow rates from each major salivary gland were measured before and periodically after treatment. Results: On average, the minimal dose to the primary PTVs in the conformal plans [95.2% of the prescribed dose, standard deviation (SD) 4%] was higher than in the standard plans (91%, SD 7%; p = 0.02), and target volumes receiving <95% or <90% of the prescribed dose were smaller in the conformal plans (p = 0.004 and 0.02, respectively). Similar advantages of the conformal plans compared to standard plans were found in ipsilateral jugular nodes PTV coverage. The reason for underdosing in the standard treatment plans was primarily failure of electron beams to fully encompass targets. No significant differences were found in contralateral jugular or posterior neck nodes coverage. The minimal dose to the retropharyngeal nodes was higher in the standard plans. However, all conformal plans

  1. Role of the parameters involved in the plan optimization based on the generalized equivalent uniform dose and radiobiological implications

    International Nuclear Information System (INIS)

    Widesott, L; Strigari, L; Pressello, M C; Landoni, V; Benassi, M

    2008-01-01

    We investigated the role and the weight of the parameters involved in the intensity modulated radiation therapy (IMRT) optimization based on the generalized equivalent uniform dose (gEUD) method, for prostate and head-and-neck plans. We systematically varied the parameters (gEUD max and weight) involved in the gEUD-based optimization of rectal wall and parotid glands. We found that the proper value of weight factor, still guaranteeing planning treatment volumes coverage, produced similar organs at risks dose-volume (DV) histograms for different gEUD max with fixed a = 1. Most of all, we formulated a simple relation that links the reference gEUD max and the associated weight factor. As secondary objective, we evaluated plans obtained with the gEUD-based optimization and ones based on DV criteria, using the normal tissue complication probability (NTCP) models. gEUD criteria seemed to improve sparing of rectum and parotid glands with respect to DV-based optimization: the mean dose, the V 40 and V 50 values to the rectal wall were decreased of about 10%, the mean dose to parotids decreased of about 20-30%. But more than the OARs sparing, we underlined the halving of the OARs optimization time with the implementation of the gEUD-based cost function. Using NTCP models we enhanced differences between the two optimization criteria for parotid glands, but no for rectum wall

  2. Experimental study on changing of the irradiated salivary glands and it's influence on the pancreas

    International Nuclear Information System (INIS)

    Satoh, Kazunori

    1982-01-01

    The salivary glands of mice were irradiated with 1800 rad of #betta# ray. The amounts of 14 C-leucine incorporated into the submandibular and parotid glands and pancreas for protein synthesis of the irradiated group showed marked decrease (p < 0.01). The amylase activity in these three tissues gradually decreased after irradiation with the nadir on the 7th day, followed by recovery. Histologically, the submandibular gland partially showed pyknosis and atypia of arrangement and mild vacuolar degeneration of adenocytes in the terminal portion on the 7th day after irradiation, but the other organs showed no marked changes. #betta#-ray irradiation of the salivary glands decreases the protein synthesis in the submandibular and parotid glands and also affects the pancreas. (Chiba, N.)

  3. 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 ...

  4. Lysosomal Exoglycosidase Profile and Secretory Function in the Salivary Glands of Rats with Streptozotocin-Induced Diabetes.

    Science.gov (United States)

    Maciejczyk, Mateusz; Kossakowska, Agnieszka; Szulimowska, Julita; Klimiuk, Anna; Knaś, Małgorzata; Car, Halina; Niklińska, Wiesława; Ładny, Jerzy Robert; Chabowski, Adrian; Zalewska, Anna

    2017-01-01

    Before this study, there had been no research evaluating the relationship between a lysosomal exoglycosidase profile and secretory function in the salivary glands of rats with streptozotocin- (STZ-) induced type 1 diabetes. In our work, rats were divided into 4 groups of 8 animals each: control groups (C2, C4) and diabetic groups (STZ2, STZ4). The secretory function of salivary glands-nonstimulated and stimulated salivary flow, α -amylase, total protein-and salivary exoglycosidase activities-N-acetyl- β -hexosaminidase (HEX, HEX A, and HEX B), β -glucuronidase, α -fucosidase, β -galactosidase, and α -mannosidase-was estimated both in the parotid and submandibular glands of STZ-diabetic and control rats. The study has demonstrated that the activity of most salivary exoglycosidases is significantly higher in the parotid and submandibular glands of STZ-diabetic rats as compared to the healthy controls and that it increases as the disease progresses. Reduced secretory function of diabetic salivary glands was also observed. A significant inverse correlation between HEX B, α -amylase activity, and stimulated salivary flow in diabetic parotid gland has also been shown. Summarizing, STZ-induced diabetes leads to a change in the lysosomal exoglycosidase profile and reduced function of the salivary glands.

  5. Evidence for interphase death in irradiated primate salivary glands

    International Nuclear Information System (INIS)

    Stephens, L.C.; King, G.K.; Peters, L.J.

    1985-01-01

    In radiotherapy patients, exposure of the salivary glands to ionizing radiation produces acute swelling and can result in chronic hypofunction which predisposes to oral infections and dental caries. Because the pathogenesis or the acute reaction is unknown, sequential biopsies were taken from irradiated rhesus monkey parotid and mandibular salivary glands at 1,3,6,9,12,24,48 and 72 hrs postirradiation (PI). Singe /sup 60/Co γ-ray doses of 250,500,750,1000,1250 and 1500 rads were used. At 1-24 hrs PI there was a classical acute inflammatory reaction. This reaction subsided 24-72 hrs PI changing to a lymphoplasmacytic response at the doses of 750 to 1500 rad. At doses above 750 rad there were necrosis of serous acinar cells but relative sparing of mucous cells, ducts and blood vessels. Study at 20 and 40 mos PI confirmed that there was significant serous cell loss in a dose related fashion at 750 through 1500 rad. Below 750 rad no residual damage was evident. Normal tissues with long cell turnover times are usually slow to manifest radiation injury, since this is classically linked to mitotic division. The acute lysis of serous salivary cells is an exception to this rule, and indicates a unique sensitivity of these cells to interphase death

  6. 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

  7. 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.

  8. A Nomogram to predict parotid gland overdose in head and neck IMRT

    International Nuclear Information System (INIS)

    Castelli, J.; Simon, A.; Rigaud, B.; Lafond, C.; Chajon, E.; Ospina, J. D.; Haigron, P.; Laguerre, B.; Loubière, A. Ruffier; Benezery, K.; Crevoisier, R. de

    2016-01-01

    To generate a nomogram to predict parotid gland (PG) overdose and to quantify the dosimetric benefit of weekly replanning based on its findings, in the context of intensity-modulated radiotherapy (IMRT) for locally-advanced head and neck carcinoma (LAHNC). Twenty LAHNC patients treated with radical IMRT underwent weekly computed tomography (CT) scans during IMRT. The cumulated PG dose was estimated by elastic registration. Early predictors of PG overdose (cumulated minus planned doses) were identified, enabling a nomogram to be generated from a linear regression model. Its performance was evaluated using a leave-one-out method. The benefit of weekly replanning was then estimated for the nomogram-identified PG overdose patients. Clinical target volume 70 (CTV70) and the mean PG dose calculated from the planning and first weekly CTs were early predictors of PG overdose, enabling a nomogram to be generated. A mean PG overdose of 2.5Gy was calculated for 16 patients, 14 identified by the nomogram. All patients with PG overdoses >1.5Gy were identified. Compared to the cumulated delivered dose, weekly replanning of these 14 targeted patients enabled a 3.3Gy decrease in the mean PG dose. Based on the planning and first week CTs, our nomogram allowed the identification of all patients with PG overdoses >2.5Gy to be identified, who then benefitted from a final 4Gy decrease in mean PG overdose by means of weekly replanning

  9. 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 ...

  10. 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.

  11. 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

  12. 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...

  13. 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.

    Science.gov (United States)

    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.

  14. 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...

  15. Purification and partial characterization of analogous 26-kDa rat submandibular and parotid gland integral membrane phosphoproteins that may have a role in exocytosis.

    Science.gov (United States)

    Quissell, D O; Deisher, L M

    1992-04-01

    Rat submandibular and parotid gland exocytosis is primarily controlled by beta-adrenergic receptor stimulation. Although its precise role in the regulation of salivary gland exocytosis is not fully understood, protein phosphorylation, mediated by the activation of cAMP-dependent protein kinase, may be directly involved. Previous studies suggest that analogous 26-kDa integral membrane phosphoproteins may play a direct role in regulating exocytosis. Studies were here undertaken to purify and partially characterize both phosphoproteins. After endogenous phosphorylation with 32P, subcellular fraction and solubilization of the microsomal fraction in n-octyl beta-glucopyranoside, the 26-kDa integral membrane phosphoproteins were purified by high performance liquid chromatography (HPLC), followed by sodium dodecyl sulphate-polyacrylamide gel electrophoresis and electroelution of the proteins. Amino acid analysis indicated a significant number of serine amino acids: N-terminal sequence data demonstrated a high level of homology; and trypsin digestion followed by reversed-phase HPLC indicated the possibility of multiple phosphorylation sites.

  16. 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.

  17. 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)

  18. 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.

  19. Lysosomal Exoglycosidase Profile and Secretory Function in the Salivary Glands of Rats with Streptozotocin-Induced Diabetes

    Directory of Open Access Journals (Sweden)

    Mateusz Maciejczyk

    2017-01-01

    Full Text Available Before this study, there had been no research evaluating the relationship between a lysosomal exoglycosidase profile and secretory function in the salivary glands of rats with streptozotocin- (STZ- induced type 1 diabetes. In our work, rats were divided into 4 groups of 8 animals each: control groups (C2, C4 and diabetic groups (STZ2, STZ4. The secretory function of salivary glands—nonstimulated and stimulated salivary flow, α-amylase, total protein—and salivary exoglycosidase activities—N-acetyl-β-hexosaminidase (HEX, HEX A, and HEX B, β-glucuronidase, α-fucosidase, β-galactosidase, and α-mannosidase—was estimated both in the parotid and submandibular glands of STZ-diabetic and control rats. The study has demonstrated that the activity of most salivary exoglycosidases is significantly higher in the parotid and submandibular glands of STZ-diabetic rats as compared to the healthy controls and that it increases as the disease progresses. Reduced secretory function of diabetic salivary glands was also observed. A significant inverse correlation between HEX B, α-amylase activity, and stimulated salivary flow in diabetic parotid gland has also been shown. Summarizing, STZ-induced diabetes leads to a change in the lysosomal exoglycosidase profile and reduced function of the salivary glands.

  20. Effect of P2X(7) receptor knockout on exocrine secretion of pancreas, salivary glands and lacrimal glands

    DEFF Research Database (Denmark)

    Novak, Ivana; Jans, Ida M; Wohlfahrt, Louise

    2010-01-01

    the P2X(7) receptors affect fluid secretion in pancreas, salivary glands and tear glands. We monitored gland secretions in in vivo preparations of wild-type and P2X(7)(-/-) (Pfizer) mice stimulated with pilocarpine. In cell preparations from pancreas, parotid and lacrimal glands we measured ATP release...... and intracellular Ca(2+) activity using Fura-2. The data showed that pancreatic secretion and salivary secretions were reduced in P2X(7)(-/-) mice, and in contrast, tear secretion was increased in P2X(7)(-/-) mice. The secretory phenotype was also dependent on the sex of the animal, such that males were more...

  1. Oncocytic carcinoma of the salivary glands: A Danish national study

    DEFF Research Database (Denmark)

    Westergaard-Nielsen, Marie; Godballe, Christian; Andersen, Lisbeth Juhler

    2017-01-01

    demographics, tumor site, clinical stage and treatment profiles were extracted. A follow-up was carried out. RESULTS: Of the 15 cases of salivary gland OC, eight were female. The incidence was 0.02/100.000 inhabitants per year in Denmark, 13 patients presented with OC in the parotid gland and two patients...

  2. Application of MR diffusion-weighted imaging in the evaluation of salivary glands with gustatory stimulation

    International Nuclear Information System (INIS)

    Zhang Yunyan; Ou Dan; Gu Yajia; He Xiayun; Mao Jian; Shen Xigang; Yue Lei; Peng Weijun

    2012-01-01

    Objective: To evaluate the function of the salivary glands with gustatory stimulation by using MR DWI. Methods: A prospective study was conducted in 30 patients with nasopharyngeal carcinoma who had normal salivary function. A DWI sequence was performed on the salivary glands at resting state, and continually repeated on the parotid immediately after oral ascorbic acid stimulation over a period of 21 minutes (once every 18 seconds). The multiple b-values (0, 400, 600, 800, 1000 s/mm 2 ) were used. ADC maps were evaluated with a manually placed region of interest including the entire salivary gland. The ADC of each gland was obtained by taking the mean of values on three contiguous sections containing the largest areas of the gland. The paired two-tailed Student t test was used to compare the ADC values of the parotid and the submandibular glands at rest, and of the parotid before and after stimulation. Results: The mean ADC value at rest was significantly lower in the parotid [(1.23 ±0.12) × 10 -3 mm 2 /s] than in the submandibular glands [(1.34 ± 0.07) × 10 -3 mm 2 /s, t=4.545, P<0.01]. After acid stimulation,the ADC value increased from the baseline to (1.41 ±0.19) × 10 -3 mm 2 /s firstly and then fluctuated at the following time, with a peak value of (1.49 ± 0.20) × 10 -3 mm 2 /s and the average value of (1.36 ±0.17) × 10 -3 mm 2 /s. The average value was significantly different from the baseline value (t=15.127, t=11.905, P<0.01). The minimum value [ ( 1.24 ± 0.14) × 10 -3 mm 2 /s] was not significantly different compared to the baseline value (t=1.329, P>0.05). Conclusion: MR DWI can noninvasively evaluate the physiologic changes of salivary glands before and after acid stimulation. (authors)

  3. 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.

  4. Metabolic Imaging Biomarkers of Postradiotherapy Xerostomia

    Energy Technology Data Exchange (ETDEWEB)

    Cannon, Blake [Department of Radiation Physics, University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Schwartz, David L., E-mail: dschwartz3@nshs.edu [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Department of Radiation Medicine, Hofstra North Shore-LIJ School of Medicine, New Hyde Park, New York (United States); Feinstein Institute for Medical Research, Manhasset, New York (United States); Dong Lei [Department of Radiation Physics, University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States)

    2012-08-01

    Purpose: Xerostomia is a major complication of head and neck radiotherapy (RT). Available xerostomia measures remain flawed. [{sup 18}F]fluorodeoxyglucose-labeled positron emission tomography-computed tomography (FDG-PET-CT) is routinely used for staging and response assessment of head and neck cancer. We investigated quantitative measurement of parotid gland FDG uptake as a potential biomarker for post-RT xerostomia. Methods and Materials: Ninety-eight locally advanced head and neck cancer patients receiving definitive RT underwent baseline and post-RT FDG-PET-CT on a prospective imaging trial. A separate validation cohort of 14 patients underwent identical imaging while prospectively enrolled in a second trial collecting sialometry and patient-reported outcomes. Radiation dose and pre- and post-RT standard uptake values (SUVs) for all voxels contained within parotid gland ROI were deformably registered. Results: Average whole-gland or voxel-by-voxel models incorporating parotid D{sub Met} (defined as the pretreatment parotid SUV weighted by dose) accurately predicted posttreatment changes in parotid FDG uptake (e.g., fractional parotid SUV). Fractional loss of parotid FDG uptake closely paralleled early parotid toxicity defined by posttreatment salivary output (p < 0.01) and Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer xerostomia scores (p < 0.01). Conclusions: In this pilot series, loss of parotid FDG uptake was strongly associated with acute clinical post-RT parotid toxicity. D{sub Met} may potentially be used to guide function-sparing treatment planning. Prospective validation of FDG-PET-CT as a convenient, quantifiable imaging biomarker of parotid function is warranted and ongoing.

  5. 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 ...

  6. 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.

  7. 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

  8. Salivary gland carcinoma in Denmark 1990-2005: a national study of incidence, site and histology. Results of the Danish Head and Neck Cancer Group (DAHANCA)

    DEFF Research Database (Denmark)

    Bjørndal, Kristine; Krogdahl, Annelise; Therkildsen, Marianne Hamilton

    2011-01-01

    years. The parotid gland was the most common site (52.5%) followed by the minor salivary glands of the oral cavity (26.3%). The most frequent histological subtypes were adenoid cystic carcinoma (25.2%), mucoepidermoid carcinoma (16.9%), adenocarcinoma NOS (12.2%) and acinic cell carcinoma (10.......2%). The revision process changed the histological diagnosis in 121 out of 886 cases (14%). The incidence of salivary gland carcinoma in Denmark is higher than previously reported. More than half of salivary gland carcinomas are located in the parotid gland with adenoid cystic carcinoma being the most frequent...

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

    Directory of Open Access Journals (Sweden)

    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.

  10. Sialolipoma of salivary glands: Two case reports and review of the literature

    Directory of Open Access Journals (Sweden)

    Kamran Khazaeni

    2013-01-01

    Full Text Available Sialolipoma is a rare neoplasm of salivary glands, described as a distinct entity by Nagao et al. in 2001. Thirty-six cases of sialolipoma in minor and major salivary glands have been reported thus far in addition to the two new cases of sialolipoma arising in the major salivary glands in this study. Thirty-six cases of sialolipoma published in English language reports were analyzed considering gender, age, location, size, duration of symptoms, treatment mode, follow-up, and histologic findings. Congenital sialolipomas were considered in this study. The first case occurred in a 45-year-old female and presented as a localized swelling in right parotid area. The second case occurred in an 18-year-old female as a swelling in the left parotid region. On histopathological examination, these lesions were diagnosed as sialolipoma.

  11. Sialolipoma of salivary glands: Two case reports and review of the literature

    Science.gov (United States)

    Khazaeni, Kamran; Jafarian, Amir Hosein; Khajehahmadi, Saeedeh; Rahpeyma, Amin; Asadi, Ladan

    2013-01-01

    Sialolipoma is a rare neoplasm of salivary glands, described as a distinct entity by Nagao et al. in 2001. Thirty-six cases of sialolipoma in minor and major salivary glands have been reported thus far in addition to the two new cases of sialolipoma arising in the major salivary glands in this study. Thirty-six cases of sialolipoma published in English language reports were analyzed considering gender, age, location, size, duration of symptoms, treatment mode, follow-up, and histologic findings. Congenital sialolipomas were considered in this study. The first case occurred in a 45-year-old female and presented as a localized swelling in right parotid area. The second case occurred in an 18-year-old female as a swelling in the left parotid region. On histopathological examination, these lesions were diagnosed as sialolipoma. PMID:23878570

  12. Anatomy and histology of rodent and human major salivary glands: -overview of the Japan salivary gland society-sponsored workshop-.

    Science.gov (United States)

    Amano, Osamu; Mizobe, Kenichi; Bando, Yasuhiko; Sakiyama, Koji

    2012-10-31

    MAJOR SALIVARY GLANDS OF BOTH HUMANS AND RODENTS CONSIST OF THREE PAIRS OF MACROSCOPIC GLANDS: parotid, submandibular, and sublingual. These glands secrete serous, mucous or mixed saliva via the proper main excretory ducts connecting the glandular bodies with the oral cavity. A series of discoveries about the salivary ducts in the 17th century by Niels Stensen (1638-1686), Thomas Wharton (1614-1673), and Caspar Bartholin (1655-1738) established the concept of exocrine secretion as well as salivary glands. Recent investigations have revealed the endocrine functions of parotin and a variety of cell growth factors produced by salivary glands.The present review aims to describe macroscopic findings on the major salivary glands of rodents and the microscopic differences between those of humans and rodents, which review should be of interest to those researchers studying salivary glands.

  13. 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)

  14. Homer2 protein regulates plasma membrane Ca²⁺-ATPase-mediated Ca²⁺ signaling in mouse parotid gland acinar cells.

    Science.gov (United States)

    Yang, Yu-Mi; Lee, Jiae; Jo, Hae; Park, Soonhong; Chang, Inik; Muallem, Shmuel; Shin, Dong Min

    2014-09-05

    Homer proteins are scaffold molecules with a domain structure consisting of an N-terminal Ena/VASP homology 1 protein-binding domain and a C-terminal leucine zipper/coiled-coil domain. The Ena/VASP homology 1 domain recognizes proline-rich motifs and binds multiple Ca(2+)-signaling proteins, including G protein-coupled receptors, inositol 1,4,5-triphosphate receptors, ryanodine receptors, and transient receptor potential channels. However, their role in Ca(2+) signaling in nonexcitable cells is not well understood. In this study, we investigated the role of Homer2 on Ca(2+) signaling in parotid gland acinar cells using Homer2-deficient (Homer2(-/-)) mice. Homer2 is localized at the apical pole in acinar cells. Deletion of Homer2 did not affect inositol 1,4,5-triphosphate receptor localization or channel activity and did not affect the expression and activity of sarco/endoplasmic reticulum Ca(2+)-ATPase pumps. In contrast, Homer2 deletion markedly increased expression of plasma membrane Ca(2+)-ATPase (PMCA) pumps, in particular PMCA4, at the apical pole. Accordingly, Homer2 deficiency increased Ca(2+) extrusion by acinar cells. These findings were supported by co-immunoprecipitation of Homer2 and PMCA in wild-type parotid cells and transfected human embryonic kidney 293 (HEK293) cells. We identified a Homer-binding PPXXF-like motif in the N terminus of PMCA that is required for interaction with Homer2. Mutation of the PPXXF-like motif did not affect the interaction of PMCA with Homer1 but inhibited its interaction with Homer2 and increased Ca(2+) clearance by PMCA. These findings reveal an important regulation of PMCA by Homer2 that has a central role on PMCA-mediated Ca(2+) signaling in parotid acinar cells. © 2014 by The American Society for Biochemistry and Molecular Biology, Inc.

  15. 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.

  16. Cholera toxin B subunit-binding and ganglioside GM1 immuno-expression are not necessarily correlated in human salivary glands

    DEFF Research Database (Denmark)

    Kirkeby, Svend

    2014-01-01

    human submandibular, parotid and palatinal glands using cholera toxin sub-unit B and two polyclonal antibodies against ganglioside GM1 as biomarkers. RESULTS: Immunofluorescence microscopy showed that the toxin and antibodies were co-localized in some acini but not in others. The cholera toxin mainly...... reacted with the cell membranes of the mucous acini in the submandibular gland, while incubation with the antibody against GM1 gave rise to a staining of the cytoplasm. The cytoplasm in some secretory acinar cells in the parotid gland was stained by the cholera toxin, whereas only small spots...... on the plasma membranes reacted with anti-GM1. The plasma membranes in the parotid excretory ducts appeared to react to anti-GM1, but not to cholera toxin. CONCLUSIONS: Cholera toxin induces the expression of ion channels and carriers in the small intestine and increases the production of secretory mucins...

  17. [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.

  18. A histochemical study of rat salivary gland acid phosphatase.

    Science.gov (United States)

    Isacsson, G

    1986-01-01

    Male Sprague-Dawley rats received 4 mg pilocarpine/100 g body wt intraperitoneally or physiological saline as control and were killed at various intervals. Acid phosphatase was reacted on frozen sections from soft palate, parotid and submandibular glands using sodium-alpha-naphthyl acid phosphate as substrate. Various inhibitors were added to the incubation medium. The strongest acid phosphatase activity was in the parotid gland acinar and proximal secretory duct cells; the mucous minor glands of the palate were completely negative. Activity was found in the acinar cells, proximal secretory duct cells, granular and striated duct and excretory duct cells. Pilocarpine injection slightly reduced the activity up to 6 h after injection. Cupric chloride added to the incubation medium lowered the overall activity. Fluoride and molybdate inhibited the acid phosphatase reaction in all structures. Tartrate inhibited the reaction in all structures except the submandibular striated duct cells. The tartrate-resistant activity may be a Na+K+-dependent ATPase involved in re-absorbing water and electrolytes from the primary saliva.

  19. 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)

  20. Sudden onset of facial edema and serum LDH elevation after radiation therapy for malignant lymphoma of the left parotid gland. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Gen; Ogo, Etuyo; Toda, Yukihiro; Suefuji, Hiroaki; Hayabuchi, Naofumi [Kurume Univ., Fukuoka (Japan). School of Medicine

    2001-12-01

    A report of a 48 year-old male with non-Hodgkin's lymphoma of the left parotid gland (clinical stage I EA, follicular medium-sized B cell type) is presented. He was solely treated with 30 Gy of radiation to the whole neck region, bilateral paraclavicular region and the left axilla, and 10.6 Gy boost was given to the primary lesion. Five months later, facial edema and serum LDH elevation developed suddenly. Relapse of the malignant lymphoma was suspected, but a whole body CT scan failed to show this. On the contrary, the CT scan showed a diffuse hypoattenuated area of the thyroid gland. In addition to positive antibodies, i.e, antithyroglobulin and antimicrosomal antibodies, total cholesterol and other serum markers also suggested hypofunction of the thyroid due to acute exacerbation of chronic thyroiditis. Immediately after hormone-replacement therapy, his symptoms disappeared and the abnormal serum data improved. Although the relationship between chronic thyroiditis and radiation injury has not been clearly demonstrated, it seems necessary to evaluate thyroid function before radiotherapy for head and neck tumors. Patients with chronic thyroiditis should be followed carefully after radiotherapy. (author)

  1. A kinetic compartment model for evaluating salivary gland scintigraphies

    DEFF Research Database (Denmark)

    Afzelius, Pia; Fuglsang, Stefan

    2014-01-01

    referred for (99m) Tc-pertechnetate thyroid scintigraphy were studied. Dynamic imaging of the head in a fixed anterior projection was performed after an intravenous bolus injection of 150 MBq (99m) Tc-pertechnetate using a gamma scintillation camera. After 30 min, lemon juice was orally administered...... through a syringe. Time activity curves were generated for each of the four major salivary glands (i.e. the right and left submandibular and right and left parotid glands). Excretion fractions (the fraction of mobilizable radioactivity after administering lemon juice) and the gland activity...

  2. Parotid-Absorbed Doses: A Comparison Between Spiral Tomography and Panoramic

    Directory of Open Access Journals (Sweden)

    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.

  3. Salivary glands in Svalbard reindeer (Rangifer tarandus platyrhynchus and in Norwegian reindeer (Rangifer tarandus tarandus

    Directory of Open Access Journals (Sweden)

    Svein D. Mathiesen

    1999-04-01

    Full Text Available The aim of this investigation was to compare the size of salivaty glands in Svalbard reindeer {Rangifer tarandus platyrhynchus and in Norwegian reindeer (Rangifer t. tarandus in relation to feeding strategy, season and reproductive status. The mean body mass (BM, standard deviation j in adult non-lactating female Svalbard reindeer was 72.0, s = 4.2, kg (n = 8 in September and 46.7, s = 7.1, kg (« = 4 in April. The mean BM of adult non-lactating Norwegian reindeer was 67.5, s = 7.7, kg (» = 8 in September and 59.2, s = 9.6, kg (n = 9 in March. In non-lactating female Svalbard reindeer the mean combined mass of parotid glands was 82.7, s = 4.5, g in September and 58.8, s = 8.7, g in April (P < 0.05. In the Norwegian reindeer the mean combined mass of the parotid glands was 95.2, s = 14.4, g in Septembet and 68.1, s = 9.5, g in Match (P < 0.05. We wete not able to find any sub-species differences in the size of the salivaty glands which could be related to phenotypic difference in feeding strategy. Both sub-species had parotid glands sizes similar to that of intermediate ruminant types, ranging from 0.11-0.14% of BM. The larger absolute size of salivaty glands in summer compared to winter reflects the importance of high rates of production of saliva when the dry matter intake and microbial fermentation is high.

  4. Apparent diffusion coefficient histogram analysis can evaluate radiation-induced parotid damage and predict late xerostomia degree in nasopharyngeal carcinoma.

    Science.gov (United States)

    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.

  5. 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.

  6. Salivary gland carcinosarcoma: oligonucleotide array CGH reveals similar genomic profiles in epithelial and mesenchymal components

    NARCIS (Netherlands)

    Vékony, H.; Leemans, C.R.; Ylstra, B.; Meijer, G.A.; van der Waal, I.; Bloemena, E.

    2009-01-01

    In this study, we present a case of parotid gland de novo carcinosarcoma. Salivary gland carcinosarcoma (or true malignant mixed tumor) is a rare biphasic neoplasm, composed of both malignant epithelial and malignant mesenchymal components. It is yet unclear whether these two phenotypes occur by

  7. Radionuclide salivary gland imaging

    Energy Technology Data Exchange (ETDEWEB)

    Mishkin, F.S.

    1981-10-01

    Salivary gland imaging with 99mTc as pertechnetate provides functional information concerning trapping and excretion of the parotid and submandibular glands. Anatomic information gained often adds little to clinical evaluation. On the other hand, functional information may detect subclinical involvement, which correlates well with biopsy of the minor labial salivary glands. Salivary gland abnormalities in systemic disease such as sarcoidosis, rheumatoid arthritis, lupus erythematosus, and other collagenvascular disorders may be detected before they result in the clinical manifestaions of Sjoegren's syndrome. Such glands, after initially demonstrating increased trapping in the acute phase, tend to have decreased trapping and failure to discharge pertechnetate in response to an appropriate physiologic stimulus. Increased uptake of gallium-67 citrate often accompanies these findings. Inflammatory parotitis can be suspected when increased perfusion is evident on radionuclide angiography with any agent. The ability of the salivary gland image to detect and categorize mass lesions, which result in focal areas of diminished activity such as tumors, cysts, and most other masses, is disappointing, while its ability to detect and categorize Warthin's tumor, which concentrates pertechnetate, is much more valuable, although not specific.

  8. Radionuclide salivary gland imaging

    International Nuclear Information System (INIS)

    Mishkin, F.S.

    1981-01-01

    Salivary gland imaging with 99mTc as pertechnetate provides functional information concerning trapping and excretion of the parotid and submandibular glands. Anatomic information gained often adds little to clinical evaluation. On the other hand, functional information may detect subclinical involvement, which correlates well with biopsy of the minor labial salivary glands. Salivary gland abnormalities in systemic disease such as sarcoidosis, rheumatoid arthritis, lupus erythematosus, and other collagenvascular disorders may be detected before they result in the clinical manifestaions of Sjoegren's syndrome. Such glands, after initially demonstrating increased trapping in the acute phase, tend to have decreased trapping and failure to discharge pertechnetate in response to an appropriate physiologic stimulus. Increased uptake of gallium-67 citrate often accompanies these findings. Inflammatory parotitis can be suspected when increased perfusion is evident on radionuclide angiography with any agent. The ability of the salivary gland image to detect and categorize mass lesions, which result in focal areas of diminished activity such as tumors, cysts, and most other masses, is disappointing, while its ability to detect and categorize Warthin's tumor, which concentrates pertechnetate, is much more valuable, although not specific

  9. Effects of the cafeteria diet on the salivary glands of trained and sedentary Wistar rats - doi: 10.4025/actascibiolsci.v34i1.7473

    Directory of Open Access Journals (Sweden)

    Maria Raquel Marçal Natali

    2011-11-01

    Full Text Available The objective of this work was to study the effect of the aerobic physical training and the cafeteria diet introduced after weaning of Wistar rats and on the morphology of the main salivary glands (parotid, submandibular, sublingual. Male rats after weaning were subjected to the cafeteria diet or the standard rodent chow, and either performed aerobic physical training in a treadmill for 100 days, or did not performed any physical activity. Analyses were done considering the response in body weight, adipose tissues and salivary glands, and the data were submitted to statistical treatment (p < 0.05. The morphological and morphometric analyses of the salivary glands were performed through histological sections stained with hematoxylin and eosin. Despite the normophagic behavior, the rodents fed with the cafeteria diet became obese, with repercussions on parotid gland weight. However, this obesity and/or physical training did not influence the histological organization of the salivary glands. The morphometric analysis of the submandibular glands pointed out a reduction in the levels of serous acinar cells as an effect of the diet and physical training. In conclusion, the parotid and the submandibular glands alter themselves due to the nature and consistency of food present in the cafeteria diet as well as due to the aerobic physical training.

  10. 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...

  11. Xerostomia, salivary characteristics and gland volumes following intensity-modulated radiotherapy for nasopharyngeal carcinoma: a two-year follow up.

    Science.gov (United States)

    Sim, Cpc; Soong, Y L; Pang, Epp; Lim, C; Walker, G D; Manton, D J; Reynolds, E C; Wee, Jts

    2018-03-23

    To evaluate changes in xerostomia status, salivary characteristics and gland volumes 2 years following radiotherapy in nasopharyngeal carcinoma patients. Xerostomia scores, salivary flow rates, pH and buffering capacity were measured at pre-radiotherapy, mid-radiotherapy, 2 weeks, 3 months and 2 years post-radiotherapy. Salivary gland volumes and their correlation with radiation dose were also assessed. Mean radiation dose to oral cavity, parotid and submandibular glands (SMG) was 44.5, 65.0 and 38.6 Gy respectively. Parotid and SMG volumes decreased 33% at 3 months post-radiotherapy; volumes at 2 years post-radiotherapy were 84% and 51% of pre-radiotherapy levels, respectively. Correlations were observed between parotid gland volume per cent reduction and its radiation dose and between resting salivary flow rate reduction and post-radiotherapy/pre-radiotherapy SMG volume ratio. Salivary flow rates and resting saliva pH remained significantly low at 2 years post-radiotherapy (both flow rates, P = 0.001; resting saliva pH, P = 0.005). Similarly, xerostomia scores remained significantly higher compared with pre-radiotherapy levels. Submandibular gland volumetric shrinkage persisted 2 years after radiotherapy. Xerostomia scores remained significantly higher, and salivary flow rates and resting saliva pH remained significantly lower, suggesting that study participants were still at risk for hyposalivation-related oral diseases. © 2018 Australian Dental Association.

  12. Clozapine- induced recurrent and transient parotid gland swelling

    African Journals Online (AJOL)

    effect of clozapine, may sometimes cause salivary gland swelling. Rarely, the ... side effect of clozapine to the attention of clinicians is to discuss its pathogenesis. Informed ... selective muscarinic M4 receptor agonist. Eur J Pharmacol 1994;.

  13. 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.

  14. Salivary gland scintigraphy with 99mTc-pertechnetate in Sjoegren's syndro Relationship to clinicopathologic features of salivary and lacrimal glands

    International Nuclear Information System (INIS)

    Saito, Tohru; Fukuda, Hiroshi; Horikawa, Masa-aki; Ohmori, Kei-ichi; Shindoh, Masanobu; Amemiya, Akira

    1997-01-01

    Salivary gland scintigraphy was performed on 52 patients who were suspected of having Sjoegren's syndrome (SS), and the results were compared with clinicopathologic features of the salivary and lacrimal glands. The time-activity curves which were obtained from computer-assisted analysis of 99m Tc-pertechnetate ( 99m Tc) scintigraphy were classified into four types (normal, median, flat and sloped types). The stimulated parotid flow rate decreased and the incidence of SS-related sialographic and histopathologic findings increased significantly as the scintigraphic abnormality advanced. In addition, the lacrimal gland function decreased and the proportion of patients diagnosed as having keratoconjunctivitis sicca (KCS) increased significantly as the scintigraphic abnormality advanced. These results indicate that the results of scintigraphy are related not only to the clinicopathologic features of the salivary glands but also to the lacrimal gland functions in SS. (au) 25 refs

  15. Thomsen-Friedenreich (T) antigen as marker of myoepithelial and basal cells in the parotid gland, pleomorphic adenomas and adenoid cystic carcinomas. An immunohistological comparison between T and sialosyl-T antigens, alpha-smooth muscle actin and cytokeratin 14

    DEFF Research Database (Denmark)

    Therkildsen, M H; Mandel, U; Christensen, M

    1995-01-01

    was the only marker of cells in solid undifferentiated areas of adenoid cystic carcinomas. Our study supports the view, that modified "myoepithelial" cells in the tumours consist of a mixture of basal cells and myoepithelial cells. None of the investigated structures was in itself an ideal marker......Controversy centres on the role and identification of myoepithelial (MEC) and basal cells in salivary gland tumours, and recent studies suggest that both basal cells and myoepithelial cells participate in the formation of salivary gland tumours. We have correlated the expression of different well......-known markers of normal MEC/basal cells (i.e. alpha-smooth muscle actin and cytokeratin 14) with T (Thomsen-Friedenreich) antigen and its sialylated derivative: sialosyl-T antigen,) in 17 normal parotid glands and in two tumour types with MEC participation (i.e pleomorphic adenomas (PA) and adenoid cystic...

  16. Analysis on the time/activity curve of salivary gland scintigraphy in salivary gland diseases; The correlation between the pattern of time/activity curve and the amount of saliva

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Kazufumi; Hosokawa, Yoichiro; Kaneko, Masanori; Ohmori, Keiichi; Minowa, Kazuyuki; Fukuda, Hiroshi; Yamasaki, Michio (Hokkaido Univ., Sapporo (Japan). School of Dentistry)

    1992-04-01

    Salivary gland scintigraphy with {sup 99m}TcO{sub 4}{sup -} is a simple method to evaluate salivary gland function and has been available as a technique using a time/activity curve for a number of years. But, there were few reports on the relationship between the various patterns of the time/activity curves and the salivary flow rate from the gland. This presents correlation between the time/activity curve pattern and the salivary flow rate from the parotid gland. Sixty-five patients complaining of xerostomia were examined. Sixty-two were female and 3 male (average age 45.6 years, range 17-69 years). Their diagnosis were 26 Sjoegren Syndrome, 28 suspicion of Sjoegren Syndrome and 11 parotiditis. The salivary flow rate from parotid gland was measured by stimulation with 10% citric acid using modified Carlson crittenden cup every 10 seconds for 5 min. 185 MBq {sup 99m}TcO{sub 4}{sup -} was injected intravenously and sequential scintigraphy was performed. Time/activity curves were recorded on film. Six kinds of basic patterns were as follows: normal pattern, median pattern, flat pattern and sloped pattern (Mita et al 1981), reaccumulation flat pattern and poor secretion (Stimulant secretory ratio: less than 70%) pattern by us. The amount of saliva was as follows: normal pattern (n=31), 5.4+0.4 ml; reaccumulation flat pattern (n=3), 4.2+0.6 ml; poor secretion pattern (n=18), 4.1+0.5 ml; median pattern (n=20), 3.5+0.5 ml; flat pattern (n=11), 2.6+0.5 ml and sloped pattern (n=1), 1.5 ml. Normal pattern versus poor secretion pattern, median pattern and flat pattern in the salivary flow rate were statistically significant as determined by Students' t-test. We assessed the correlation between the pattern of time/activity curve in the salivary gland scintigraphy and the amount of saliva. (author).

  17. 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

  18. 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.

  19. Xerostomia in patients treated for oropharyngeal carcinoma: comparing linear accelerator-based intensity-modulated radiation therapy with helical tomotherapy.

    Science.gov (United States)

    Fortin, Israël; Fortin, Bernard; Lambert, Louise; Clavel, Sébastien; Alizadeh, Moein; Filion, Edith J; Soulières, Denis; Bélair, Manon; Guertin, Louis; Nguyen-Tan, Phuc Felix

    2014-09-01

    In comparison to sliding-window intensity-modulated radiation therapy (sw-IMRT), we hypothesized that helical tomotherapy (HT) would achieve similar locoregional control and, at the same time, decrease the parotid gland dose, thus leading to a xerostomia reduction. The association between radiation techniques, mean parotid dose, and xerostomia incidence, was reviewed in 119 patients with advanced oropharyngeal carcinoma treated with concurrent chemoradiation using sw-IMRT (n = 59) or HT (n = 60). Ipsilateral and contralateral parotid mean doses were significantly lower for patients treated with HT versus sw-IMRT: 24 Gy versus 32 Gy ipsilaterally and 20 Gy versus 25 Gy contralaterally. The incidence of grade ≥2 xerostomia was significantly lower in the HT group than in the sw-IMRT group: 12% versus 78% at 6 months, 3% versus 51% at 12 months, and 0% versus 25% at 24 months. Total parotid mean dose xerostomia at 6, 12, and 24 months. This retrospective series suggests that using HT can better spare the parotid glands while respecting quantitative analysis of normal tissue effects in the clinic (QUANTEC)'s criteria. Copyright © 2013 Wiley Periodicals, Inc.

  20. Automated IMRT planning in Pinnacle. A study in head-and-neck cancer

    International Nuclear Information System (INIS)

    Kusters, J.M.A.M.; Kollenburg, P.G.M. van; Kunze-Busch, M.C.; Wendling, M.; Dijkema, T.; Kaanders, J.H.A.M.; Bzdusek, K.; Kumar, P.

    2017-01-01

    This study evaluates the performance and planning efficacy of the Auto-Planning (AP) module in the clinical version of Pinnacle 9.10 (Philips Radiation Oncology Systems, Fitchburg, WI, USA). Twenty automated intensity-modulated radiotherapy (IMRT) plans were compared with the original manually planned clinical IMRT plans from patients with oropharyngeal cancer. Auto-Planning with IMRT offers similar coverage of the planning target volume as the original manually planned clinical plans, as well as better sparing of the contralateral parotid gland, contralateral submandibular gland, larynx, mandible, and brainstem. The mean dose of the contralateral parotid gland and contralateral submandibular gland could be reduced by 2.5 Gy and 1.7 Gy on average. The number of monitor units was reduced with an average of 143.9 (18%). Hands-on planning time was reduced from 1.5-3 h to less than 1 h. The Auto-Planning module was able to produce clinically acceptable head and neck IMRT plans with consistent quality. (orig.) [de

  1. Automated IMRT planning in Pinnacle : A study in head-and-neck cancer.

    Science.gov (United States)

    Kusters, J M A M; Bzdusek, K; Kumar, P; van Kollenburg, P G M; Kunze-Busch, M C; Wendling, M; Dijkema, T; Kaanders, J H A M

    2017-12-01

    This study evaluates the performance and planning efficacy of the Auto-Planning (AP) module in the clinical version of Pinnacle 9.10 (Philips Radiation Oncology Systems, Fitchburg, WI, USA). Twenty automated intensity-modulated radiotherapy (IMRT) plans were compared with the original manually planned clinical IMRT plans from patients with oropharyngeal cancer. Auto-Planning with IMRT offers similar coverage of the planning target volume as the original manually planned clinical plans, as well as better sparing of the contralateral parotid gland, contralateral submandibular gland, larynx, mandible, and brainstem. The mean dose of the contralateral parotid gland and contralateral submandibular gland could be reduced by 2.5 Gy and 1.7 Gy on average. The number of monitor units was reduced with an average of 143.9 (18%). Hands-on planning time was reduced from 1.5-3 h to less than 1 h. The Auto-Planning module was able to produce clinically acceptable head and neck IMRT plans with consistent quality.

  2. A study on the changing of the irradiated mice salivary glands and it's influence to the pancreas

    International Nuclear Information System (INIS)

    Funahara, Takayuki; Nasu, Masanori; Furumoto, Keiichi

    1991-01-01

    X-ray irradiation (10 Gy) was given to the salivary gland in mice. Protein and glycoprotein syntheses in the salivary glands and pancreas were examined by using 3 H-leucine and 14 C-acetylglucosamine as tracers. Quantitative analysis of serum amylase and histochemical examination were also conducted. Uptake of 3 H-leucine was low in the parotid, submandibular, and sublingual glands 3 and 7 days after irradiation, which were close to those in the non-irradiated group 21 days after irradiation. Uptake of 14 C-acetylglucosamine in the parotid, submandibular, and sublingual glands varied with time, which was similar to that of 3 H-leucine uptake. The uptake of both 14 C-acetylglucosamine and 3 H-leucine in the pancreas, as opposed to that in the salivary glands, varied with time, with the highest levels on Days 3 and 7, respectively. Serum amylase level, determined by the maltopentaose method, was 5,341±772 mU/ml in the non-irradiated group. On Day 3, it was 6,706±583 mU/ml. This was slightly higher than the level in the non-irradiated group on Days 7 and 21, with no statistically significant difference. Hematoxylin-eosin staining revealed hypertrophy of the glandular cells on Day 3, atrophy of the glandular cells on Day 7, and irregular cell arrangement on Day 21 for the parotid gland; and atrophied granular ampulla on Day 3, and hypertrophy on Day 7 for the submandibular gland. No marked changes were observed in either the sublingual gland or pancreas. Ninhydrin staining revealed a decreased stainability in the submandibular gland on Day 3; and an increased stainability in the pancreas on Day 7. In conclusion, protein and glycoprotein syntheses in the salivary glands after X-ray irradiation of 10 Gy decreased on Days 3 and 7, respectively. This seemed to be associated with compensatory function of the pancreas. (N.K.)

  3. Anatomy and Histology of Rodent and Human Major Salivary Glands

    Science.gov (United States)

    Amano, Osamu; Mizobe, Kenichi; Bando, Yasuhiko; Sakiyama, Koji

    2012-01-01

    Major salivary glands of both humans and rodents consist of three pairs of macroscopic glands: parotid, submandibular, and sublingual. These glands secrete serous, mucous or mixed saliva via the proper main excretory ducts connecting the glandular bodies with the oral cavity. A series of discoveries about the salivary ducts in the 17th century by Niels Stensen (1638–1686), Thomas Wharton (1614–1673), and Caspar Bartholin (1655–1738) established the concept of exocrine secretion as well as salivary glands. Recent investigations have revealed the endocrine functions of parotin and a variety of cell growth factors produced by salivary glands. The present review aims to describe macroscopic findings on the major salivary glands of rodents and the microscopic differences between those of humans and rodents, which review should be of interest to those researchers studying salivary glands. PMID:23209333

  4. Magnetic resonance sialography for investigating major salivary gland duct system after intensity-modulated radiotherapy of nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Ou Dan; He Xiayun; Zhang Yunyan

    2013-01-01

    We investigated the value of magnetic resonance sialography for evaluating xerostomia induced by intensity-modulated radiotherapy for nasopharyngeal carcinoma. Fourteen patients with nasopharyngeal carcinoma were treated with intensity-modulated radiotherapy. Salivary function was assessed by magnetic resonance sialography and subjective evaluation criteria pre-treatment, 1 week and 1 year post-radiotherapy. A magnetic resonance sialography categorical scoring system was used to compare the visibility of salivary ducts. The average mean dose was 38.93 Gy to the parotid glands and 59.34 Gy to the submandibular glands. Before radiotherapy, the visibility scores of both the parotid and submandibular ducts increased after secretion stimulation. The scores decreased and the response to stimulation was attenuated 1 week post-radiotherapy. For most of the parotid ducts, the visibility score improved at 1 year post-radiotherapy both at rest and under stimulation, but not for the submandibular ducts. With a median follow-up of 12.3 months, 8/12 patients had grade 1 xerostomia and 4/12 had grade 2 xerostomia. Magnetic resonance sialography allows non-invasive evaluation of radiation-induced ductal changes in the major salivary glands and enables reliable prediction of radiation-induced xerostomia. (author)

  5. Amifostine is a potent radioprotector of salivary glands in radioiodine therapy. Structural and ultrastructural findings

    International Nuclear Information System (INIS)

    Kutta, H.; Kampen, U.; Sagowski, C.; Brenner, W.; Bohuslavizki, K.H.; Paulsen, F.

    2005-01-01

    Background and purpose: salivary gland impairment following high-dose radioiodine treatment is well recognized. Since differentiated thyroid cancer has a good prognosis, reduction of long-term side effects is important. This study investigates the radioprotective effects of amifostine in salivary glands of rabbits receiving high-dose radioiodine therapy so as to obtain deeper insight in changes on the cellular and ultrastructural level. Material and methods: a total of 20 rabbits were investigated. High-dose radioiodine therapy applying 1 GBq 131 I was performed in 16 animals. Eight of these 16 animals received 200 mg/m 2 body surface amifostine prior to high-dose radioiodine therapy. Four additional rabbits served as controls, two receiving amifostine, the other two no treatment at all. Subsequently, salivary glands (submandibular and parotid glands, respectively) of all animals were examined by light and transmission electron microscopy. Results: parenchymal damage of both parotid and submandibular glands, specially acinar structures comprising cell organelles and nuclei, of animals pretreated with amifostine was much less pronounced than in animals without amifostine pretreatment. Conclusion: the results indicate that parenchymal damage in salivary glands induced by high-dose radioiodine therapy can significantly be reduced by amifostine. Therefore, amifostine therapy may increase quality of life in patients with differentiated thyroid cancer after radioiodine treatment. (orig.)

  6. 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)

  7. Sjoegren's syndrome. A functional scintigraphic study of salivary glands

    International Nuclear Information System (INIS)

    Arrago, J.P.; Rain, J.D.; Rocher, F.; Vigneron, N.; Pecking, A.; Najean, Y.

    1984-01-01

    One-hundred and twenty patients with sicca syndrome, connective tissue disease or chronic graft-versus-host disease were investigated in the Saint-Louis Hospital Department of Nuclear Medicine. Technetium scanning of the salivary glands was performed in all patients. The results of the scintigraphic study were closely correlated with clinical and histological data in patients with Sjoegren's syndrome. This method, which accurately quantifies the salivary function without danger nor discomfort to the patients, has a number of advantages: (a) it is sensitive enough to detect minimal salivary gland dysfunction; (b) it differentiates between parotid gland and submandibular gland involvement demonstrates assymetry in pathological processes; (c) it helps in following up patients with Sjoegren's disease and in assessing the results of immunosuppressive or anti-inflammatory treatment [fr

  8. Incisão periauricular para operações da glândula parótida Periauricular incision for surgical procedures on the parotid gland

    Directory of Open Access Journals (Sweden)

    Andy Petroianu

    2010-12-01

    parotid tumors were reviewed. Pleomorphic adenoma (20 cases was the most common disease followed by other benign tumors (9 cases, carcinoma (5 cases, parotid cyst (3 cases and chronic parotiditis (2 cases. All parotidectomies were performed through a periauricular incision. RESULTS: The parotid tumors were removed in all cases without complementary skin approach. The incisions had good aesthetic result and almost imperceptible scars were verified after six months. The patients were very satisfied with the appearance of the operative scar. All patients complained hypostesia of the operative area during a period not longer than six months. Temporary postoperative facial weakness occurred after 28 operations and was permanent in three of patients operated on for carcinoma. Transitory ear discomfort occurred in 22 patients. Two cases of local infection were recorded. All of these complications have been described previously by other authors using other incisions and are mostly due to removal of the gland. CONCLUSION: Periauricular incision is a good and highly aesthetic option for surgical approach of the parotid.

  9. Simple mucin-type carbohydrate antigens in major salivary glands

    DEFF Research Database (Denmark)

    Therkildsen, M H; Mandel, U; Thorn, J

    1994-01-01

    Simple mucin-type carbohydrate antigens Tn, sialosyl-Tn and T are often markers of neoplastic transformation and have very limited expression in normal tissues. We performed an immunohistological study of simple mucin-type carbohydrate antigens, including H and A variants, with well......-defined monoclonal antibodies (MAb) on frozen and paraffin-embedded normal salivary gland tissue from 22 parotid, 14 submandibular, six sublingual, and 13 labial glands to elucidate the simple mucin-type glycosylation pattern in relation to cyto- and histodifferentiation. The investigated carbohydrate structures...

  10. Lymphoepithelial cyst of the submandibular gland

    Directory of Open Access Journals (Sweden)

    A Saneem Ahamed

    2014-01-01

    Full Text Available Lymphoepithelial cysts are benign, slowly growing unilocular or multilocular lesions that appear in the head and neck. They are also called Branchial cyst. The head and neck sites are the salivary glands(more commonly parotid and rarely submandibular gland and the oral cavity (usually the floor of the mouth. there are various methods of investigation available today, of which Fine needle aspiration cytology (FNAC can be used to provide an immediate diagnosis of a lymphoepithelial cyst. The other investigations include, Ultrasonogram,and Computed tomography.It usually occurs due to the process of lymphocyte-induced cystic ductular dilatation and the confirmatory diagnosis is always made postoperatively by histopathological examination. The mainstay in the treatment of a lymphoepithelial cyst remains the surgical approach, which includes complete enucleation of the cyst along with total excision of the involved salivary gland. This is a report of a lymphoepithelial cyst involving the submandibular salivary gland and its management.

  11. HIV-associated salivary gland disease--clinical or imaging diagnosis?

    Science.gov (United States)

    da Silva Rath, Inês Beatriz; Beltrame, Ana Paula C A; Carvalho, Aroldo P; Schaeffer, Marcela B; Almeida, Izabel C S

    2015-07-01

    This work aimed at studying the salivary gland disease (SGD) as it relates to associated factors, such as persistent generalised lymphadenopathy (PGL), lymphocytic interstitial pneumonia (LIP), clinical and immunological features of AIDS, and salivary flow rate and pH, as well as at exploring the relationship between the clinical diagnosis and the imaging diagnosis by ultrasound (US) examination of the parotid glands. Information regarding the observation of parotid gland enlargement, PGL, LIP, and clinical and immunological features of AIDS was gathered from medical records, and a saliva sample for unstimulated salivary flow rate and pH measurement was collected from 142 children aged 3 through 10 years treated at the Department of Infectious Diseases of Joana de Gusmão Children's Hospital, Florianópolis, SC, Brazil. High-resolution ultrasonography was performed in 58 children. Pearson's chi-square test and t-test were used to evaluate the association between the variables. A significant association was found between SGD and LIP. Ultrasound revealed a 50% higher incidence of SGD that was not reported in the patients' records. US examination proved to be essential for the correct diagnosis and monitoring of the progression of HIV/SGD. © 2014 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. The effect of customized beam shaping on normal tissue complications in radiation therapy of parotid gland tumors

    International Nuclear Information System (INIS)

    Keus, R.; Boer, R. de; Lebesque, J.; Noach, P.

    1991-01-01

    The impact of customized beam shaping was studied for 5 patients with parotid tumors treated with a paired wedged field technique. For each patient 2 plans were generated. The standard plan had unblocked portals with field sizes defined by the largest target contour found in any CT slice. In the 2nd plan customized beam's view (BEV) designed blocks were added to both beams. The differences in those distributions between the 2 types of plans were evaluated using dose-volume histograms (DVH). As expected, the dose distribution within the target volume showed no difference. However, a considerable sparing of normal tissue was observed for the plans with customized blocks. The volume of un-necessary exposed normal tissue that received more than 90 percent of the prescribed dose, was reduced by a factor of about 4: from 165 to 44 percent on an average, if the volume is expressed as a percentage of the target volume in each patient. In particular, the homolateral mandible showed a mean decrease of 21 percent of integral dose when blocks were used. Normal tissue complication probabilities (NTCP) were calculated. For a tumor dose of 70 Gy, the average bone necrosis probability was reduced from 8.4 percent (no blocks) to 4.1. percent (blocks). For other normal tissues such as nervous tissue, other soft tissues and bones a substantial reduction of integral dose was found for al patients when individual blocks were used. (author). 10 refs.; 4 figs.; 2 tabs

  13. Parotid lipoblastoma in a child: Rare presentation as huge infratemporal mass with cervical extension

    Directory of Open Access Journals (Sweden)

    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.

  14. Quantitative analysis of normal tissue effects in the clinic (QUANTEC) guideline validation using quality of life questionnaire datasets for parotid gland constraints to avoid causing xerostomia during head-and-neck radiotherapy

    International Nuclear Information System (INIS)

    Lee, Tsair-Fwu; Fang, Fu-Min

    2013-01-01

    Purpose: To perform a validation test of the quantitative analysis of normal tissue effects in the clinic (QUANTEC) guidelines against quality of life (QoL) questionnaire datasets collected prospectively from patients with head and neck (HN) cancers, including HN squamous cell carcinoma (HNSCC) and nasopharyngeal carcinoma (NPC). Methods and materials: QoL questionnaire datasets from 95 patients with NPC and 142 with HNSCC were analyzed separately. The European Organization for Research and Treatment of Cancer H and N35 QoL questionnaire was used as the endpoint evaluation. The primary endpoint (grade 3 + xerostomia) was defined as moderate to severe xerostomia 3 and 12 months after the completion of RT, and excluded patients with grade 3 + xerostomia at the baseline. The Lyman–Kutcher–Burman normal tissue complication probability (NTCP) model was used to describe the incidence of xerostomia. Negative predictive values (NPVs) were used to determine the rate of correctly predicting the lack of complications. Results: NTCP fitted parameters were TD 50 = 37.8 Gy (CI: 29.1–46.9 Gy), m = 0.59 (CI: 0.48–0.80) and TD 50 = 43.9 Gy (CI: 33.2–52.8 Gy), m = 0.48 (CI: 0.37–0.76) at the 3-month and 12-month time points, respectively. For QUANTEC validation, HN and HNSCC data validation gave similar results at 3 months; at mean doses to the spared parotid of ⩽20 and ⩽25 Gy, the QoL dataset showed approximately 22% and 28% rates of xerostomia, respectively. At 12 months, the rates of xerostomia were approximately 13% and 19%, respectively. For NPC cases, the dataset showed approximately 0% and 33% (∼67% NPV) rates of xerostomia at 3 months. At 12 months, both rates of xerostomia were approximately 0% (∼100% NPV), which differed significantly from the results for the HNSCC cohort. Conclusion: The QoL datasets validated the QUANTEC guidelines and suggested that the modified QUANTEC 20/20-Gy spared-gland guideline is suitable for clinical use in HNSCC cohorts to

  15. Parotid duct laceration repair in two horses : case report

    Directory of Open Access Journals (Sweden)

    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.

  16. A study on the changing of the irradiated mice salivary glands and it's influence to the pancreas

    Energy Technology Data Exchange (ETDEWEB)

    Funahara, Takayuki; Nasu, Masanori; Furumoto, Keiichi (Nippon Dental Univ., Tokyo (Japan))

    1991-02-01

    X-ray irradiation (10 Gy) was given to the salivary gland in mice. Protein and glycoprotein syntheses in the salivary glands and pancreas were examined by using {sup 3}H-leucine and {sup 14}C-acetylglucosamine as tracers. Quantitative analysis of serum amylase and histochemical examination were also conducted. Uptake of {sup 3}H-leucine was low in the parotid, submandibular, and sublingual glands 3 and 7 days after irradiation, which were close to those in the non-irradiated group 21 days after irradiation. Uptake of {sup 14}C-acetylglucosamine in the parotid, submandibular, and sublingual glands varied with time, which was similar to that of {sup 3}H-leucine uptake. The uptake of both {sup 14}C-acetylglucosamine and {sup 3}H-leucine in the pancreas, as opposed to that in the salivary glands, varied with time, with the highest levels on Days 3 and 7, respectively. Serum amylase level, determined by the maltopentaose method, was 5,341+-772 mU/ml in the non-irradiated group. On Day 3, it was 6,706+-583 mU/ml. This was slightly higher than the level in the non-irradiated group on Days 7 and 21, with no statistically significant difference. Hematoxylin-eosin staining revealed hypertrophy of the glandular cells on Day 3, atrophy of the glandular cells on Day 7, and irregular cell arrangement on Day 21 for the parotid gland; and atrophied granular ampulla on Day 3, and hypertrophy on Day 7 for the submandibular gland. No marked changes were observed in either the sublingual gland or pancreas. Ninhydrin staining revealed a decreased stainability in the submandibular gland on Day 3; and an increased stainability in the pancreas on Day 7. In conclusion, protein and glycoprotein syntheses in the salivary glands after X-ray irradiation of 10 Gy decreased on Days 3 and 7, respectively. This seemed to be associated with compensatory function of the pancreas. (N.K.).

  17. Proinflammatory cytokines tumor necrosis factor-alpha and interferon-gamma alter tight junction structure and function in the rat parotid gland Par-C10 cell line.

    Science.gov (United States)

    Baker, Olga J; Camden, Jean M; Redman, Robert S; Jones, Jonathan E; Seye, Cheikh I; Erb, Laurie; Weisman, Gary A

    2008-11-01

    Sjögren's syndrome (SS) is an autoimmune disorder characterized by inflammation and dysfunction of salivary glands, resulting in impaired secretory function. The production of the proinflammatory cytokines tumor necrosis factor-alpha (TNF-alpha) and interferon-gamma (IFN-gamma) is elevated in exocrine glands of patients with SS, although little is known about the effects of these cytokines on salivary epithelial cell functions necessary for saliva secretion, including tight junction (TJ) integrity and the establishment of transepithelial ion gradients. The present study demonstrates that chronic exposure of polarized rat parotid gland (Par-C10) epithelial cell monolayers to TNF-alpha and IFN-gamma decreases transepithelial resistance (TER) and anion secretion, as measured by changes in short-circuit current (I(sc)) induced by carbachol, a muscarinic cholinergic receptor agonist, or UTP, a P2Y(2) nucleotide receptor agonist. In contrast, TNF-alpha and IFN-gamma had no effect on agonist-induced increases in the intracellular calcium concentration [Ca(2+)](i) in Par-C10 cells. Furthermore, treatment of Par-C10 cell monolayers with TNF-alpha and IFN-gamma increased paracellular permeability to normally impermeant proteins, altered cell and TJ morphology, and downregulated the expression of the TJ protein, claudin-1, but not other TJ proteins expressed in Par-C10 cells. The decreases in TER, agonist-induced transepithelial anion secretion, and claudin-1 expression caused by TNF-alpha, but not IFN-gamma, were reversible by incubation of Par-C10 cell monolayers with cytokine-free medium for 24 h, indicating that IFN-gamma causes irreversible inhibition of cellular activities associated with fluid secretion in salivary glands. Our results suggest that cytokine production is an important contributor to secretory dysfunction in SS by disrupting TJ integrity of salivary epithelium.

  18. [Application scintigraphy in evaluation of salivary gland function].

    Science.gov (United States)

    Mojsak, Małgorzata Natalia; Rogowski, Franciszek

    2010-03-01

    The salivary glands belong to the exocrine glands. There are tree main pairs of salivary glands: parotid, submandibular, sublingual. Several modalities are used for salivary gland imaging, such as sonography, computer tomography and magnetic resonance imaging. The aim of these methods is mainly to present morphological impairment. Parenchymal function and excretion function of all salivary glands can be quantified by scintigraphy. After single intravenous injection of 99mTc-pertechnetate sequential images are acquired up to 25-40 minutes. Usually about fifteen minutes postinjection 3 ml of lemon juice are administered intraorally as sialogogue. Salivary scintigraphy can estimate the severity of salivary gland involvement and function disorders, which may not be accurately reflected by the morphological damage. The clinical impact of scintigraphy has been reported in multiple salivary glands diseases, such as Sjogren's syndrome, sialolithiasis with or without parenchymal damage, iatrogenic irradiation of the salivary glands for therapy of head and neck tumors or radioiodine treatment of thyroid cancer. No other method can give so much information about function of salivary glands. Scintigraphy is noninvasive examination, easy to perform, reproducible and well-tolerated by the patient.

  19. Schwannoma of the sublingual gland: report of a case

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Sook; Choi, Soon Chul; Park, Tae Won; You, Dong Soo [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    1994-08-15

    Schwannoma, also referred to as neurilemmoma, is a solitary, benign and slow growing tumor of nerve sheath origin. This rare lesion originates from Schwann cell of peripheral, autonomic and cranial nerve. Extracranial neurogenic tumor of the head and neck is uncommon. Schwannoma of the salivary gland is a particularly rare form of an extracranial neurogenic tumor, with most presenting in the parotid gland originating from a peripheral branch of the facial nerve. In this report, an unusual case of schwannoma in the sublingual region is presented and the literature concerning this subject is reviewed.

  20. Histopathologic correlation of parotid tumors

    International Nuclear Information System (INIS)

    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

  1. Diffusion-weighted MR imaging of salivary glands with gustatory stimulation - Comparison before and after radiotherapy

    International Nuclear Information System (INIS)

    Zhang, Yunyan; Gu, Yajia; Peng, Weijun; Mao, Jian; Lei, Yue; Shen, Xigang; Ou, Dan; He, Xiayun

    2013-01-01

    Background: Xerostomia is the most prominent complication in patients with head and neck carcinoma after radiotherapy (RT). Diffusion-weighted magnetic resonance imaging (DWI) with gustatory stimulation may contribute to the evaluation of salivary gland function. Purpose: To investigate the value of DWI for quantifying physiological changes of the parotid gland during gustatory stimulation in patients before and after RT. Material and Methods: Magnetic resonance imaging (MRI) was performed in 28 consecutive patients with nasopharyngeal carcinoma before and after RT and clinical xerostomia was also assessed. A DWI sequence was performed once at rest and continually repeated seven times during stimulation with ascorbic acid. Apparent diffusion coefficient (ADC) maps for parotid glands at different time points and the range of increase with stimulation were calculated. Paired two-tailed Student t tests were used to compare the ADC values before and after stimulation, and before and after RT. Results: Before RT, the ADC showed an initial increase (P<0.001) and then fluctuated during stimulation. After RT, as the clinical xerostomia changed from Grade 0 to Grade 2, the mean ADC at rest increased compared with the pre-RT value (P<0.001). A similar response to stimulation was observed, but the range of increase between the maximum ADC during stimulation and the baseline value at rest was higher post-RT than pre-RT (P=0.022). The minimum ADC during stimulation was higher than the baseline value post-RT (P=0.028), but there was no difference pre-RT (P=0.603). Conclusion: DWI combined with gustatory stimulation seems to display the physiological changes of the parotid gland following RT and may be a potential tool for non-invasively assessing salivary gland function

  2. Diffusion-weighted MR imaging of salivary glands with gustatory stimulation - Comparison before and after radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Yunyan; Gu, Yajia; Peng, Weijun; Mao, Jian; Lei, Yue; Shen, Xigang [Dept. of Radiology, Fudan Univ. Shanghai Cancer Center, Shanghai (China); Dept. of Oncology, Shanghai Medical College, Fudan Univ., Shanghai (China); Ou, Dan; He, Xiayun [Dept. of Radiation Oncology, Fudan Univ. Shanghai Cancer Center, Shanghai (China); Dept. of Oncology, Shanghai Medical College, Fudan Univ., Shanghai (China)

    2013-10-15

    Background: Xerostomia is the most prominent complication in patients with head and neck carcinoma after radiotherapy (RT). Diffusion-weighted magnetic resonance imaging (DWI) with gustatory stimulation may contribute to the evaluation of salivary gland function. Purpose: To investigate the value of DWI for quantifying physiological changes of the parotid gland during gustatory stimulation in patients before and after RT. Material and Methods: Magnetic resonance imaging (MRI) was performed in 28 consecutive patients with nasopharyngeal carcinoma before and after RT and clinical xerostomia was also assessed. A DWI sequence was performed once at rest and continually repeated seven times during stimulation with ascorbic acid. Apparent diffusion coefficient (ADC) maps for parotid glands at different time points and the range of increase with stimulation were calculated. Paired two-tailed Student t tests were used to compare the ADC values before and after stimulation, and before and after RT. Results: Before RT, the ADC showed an initial increase (P<0.001) and then fluctuated during stimulation. After RT, as the clinical xerostomia changed from Grade 0 to Grade 2, the mean ADC at rest increased compared with the pre-RT value (P<0.001). A similar response to stimulation was observed, but the range of increase between the maximum ADC during stimulation and the baseline value at rest was higher post-RT than pre-RT (P=0.022). The minimum ADC during stimulation was higher than the baseline value post-RT (P=0.028), but there was no difference pre-RT (P=0.603). Conclusion: DWI combined with gustatory stimulation seems to display the physiological changes of the parotid gland following RT and may be a potential tool for non-invasively assessing salivary gland function.

  3. Mammary analogue secretory carcinoma (MASC) of salivary gland in four Mexican patients.

    Science.gov (United States)

    Serrano-Arévalo, Mónica L; Mosqueda-Taylor, Adalberto; Domínguez-Malagón, Hugo; Michal, Michal

    2015-01-01

    The Clinco-pathological, immunohistochemical and molecular findings of four cases of Mammary Analogue Secretory Carcinoma (MASC) of salivary glands found in Mexico are described. The cases were extracted from 253 salivary gland tumors from a single institution in Mexico City. The 85 Candidates for initial selection were: low grade mucoepidermoid carcinoma (MEC) (N=70 ), Acinic cell cancinoma (AciCC) (N=14), papillary cystadenocarcinoma (N=1), and adenocarcinoma NOS (N=0). Tumors with some histological features consistent with MASC (N= 17, 6.7%) were studied by immunohistochemistry for mammaglobin, STAT5, and S-100 protein and four cases were positive (1.5%), thus the diagnosis of MASC was established, and these were submitted for molecular studies for ETV6-NTRK3. Fusion gene was demonstrated in three cases, two had been erroneously diagnosed as poorly granulated AciCC, and one as low grade MEC with microcystic pattern. Female gender predominated (3:1); one occurred in the parotid, two in minor salivary glands and one in the submaxillary gland; infiltrating borders, atypical mitosis and lymph node metastases were seen in the parotideal tumor. Two patients with major salivary gland tumors are alive and well at 10 and 20 months respectively, the two patients with minor salivary gland tumors are lost. It can be concluded that is important to think in MASC in poorly granulated AciCC and low grade MEC with microcystic pattern. Immunohistochemisty studies confirm the diagnosis, preferentially supported by molecular studies. MASC may follow aggressive behavior or transform into a high grade neoplasm.

  4. High prevalence of thyroid disease and role of salivary gland scintigraphy in patients with xerostomia

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Ji Hoon; Lee, Chang Hee; Son, Seung Hyun; Jeong, Ju Hye; Jeong, Shin Young; Lee, Sang Woo; Lee, Jae Tae; Ahn, Byeong Cheol [Dept. of Nuclear Medicine, Kyungpook National University School of Medicine/Hospital, Daegu (Korea, Republic of)

    2017-06-15

    Although Sjös syndrome (SS) is the most common disease causing xerostomia, autoimmune thyroid diseases can also affect the salivary glands. The aim of our study was to estimate the prevalence of thyroid diseases (TD) in subjects with symptoms of xerostomia and evaluate the efficacy of salivary gland scintigraphy (SGS) in the detection of TD in patients with SS and without SS. We retrospectively reviewed the SGS findings of 173 subjects (men:women, 29:144) with symptoms of xerostomia. Ejection fractions (EF) in the parotid and submandibular glands were calculated. Thyroid disease was diagnosed on the basis of the results of the visual assessment of tracer uptake in the thyroid gland on SGS images as well as serological thyroid function tests. Based on the American-European Criteria, 94 patients were diagnosed with SS. Hashimoto's thyroiditis was diagnosed in 63 patients, subacute thyroiditis in 23, subclinical hypothyroidism in five, and Graves' disease in one. There were significant differences in the EF values of the parotid and submandibular glands between patients with TD and those with undetermined diagnoses. More than half of patients with xerostomia exhibited TD. Thyroid assessment by SGS is feasible, and SGS appears to be useful for the patients with xerostomia caused by TD. SGS may be the first imaging modality capable of evaluating both salivary gland function and thyroid gland status in patients with xerostomia. This strategy would make the requirement for additional workup for thyroid disease.

  5. High prevalence of thyroid disease and role of salivary gland scintigraphy in patients with xerostomia

    International Nuclear Information System (INIS)

    Jung, Ji Hoon; Lee, Chang Hee; Son, Seung Hyun; Jeong, Ju Hye; Jeong, Shin Young; Lee, Sang Woo; Lee, Jae Tae; Ahn, Byeong Cheol

    2017-01-01

    Although Sjös syndrome (SS) is the most common disease causing xerostomia, autoimmune thyroid diseases can also affect the salivary glands. The aim of our study was to estimate the prevalence of thyroid diseases (TD) in subjects with symptoms of xerostomia and evaluate the efficacy of salivary gland scintigraphy (SGS) in the detection of TD in patients with SS and without SS. We retrospectively reviewed the SGS findings of 173 subjects (men:women, 29:144) with symptoms of xerostomia. Ejection fractions (EF) in the parotid and submandibular glands were calculated. Thyroid disease was diagnosed on the basis of the results of the visual assessment of tracer uptake in the thyroid gland on SGS images as well as serological thyroid function tests. Based on the American-European Criteria, 94 patients were diagnosed with SS. Hashimoto's thyroiditis was diagnosed in 63 patients, subacute thyroiditis in 23, subclinical hypothyroidism in five, and Graves' disease in one. There were significant differences in the EF values of the parotid and submandibular glands between patients with TD and those with undetermined diagnoses. More than half of patients with xerostomia exhibited TD. Thyroid assessment by SGS is feasible, and SGS appears to be useful for the patients with xerostomia caused by TD. SGS may be the first imaging modality capable of evaluating both salivary gland function and thyroid gland status in patients with xerostomia. This strategy would make the requirement for additional workup for thyroid disease

  6. Intensity-modulated radiotherapy significantly reduces xerostomia compared with conventional radiotherapy

    International Nuclear Information System (INIS)

    Braam, Petra M.; Terhaard, Chris H.J. M.D.; Roesink, Judith M.; Raaijmakers, Cornelis P.J.

    2006-01-01

    Purpose: Xerostomia is a severe complication after radiotherapy for oropharyngeal cancer, as the salivary glands are in close proximity with the primary tumor. Intensity-modulated radiotherapy (IMRT) offers theoretical advantages for normal tissue sparing. A Phase II study was conducted to determine the value of IMRT for salivary output preservation compared with conventional radiotherapy (CRT). Methods and Materials: A total of 56 patients with oropharyngeal cancer were prospectively evaluated. Of these, 30 patients were treated with IMRT and 26 with CRT. Stimulated parotid salivary flow was measured before, 6 weeks, and 6 months after treatment. A complication was defined as a stimulated parotid flow rate <25% of the preradiotherapy flow rate. Results: The mean dose to the parotid glands was 48.1 Gy (SD 14 Gy) for CRT and 33.7 Gy (SD 10 Gy) for IMRT (p < 0.005). The mean parotid flow ratio 6 weeks and 6 months after treatment was respectively 41% and 64% for IMRT and respectively 11% and 18% for CRT. As a result, 6 weeks after treatment, the number of parotid flow complications was significantly lower after IMRT (55%) than after CRT (87%) (p = 0.002). The number of complications 6 months after treatment was 56% for IMRT and 81% for CRT (p = 0.04). Conclusions: IMRT significantly reduces the number of parotid flow complications for patients with oropharyngeal cancer

  7. Light microscopic detection of sugar residues in glycoconjugates of salivary glands and the pancreas with lectin-horseradish peroxidase conjugates. I. Mouse.

    Science.gov (United States)

    Schulte, B A; Spicer, S S

    1983-12-01

    Mouse salivary glands and pancreases were stained with a battery of ten horseradish peroxidase-conjugated lectins. Lectin staining revealed striking differences in the structure of oligosaccharides of stored intracellular secretory glycoproteins and glycoconjugates associated with the surface of epithelial cells lining excretory ducts. The percentage of acinar cells containing terminal alpha-N-acetylgalactosamine residues varied greatly in submandibular glands of 30 male mice, but all submandibular acinar cells contained oligosaccharides with terminal sialic acid and penultimate beta-galactose residues. The last named dimer was abundant in secretory glycoprotein of all mucous acinar cells in murine sublingual glands and an additional 20-50% of these cells in all glands contained terminal N-acetylglucosamine residues. In contrast, terminal alpha-N-acetylgalactosamine was abundant in sublingual serous demilune secretions. Serous acinar cells in the exorbital lacrimal gland, posterior lingual gland, parotid gland and pancreas exhibited a staining pattern unique to each organ. In contrast, the apical cytoplasm and surface of striated duct epithelial cells in the submandibular, sublingual, parotid and exorbital lacrimal gland stained similarly. A comparison of staining with conjugated lectins reported biochemically to have very similar carbohydrate binding specificity has revealed some remarkable differences in their reactivity, suggesting different binding specificity for the same terminal sugars having different glycosidic linkages or with different penultimate sugar residues.

  8. Is uniform target dose possible in IMRT plans in the head and neck?

    International Nuclear Information System (INIS)

    Vineberg, K.A.; Eisbruch, A.; Coselmon, M.M.; McShan, D.L.; Kessler, M.L.; Fraass, B.A.

    2002-01-01

    Purpose: Various published reports involving intensity-modulated radiotherapy (IMRT) plans developed using automated optimization (inverse planning) have demonstrated highly conformal plans. These reported conformal IMRT plans involve significant target dose inhomogeneity, including both overdosage and underdosage within the target volume. In this study, we demonstrate the development of optimized beamlet IMRT plans that satisfy rigorous dose homogeneity requirements for all target volumes (e.g., ±5%), while also sparing the parotids and other normal structures. Methods and Materials: The treatment plans of 15 patients with oropharyngeal cancer who were previously treated with forward-planned multisegmental IMRT were planned again using an automated optimization system developed in-house. The optimization system allows for variable sized beamlets computed using a three-dimensional convolution/superposition dose calculation and flexible cost functions derived from combinations of clinically relevant factors (costlets) that can include dose, dose-volume, and biologic model-based costlets. The current study compared optimized IMRT plans designed to treat the various planning target volumes to doses of 66, 60, and 54 Gy with varying target dose homogeneity while using a flexible optimization cost function to minimize the dose to the parotids, spinal cord, oral cavity, brainstem, submandibular nodes, and other structures. Results: In all cases, target dose uniformity was achieved through steeply varying dose-based costs. Differences in clinical plan evaluation metrics were evaluated for individual cases (eight different target homogeneity costlets), and for the entire cohort of plans. Highly conformal plans were achieved, with significant sparing of both the contralateral and ipsilateral parotid glands. As the homogeneity of the target dose distributions was allowed to decrease, increased sparing of the parotids (and other normal tissues) may be achieved. However, it

  9. SU-D-204-04: Correlations Between Dosimetric Indices and Follow-Up Data for Salivary Glands Six Months After Radiation Therapy for Head and Neck Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chera, B; Price, A; Kostich, M; Green, R; Das, S; Mavroidis, P [University of North Carolina, Chapel Hill, North Carolina (United States); Amdur, R; Mendenhall, W [University of Florida, Gainesville, FL (United States); Sheets, N [University of North Carolina, Raleigh, North Carolina (United States); Marks, L [UNC School of Medicine, Chapel Hill, NC (United States)

    2016-06-15

    Purpose: To investigate the correlation between different dosimetric indices of salivary glands (as separate or combined structures) to patient-reported dry mouth 6 months post radiotherapy using the novel patient reported outcome version of the CTCAE (PRO-CTCAE). Methods: Forty-three patients with oropharyngeal squamous cell carcinoma were treated on a prospective multi-institutional study. All patients received de-intensified 60 Gy intensity modulated radiotherapy. Dosimetric constraints were used for the salivary glands (e.g. mean dose to the contralateral-parotid < 26 Gy). We investigated correlations of individual patient dosimetric data of the parotid and submandibular glands (as separate or combined structures) to their self-reported 6 month post-treatment dry mouth responses. Moderate dry mouth responses were most prevalent and were used as the clinical endpoint indicating response. The correlation of Dmean, Dmax and a range of dosevolume (VD) points were assessed through the area under the Receiver Operating Characteristic curve (ROC) and Odds Ratios (OR). Results: Patients reporting non/mild dry mouth response (N=22) had average Dmean = 19.6 ± 6.2Gy to the contralateral-parotid compared to an average Dmean = 28.0 ± 8.3Gy and an AUC = 0.758 for the patients reporting moderate/severe/very severe dry mouth (N=21). Analysis of the range of VD’s for patients who had reported dry mouth showed that for the contralateral-parotid the indices V18 through V22 had the highest area under the curves (AUC) (0.762 – 0.772) compared to a more traditional dosimetric index V30, which had an AUC = 0.732. The highest AUC was observed for the combination of contralateral parotid and contralateral submandibular glands, for which V16 through V28 had AUC = 0.801 – 0.834. Conclusion: Patients who report moderate/severe/very severe dry mouth 6 months post radiotherapy had on average higher Dmean. The V16-V28 of the combination of the contralateral glands showed the highest

  10. Adenoid cystic carcinoma of sublingual glands. Surgery and radiotherapy combination

    International Nuclear Information System (INIS)

    Campagnale, Ramiro; Campagnale, Rodrigo; Varalli, Lucas

    2005-01-01

    The Adenoid Cystic Carcinoma (ACC) or Cilindroma is a strange entity classified by the WHO within the carcinomas of salivary glands. It represents only 1 % of all the wicked tumours of the oral and maxillofacial region although, when making reference to the salivary glands, it constitutes 5% of the parotid, submaxilar and sublingual carcinomas, and about 50% of the smallest ones. The most frequent location is in the palatine glands and its main characteristics are: slow but persistent growth, high rates of local relapse and metastasis at distance originating the death between the first 5 and 10 years in 50-70% of the cases approximately. A case of localization is presented in sublingual gland which was first treated surgically and later with radiotherapy, obtaining good results. (author) [es

  11. A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies

    DEFF Research Database (Denmark)

    Jensen, S.B.; Pedersen, A.M.L.; Vissink, A.

    2010-01-01

    submandibular and minor salivary glands, as these glands are major contributors to moistening of oral tissues. Other cancer treatments also induce salivary gland hypofunction, although to a lesser severity, and in the case of chemotherapy and immunotherapy, the adverse effect is temporary. Fields of sparse...... met by 184 articles covering salivary gland hypofunction and xerostomia induced by conventional, 3D conformal radiotherapy or intensity-modulated radiotherapy in head and neck cancer patients, cancer chemotherapy, total body irradiation/hematopoietic stem cell transplantation, radioactive iodine...... treatment, and immunotherapy. Salivary gland hypofunction and xerostomia are induced by radiotherapy in the head and neck region depending on the cumulative radiation dose to the gland tissue. Treatment focus should be on optimized/new approaches to further reduce the dose to the parotids, and particularly...

  12. The computed tomographic evaluation of diseases involving parotid gland

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Hyo In; Kim, Dong Ik; Suh, Jung Ho; Park, Jung Soo [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1988-10-15

    During 1983.3.-1986.8., CT findings of 35 cases of parotid lesions were retrospectively reviewed together with their surgical and histologic findings to determine its value in 3 points. 1) Anatomical localization of the lesion 2) Differentiation between benign and malignant tumors 3) The relationship with the facial nerve And also CT Sialography was done in 4 cases. The results were as follows. 1) The age distribution was 1 month-66 years of age. Male to female ratio was 4:3. 2) The most common benign tumor was pleomorphic adenoma (15%) and the most common malignant tumor was carcinoma (15%). 3) Anatomical localization was possible in all cases by noticing the direction toward the fat plane was displaced. 4) Invasion to facial nerve was determined by obliteration of the normal 'bull's 'eye'. 5) Malignancy was rather suggested when the lesion shows ill-defined border, necrotic central low density, lymphadenopathy, and ductal obstruction without a stone. Most of the diagnosis difficulties were in cases of inflammatory mass lesions and sialography was more useful than CT in such cases.

  13. 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

  14. Immunodetection of aquaporin 5 in sheep salivary glands related to pasture vegetative cycle

    Directory of Open Access Journals (Sweden)

    Silvana Arrighi

    2011-10-01

    Full Text Available Mammalian aquaporins (AQPs are a family of at least 13 integral membrane proteins expressed in various epithelia, where they function as channels to permeate water and small solutes. AQP5 is widely expressed in the exocrine gland where it is likely involved in providing an appropriate amount of fluid to be secreted with granular contents. As regards AQP5 expression in the salivary glands, literature is lacking concerning domestic animal species. This study was chiefly aimed at immunohistochemically investigating the presence and localization of AQP5 in sheep mandibular and parotid glands. In addition, AQP5 immunoreactivity was comparatively evaluated in animals fed with forage containing different amounts of water related to the pasture vegetative cycle, in order to shed light on the possible response of the gland to environmental modifications. Moderate AQP5-immunoreactivity was shown at the level of the lateral surface of mandibular serous demilune cells, not affected by the pasture vegetative cycle or water content. On the contrary, the parotid gland arcinar cells showed AQP5-immunoreactivity at the level of apical and lateral plasma membrane, which was slight to very strong, according to the pasture vegetative development and interannual climatic variations. AQP5 expression is likely due to its involvement in providing appropriate saliva fluidity. Indeed, the lowest AQP5 immunoreactivity was noticed when food water content increased. (Folia Histochemica et Cytobiologica 2011; Vol. 49, No. 3, pp. 458–464

  15. Dual pathology of the submandibular gland: plasmacytoma and pleomorphic adenoma.

    Science.gov (United States)

    Menon, Shalini; Pujary, Kailesh; Valiathan, Manna

    2014-03-03

    Synchronous tumours of different histological types involving the salivary gland are very rare. There have been cases reported in the literature of such tumours occurring in the parotid gland. A 52-year-old man presented with a 4-year history of gradually increasing painless swelling in the right submandibular region. The ultrasound scan of the neck showed features suggestive of a submandibular sialadenitis. The right submandibular gland was then surgically excised and sent for histopathological examination. The features showed a unique dual pathology of the submandibular gland, that is, a plasmacytoma and a pleomorphic adenoma. Such a synchronous double pathology involving the submandibular gland has not been reported in the literature. A review of the literature suggests a good prognosis for the extramedullary plasmacytoma, provided multiple myeloma is ruled out. In 18 months of follow-up, the patient has been asymptomatic with a negative myeloma workup.

  16. Differentiation between Superficial and Deep Lobe Parotid Tumors by Magnetic Resonance Imaging: Usefulness of the Parotid Duct Criterion

    Energy Technology Data Exchange (ETDEWEB)

    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

  17. 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

  18. Immunolocalization and distribution of functional temperature-sensitive TRP channels in salivary glands.

    Science.gov (United States)

    Sobhan, Ubaidus; Sato, Masaki; Shinomiya, Takashi; Okubo, Migiwa; Tsumura, Maki; Muramatsu, Takashi; Kawaguchi, Mitsuru; Tazaki, Masakazu; Shibukawa, Yoshiyuki

    2013-11-01

    Transient receptor potential (TRP) cation channels are unique cellular sensors involved in multiple cellular functions. Their role in salivary secretion remains to be elucidated. The expression and localization of temperature-sensitive TRP channels in salivary (submandibular, sublingual and parotid) glands were analyzed by immunohistochemistry and quantitative real-time reverse transcription plus the polymerase chain reaction (RT-PCR). The effects of various TRP channel agonists on carbachol (CCh)-induced salivary secretion in the submandibular gland and on the intracellular Ca(2+) concentration ([Ca(2+)]i) in a submandibular epithelial cell line were also investigated. Immunohistochemistry revealed the expression of TRP-melastatin subfamily member 8 (TRPM8) and TRP-ankyrin subfamily member 1 (TRPA1) in myoepithelial, acinar and ductal cells in the sublingual, submandibular and parotid glands. In addition, TRP-vanilloid subfamily member 1 (TRPV1), TRPV3 and TRPV4 were also expressed in myoepithelial, acinar and ductal cells in all three types of gland. Quantitative real-time RT-PCR results demonstrated the mRNA expression of TRPV1, TRPV3, TRPV4, TRPM8 and TRPA1 in acinar and ductal cells in these salivary glands. Perfusion of the entire submandibular gland with the TRPV1 agonist capsaicin (1 μM) via the submandibular artery significantly increased CCh-induced salivation, whereas perfusion with TRPM8 and TRPA1 agonists (0.5 μM WS12 and 100 μM allyl isothiocyanate) decreased it. Application of agonists for each of the thermosensitive TRP channels increased [Ca(2+)]i in a submandibular epithelial cell line. These results indicate that temperature-sensitive TRP channels are localized and distributed in acinar, ductal and myoepithelial cells in salivary glands and that they play a functional role in the regulation and/or modulation of salivary secretion.

  19. Isolation and characterization of human salivary gland cells for stem cell transplantation to reduce radiation-induced hyposalivation

    International Nuclear Information System (INIS)

    Feng Jielin; Zwaag, Marianne van der; Stokman, Monique A.; Os, Ronald van; Coppes, Robert P.

    2009-01-01

    Background: Recently, we showed that transplantation of 100-300 c-Kit + stem cells isolated from cultured salispheres ameliorates radiation-damage in murine salivary glands. The aim of this study is to optimize and translate these findings from mice to man. Methods: Mouse and human non-malignant parotid and submandibular salivary gland tissue was collected and enzymatically digested. The remaining cell suspension was cultured according to our salisphere culture method optimized for murine salispheres. Salisphere cells were tested using 3D matrix culturing for their in vitro stem cell characteristics such as the potential to differentiate into tissue specific cell types. Several potential mouse and human salivary gland stem cells were selected using FACS. Results: In human salivary gland, c-Kit + cells were only detected in excretory ducts as shown previously in mice. From both human parotid and submandibular gland cell suspensions salispheres could be grown, which when placed in 3D culture developed ductal structures and mucin-expressing acinar-like cells. Moreover, cells dispersed from primary salispheres were able to form secondary spheres in matrigel, a procedure that could be repeated for at least seven passages. Approximately 3000 c-Kit + cells could be isolated from primary human salispheres per biopsy. Conclusion: Human salivary glands contain a similar 'putative' stem cell population as rodents, expressing c-kit and capable of in vitro differentiation and self-renewal. In the future, these cells may have the potential to reduce radiotherapy-induced salivary gland dysfunction in patients.

  20. 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

  1. 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

  2. Effects of thyroxine and dexamethasone on rat submandibular glands

    International Nuclear Information System (INIS)

    Sagulin, G.B.; Roomans, G.M.

    1989-01-01

    Glucocorticoids and thyroxine are known to have a marked effect on the flow rate and protein composition of rat parotid saliva in hormonally intact animals. In the present study, the effects of a one-week treatment of male rats with dexamethasone and thyroxine were studied by electron microscopy and x-ray micro-analysis, and by measurement of the flow rate and determination of the chemical composition of pilocarpine-induced submandibular saliva. Thyroxine had the most extensive effects on the submandibular gland. The acinar cells were enlarged and filled with mucus; the cellular calcium concentration was significantly increased. The flow rate of the submandibular saliva was significantly reduced compared with that in saline-injected control animals. Thyroxine caused an increase in the concentrations of protein, total calcium, and potassium in the saliva. Dexamethasone had no significant effects on gland ultrastructure or on the elemental composition of the acinar cells; flow rate was not affected, but the concentrations of protein, calcium, and potassium were significantly increased. The effects of dexamethasone and thyroxine on the flow rate and protein composition of pilocarpine-induced rat submandibular saliva differ from those reported earlier for rat parotid saliva after simultaneous stimulation with pilocarpine and isoproterenol

  3. Evaluation of Salivary Gland Dysfunction Using Salivary Gland Scintigraphy in Sjoegren's Syndrome Patients and in Thyroid Cancer Patients after Radioactive Iodine Therapy

    International Nuclear Information System (INIS)

    Kang, Ji Yeon; Jang, Su Jin; Lee, Won Woo; Jang, Sung June; Lee, Yun Jong; Kim, Sang Eun

    2011-01-01

    Salivary gland scintigraphy (SGS) provides an objective means of diagnosing salivary gland dysfunction in Sjogren's syndrome (SS) patients and in thyroid cancer patients after radioactive iodine (RAI) therapy. In the present study, SGS was performed in SS patients and in thyroid cancer patients post RAI, and scintigraphic parameters were compared. Twenty eight SS patients (males:females=1:27, age 53.3±11.9 years), 28 controls (males:females=3.25, age 54.1±10.1 years), and 92 thyroid cancer patients (males:females=28:64, age 46.2±12.9) who had undergone a session of high dose RAI therapy (mean dose, 5.2±1.5 GBq) were included. SGS was performed using Tc 99m pertechnetate (925MBq). Scintigraphic parameters (parotid uptake ratio PU, submandibular uptake ratio SU, percent age parotid excretion %PE, and percentage submandibular excretion %SE) were measured and compared for SS, thyroid cancer post RAI, and control patients. PU, SU, %SE, and %PE were all significantly lower in SS than in post RAI thyroid cancer of control patients (p<0.05), whereas only %PE was significantly lower in post RAI thyroid cancer patients than in controls (P<0.05). SU and %SE were found to be correlated with the unstimulated whole salivary flow rate. Scintigraphic parameters derived from SGS can play a crucial role in the detection of salivary gland dysfunction in SS patients and in post RAI thyroid cancer patients.

  4. Value of sialography and salivary gland scintigraphy in the evaluation of rheumatoid polyarthritis

    International Nuclear Information System (INIS)

    Rousse, M.M.

    1976-01-01

    This work aims to establish the frequency and severity of salivary gland disease. Very many techniques are available for the exploration of these glands. Each patient was subjected to: a parotid sialograph, a technetium 99m exploration of the salivary glands and mouth cavity. These two methods of salivary gland exploration should be carried out together, since sialographic data are largely static and anatomical while scintigraphy mainly supplies dynamic, functional data. The scintigraphic examinations were carried out with a Picker Dyna Camera II coupled to data processing units (NUKAB system with recorded programmes). The radiotracer used is technetium 99m. 2 millicuries of technetium as pertechnetate are injected intraveinously and reach the salivary glands through their vascular networks, thus being available to the different tissues of each gland: interstitial tissue, acini, intralobular ducts, efferent ducts [fr

  5. In vitro metabolism of testosterone-4-14C by canine salivary glands

    International Nuclear Information System (INIS)

    Mosadomi, A.; Ofner, P.

    1976-01-01

    Testosterone-4- 14 C (2430 pmol, 048 μM) was incubated aerobically in 67 mM phosphate buffer pH 7.4 with homogenates and minces of salivary glands from male dogs. Extracted radiosteroids were resolved by thin-layer chromatography on silica gel, removed and quantitated. Substantially higher NADsup(+)-dependent 17 β-hydroxy-C 19 -steroid oxidoreductase activity was found in submaxillary gland homogenates than in similar parotid-gland preparations. Preliminary evidence is presented that the enzyme activity per unit wet weight of the minced submaxillary gland is decreased in the 2-week male castrate, in the absence of any recognizable histologic changes in the gland. Testosterone metabolism by canine salivary glands is thus oxidative contrasting with the reductive 17 β-hydroxysteroid pathway characteristic of androgen-dependent organs such as the prostate, and is more extensive than in this accessory sex tissue. Our findings suggest that the canine salivary glands are not target organs for circulating male hormone. (author); LATING M

  6. 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.

  7. Factors of salivary gland tumor influence on salivary gland function. Studies on salivary scintigraphy using 99mTcO4-

    International Nuclear Information System (INIS)

    Toyama, Michio; Katada, Tsutomu; Sasaki, Yoshihiko; Togashi, Masatoshi; Tsuchimochi, Makoto

    2000-01-01

    The purpose of this study was to show clearly what factors such as tumor size, duration of illness, location, and tumor invasion in salivary gland tumor affect salivary gland function. The study cases were 42 salivary gland tumor patients who underwent computed tomography (CT) and sialoscintigraphy. Salivary gland tumor was confirmed histopathologically. The patients were 24 males and 18 females, aged from 16 to 82 years old (mean age: 52.8 years old). There were 23 patients with parotid gland tumors and 19 patients with submandibular gland tumors (27 benign tumors, 15 malignant tumors). By using 99m TcO 4 - sialoscintigraphy, the salivary gland function was classified into three different types according to stimulatory selection ratio which was expressed as the ratio of pre- to post-stimulation counts on the salivary gland, namely, normal, lower functional, and no functional types. Then the normal type was judged abnormal function, and the lower and no functional types were judged as abnormal function. The results were as follows: There was a significant difference between malignant tumor and benign tumor in salivary gland function (P<0.0001). Depending on tumor size, abnormal function was significantly higher than normal function (P<0.05). There was no statistical significant difference among duration of illness, location of tumor, and salivary gland function. There was a significant difference between tumor invasion and salivary gland function (P<0.0001). The results showed that salivary gland function was disturbed in salivary gland tumor with larger size and positive invasion. (author)

  8. Parotid Gland Biopsy, the Alternative Way to Diagnose Sjogren Syndrome

    NARCIS (Netherlands)

    Spijkervet, Fred. K.L.; Haacke, Erlin; Kroese, Frans G. M.; Bootsma, Hendrika; Vissink, Arjan

    Salivary gland biopsy is a technique broadly applied for the diagnosis of Sjogren syndrome (SS), lymphoma in SS, and connective tissue disorders (sarcoidosis, amyloidosis). In SS characteristic histology findings are found, including lymphocytic infiltration surrounding the excretory ducts in

  9. Isolation of rabies virus from the parotid salivary glands of foxes (Pseudalopex vetulus from Paraíba State, Northeastern Brazil Isolamento de vírus rábico de glândulas salivares parótidas de raposas (Pseudalopex vetulus do Estado da Paraíba, Nordeste do Brasil

    Directory of Open Access Journals (Sweden)

    Maria Luana Cristiny Rodrigues Silva

    2009-09-01

    Full Text Available To determine the presence of rabies virus in the parotid salivary glands, 12 road-killed rabies-positive hoary foxes (Pseudoalopex vetulus were tested by using the fluorescent antibody test (FAT and mouse inoculation test (MIT. All 12 parotid salivary glands were positive for both tests, although in some cases several passages were required. The findings of this study support the importance of the hoary fox as rabies reservoir in the semi-arid region of Paraíba State, Northeastern Brazil.Para determinar a presença de vírus rábico em glândulas salivares parótidas, 12 raposas (Pseudalopex vetulus atropeladas em rodovias e positivas para raiva foram testadas pelo teste de imunofluorescência direta (IFD e teste de inoculação em camundongos (IC. Todas as 12 glândulas salivares parótidas foram positivas em ambos os testes, embora, em alguns casos, várias passagens terem sido necessárias. Os achados do presente trabalho reforçam a importância das raposas como reservatórios de raiva no semi-árido do Estado da Paraíba, Nordeste do Brasil.

  10. Salivary gland carcinoma in Denmark 1990-2005: a national study of incidence, site and histology. Results of the Danish Head and Neck Cancer Group (DAHANCA)

    DEFF Research Database (Denmark)

    Bjørndal, Kristine; Krogdahl, Annelise; Therkildsen, Marianne Hamilton

    2011-01-01

    years. The parotid gland was the most common site (52.5%) followed by the minor salivary glands of the oral cavity (26.3%). The most frequent histological subtypes were adenoid cystic carcinoma (25.2%), mucoepidermoid carcinoma (16.9%), adenocarcinoma NOS (12.2%) and acinic cell carcinoma (10...

  11. Evaluation of Salivary Gland Dysfunction Using Salivary Gland Scintigraphy in Sjoegren's Syndrome Patients and in Thyroid Cancer Patients after Radioactive Iodine Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Ji Yeon; Jang, Su Jin; Lee, Won Woo; Jang, Sung June; Lee, Yun Jong; Kim, Sang Eun [Seoul National Univ., Seoul (Korea, Republic of)

    2011-09-15

    Salivary gland scintigraphy (SGS) provides an objective means of diagnosing salivary gland dysfunction in Sjogren's syndrome (SS) patients and in thyroid cancer patients after radioactive iodine (RAI) therapy. In the present study, SGS was performed in SS patients and in thyroid cancer patients post RAI, and scintigraphic parameters were compared. Twenty eight SS patients (males:females=1:27, age 53.3{+-}11.9 years), 28 controls (males:females=3.25, age 54.1{+-}10.1 years), and 92 thyroid cancer patients (males:females=28:64, age 46.2{+-}12.9) who had undergone a session of high dose RAI therapy (mean dose, 5.2{+-}1.5 GBq) were included. SGS was performed using Tc 99m pertechnetate (925MBq). Scintigraphic parameters (parotid uptake ratio PU, submandibular uptake ratio SU, percent age parotid excretion %PE, and percentage submandibular excretion %SE) were measured and compared for SS, thyroid cancer post RAI, and control patients. PU, SU, %SE, and %PE were all significantly lower in SS than in post RAI thyroid cancer of control patients (p<0.05), whereas only %PE was significantly lower in post RAI thyroid cancer patients than in controls (P<0.05). SU and %SE were found to be correlated with the unstimulated whole salivary flow rate. Scintigraphic parameters derived from SGS can play a crucial role in the detection of salivary gland dysfunction in SS patients and in post RAI thyroid cancer patients.

  12. A Randomized Controlled Trial for the Effectiveness of Aromatherapy in Decreasing Salivary Gland Damage following Radioactive Iodine Therapy for Differentiated Thyroid Cancer

    Directory of Open Access Journals (Sweden)

    Michihiro Nakayama

    2016-01-01

    Full Text Available Objective. The aim of this study was to investigate effects of aromatherapy in decreasing salivary gland damage for patients undergoing radioactive iodine (RAI therapy with differentiated thyroid cancer (DTC. Materials and Methods. The subjects were 71 patients with DTC. They were divided into aromatherapy group (group A, n=35 and a control group (group B, n=36. We blended 1.0 mL of lemon and 0.5 mL of ginger essential oils. The patients in the inhalation aromatherapy group inhaled this blend oil and those in the control group inhaled distilled water as placebo for 10 min during admission. We statistically compared salivary gland function before and after treatment between groups A and B. Results. In comparison with group B, the rate of change of the accumulation rate was significantly higher in the parotid glands and submandibular glands of group A (P<0.05. In comparison with group B, a significant increase in rate of secretion change before and after treatment was noted in the bilateral parotid glands in group A (P<0.05. Conclusion. Because an amelioration of salivary gland function was observed in the present study, our results suggest the efficacy of aromatherapy in the prevention of treatment-related salivary gland disorder. This trial is registered with UMIN Clinical Trial Registry: UMIN000013968.

  13. 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

  14. Detection of the involvement of salivary glands in autoimmune diseases of thyroid gland by using Ttc-99m MIBI

    Directory of Open Access Journals (Sweden)

    Deniz Söylemez ¹

    2017-03-01

    Full Text Available Aim: The aim of this study was to determine the involvement in the salivary glands of the patients with Graves’ Disease, Hashimoto Thyroiditis and controls by detecting the changes of Tc-99m Methoxyisobutylisonitrile (Tc-99m MIBI uptake. Material and Methods: The study was conducted between January 2008 and December 2009. 19 patients with Graves’ disease (6 men, 13 women, 28 Hashimoto Thyroiditis patients (5 men, 23 women and 11 euthyroid controls (4 men, 7 women were evaluated retrospectively. Uptake values of parotid and submandibular glands were calculated by drawing elliptical ROIs (region of interest and using the formula for uptake calculation. Result: In all three groups, in parotis glands, a statistical significant difference between Tc-99m MIBI uptake was not detected. The Tc-99m MIBI upateke values in submandibular glands were statistically different among patients with Graves’Disease, Hashimoto Thyroiditis, as well as in Control group (p<0.05. Conclusion: We concluded that the different uptake values of Tc-99m-MIBI in submandibular glands in Graves disease and Hashimoto thyroiditis as compared to the control group patient would be results of the histopathological features, such as autoimmunity, high mitochondria number and inflammatory reaction. [J Contemp Med 2017; 7(1.000: 67-73

  15. SU-E-J-109: Evaluation of Deformable Accumulated Parotid Doses Using Different Registration Algorithms in Adaptive Head and Neck Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    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

  16. Basal cell adenoma of the salivary gland: Cribriform type, a rare case with review of literature

    Directory of Open Access Journals (Sweden)

    Raghunath Prabhu

    2016-12-01

    Full Text Available Basal cell adenoma (BCA of the salivary glands is a rare benign tumor resembling pleomorphic adenoma, but with a prominent basaloid cell layer. The majority of these tumors arise in the parotid glands and account for only 1% of all salivary gland epithelial tumors. We report one such case of a swelling in the floor of the mouth in a 55-year-old female where BCA is the most likely diagnosis; however, histological variation does show a similarity to malignant adenoid cystic carcinoma, thereby making the diagnosis difficult. The incidence of malignancy is relatively higher in the submandibular, sublingual and minor salivary glands. Approximately, 85% of sublingual gland tumors are malignant. Thus, we should be more careful when making a diagnosis in minor salivary gland tumors. [Arch Clin Exp Surg 2016; 5(4.000: 246-249

  17. SU-D-204-05: Fitting Four NTCP Models to Treatment Outcome Data of Salivary Glands Recorded Six Months After Radiation Therapy for Head and Neck Tumors

    Energy Technology Data Exchange (ETDEWEB)

    Mavroidis, P; Price, A; Kostich, M; Green, R; Das, S; Marks, L; Chera, B [University North Carolina, Chapel Hill, NC (United States); Amdur, R; Mendenhall, W [University of Florida, Gainesville, FL (United States); Sheets, N [University of North Carolina, Raleigh, NC (United States)

    2016-06-15

    Purpose: To estimate the radiobiological parameters of four popular NTCP models that describe the dose-response relations of salivary glands to the severity of patient reported dry mouth 6 months post chemo-radiotherapy. To identify the glands, which best correlate with the manifestation of those clinical endpoints. Finally, to evaluate the goodness-of-fit of the NTCP models. Methods: Forty-three patients were treated on a prospective multiinstitutional phase II study for oropharyngeal squamous cell carcinoma. All the patients received 60 Gy IMRT and they reported symptoms using the novel patient reported outcome version of the CTCAE. We derived the individual patient dosimetric data of the parotid and submandibular glands (SMG) as separate structures as well as combinations. The Lyman-Kutcher-Burman (LKB), Relative Seriality (RS), Logit and Relative Logit (RL) NTCP models were used to fit the patients data. The fitting of the different models was assessed through the area under the receiver operating characteristic curve (AUC) and the Odds Ratio methods. Results: The AUC values were highest for the contralateral parotid for Grade ≥ 2 (0.762 for the LKB, RS, Logit and 0.753 for the RL). For the salivary glands the AUC values were: 0.725 for the LKB, RS, Logit and 0.721 for the RL. For the contralateral SMG the AUC values were: 0.721 for LKB, 0.714 for Logit and 0.712 for RS and RL. The Odds Ratio for the contralateral parotid was 5.8 (1.3–25.5) for all the four NTCP models for the radiobiological dose threshold of 21Gy. Conclusion: It was shown that all the examined NTCP models could fit the clinical data well with very similar accuracy. The contralateral parotid gland appears to correlated best with the clinical endpoints of severe/very severe dry mouth. An EQD2Gy dose of 21Gy appears to be a safe threshold to be used as a constraint in treatment planning.

  18. Late simultaneous metastasis of renal cell carcinoma to the submandibular and thyroid glands seven years after radical nephrectomy.

    Science.gov (United States)

    Miah, Mohammed S; White, Sharon J; Oommen, George; Birney, Esther; Majumdar, Samit

    2010-01-01

    Background. Renal cell carcinoma (RCC) metastasis to the salivary glands is extremely rare. Most cases reported previously have involved the parotid gland and only six cases involving the submandibular gland exist in the current literature. Metastasis of RCC to thyroid gland is also rare but appears to be more common than to salivary glands. Methods and Results. We present the first case of simultaneous metastasis to the submandibular and thyroid glands from clear cell RCC in a 61-year-old woman who presented seven years after the primary treatment. The submandibular and thyroid glands were excised completely with preservation of the marginal mandibular and recurrent laryngeal nerves, respectively. Conclusion. Metastatic disease should always be considered in the differential diagnosis for patients who present with painless salivary or thyroid gland swelling with a previous history of RCC. If metastatic disease is confined only to these glands, prompt surgical excision can be curative.

  19. 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 ...

  20. Evaluation of Ga-67 scintigraphy for salivary gland tumors

    International Nuclear Information System (INIS)

    Takase, Hiroshi; Toyama, Michio; Eguchi, Tooru; Maeda, Kadzuo

    1993-01-01

    It is often difficult to exactly grasp the malignancy of salivary gland tumor because of inadaptability of percutaneous biopsy. The purpose of this study is to discuss whether Ga-67 scintigraphy on patient with salivary gland tumor can provide useful information for differential diagnosis. We studied retrospectivelly the case records of twenty patients with parotid or submandibular gland tumors admitted to the Nippon Dental University, School of Dentistry at Niigata, between January 1984 and December 1991. The final diagnoses of these twenty patients were pleomorphic adenoma in 11, adenocarcinoma in 3, adenoid cystic carcinoma in 3, Warthin's tumor in 1, oncocytoma in 1, and carcinoma in pleomorphic adenoma in 1. The scintigraphic patterns of the twenty patients were classified as negative (-), weakly positive (+), moderate positive (++), strongly positive (+++). Malignant tumors showed increased activity in Ga-67 images except those in three patients with adenoid cystic carcinomas. We concluded that Ga-67 scintigraphy may be useful to distinguish benign salivary gland tumors from adenocarcinoma or carcinoma in pleomorphic adenoma, but not be useful in detection of adenoid cystic carcinoma. (author)

  1. Sjogren's syndrome combined with MALT lymphoma

    International Nuclear Information System (INIS)

    Han, Won Jeong; Cha, Sang Yun; Kim, Eun Kyung

    2000-01-01

    Sjogren's syndrome is a chronic inflammatory disease that predominantly affects salivary, lacrimal, and other exocrine glands. We report a case of Sjogren's syndrome combined with MALT (mucose associated lymphoid tissue) lymphoma which occurred in the parotid gland. A 57-year-old female with the complaint of painful swelling and lymph node enlargement was referred to our department. Sialograms of both parotid glands showed globular collections of contrast material uniformly distributed throughout the parotid gland. Salivary scintigraphy showed decreased uptake of the parotid gland. CT scan showed larger, slightly more dense parotid gland than normal and honeycomb glandular appearance. Also, It showed discrete, slightly more enhanced round mass in the left parotid gland. Histopathological finding showed replacement of salivary gland parenchyma with dense small lymphocytic infiltration having the feature of epimyoepithelial islands. Kappa light chain restriction of interglandular plasma cell could be seen.

  2. Radioprotection of salivary glands by S-2-(3-aminopropylamino)-ethylphosphorothioic (amifostine) obtained in a rabbit animal model

    Energy Technology Data Exchange (ETDEWEB)

    Bohuslavizki, Karl H; Klutmann, Susanne; Jenicke, Lars; Brenner, Winfried; Feyerabend, Bernd; Henze, Eberhard; Clausen, Malte

    1999-08-01

    Background: Impairment of salivary gland function following high-dose radioiodine treatment (HDRIT) is a well-recognized side effect of the treatment. Because differentiated thyroid cancer has an excellent prognosis, reduction of long-term side-effects is mandatory. Therefore, the aim of this study was to investigate the radioprotective effect of amifostine in a rabbit animal model. Methods: Salivary gland scintigraphy was performed in a total of 16 New Zealand White rabbits. Uptake of {sup 99m}Tc-pertechnetate was calculated in percentage of injected activity as a quantitative measure of both salivary gland and thyroid function. Reproducibility of salivary gland scintigraphy was evaluated in one rabbit without any intervention. Fifteen rabbits were studied prior to and up to 6 months after high-dose radioiodine treatment applying 2 GBq {sup 131}I. Ten animals received 200 mg/kg amifostine prior to high-dose radioiodine therapy, and 5 served as controls. Salivary glands were examined histopathologically. Results: Variation coefficient of parenchymal function was less than 3.8% in salivary glands. Prior to HDRIT, thyroid uptake was 0.417 {+-} 0.373% and 0.421 {+-} 0.241% in control and amifostine-treated rabbits, respectively. Four weeks after HDRIT, complete ablation of the thyroid was achieved in both groups. Prior to HDRIT, uptake of {sup 99m}Tc-pertechnetate in salivary glands of five control rabbits was not significantly different from ten amifostine-treated rabbits. In control rabbits 6 months after HDRIT, parenchymal function was reduced significantly (p < 0.0001) by 75.3 {+-} 5.3% and 53.6 {+-} 17.4% in parotid and submandibular glands, respectively. In contrast, in amifostine-treated rabbits, parenchymal function was reduced by 10.6 {+-} 3.4% and 6.5 {+-} 4.3% (p > 0.05) in parotid and submandibular glands, respectively. Histopathologically, marked lipomatosis was observed in control animals but was negligible in amifostine-treated animals. Conclusion

  3. Is sensorineural hearing loss a possible side effect of nasopharyngeal and parotid irradiation? A systematic review of the literature

    International Nuclear Information System (INIS)

    Raaijmakers, Esther; Engelen, Antoine M.

    2002-01-01

    Background and purpose: Little has been published about permanent hearing loss due to radiotherapy, thus making it a rather unknown phenomenon. Therefore, we performed a study of the literature over the last 20 years. Materials and methods: Sixteen relevant clinical studies were found, reporting mostly on nasopharyngeal or parotid gland treatments. Hearing loss was measured using a pure tone audiogram. Studies were assessed using a simple scoring list. Nine studies were used for further analysis. Data on the pure tone audiogram were pooled. Results: Results showed that, especially in the higher frequencies (≥4 kHz), loss can be measured. When data were pooled, in 42±3% of the patients a hearing loss was found of 10 dB or more at 4 kHz. Averaged over all measured frequencies the effect is less prominent but still statistically significant (18±2%). No significant difference between nasopharyngeal and parotid gland treatment was found (P<0.05). Conclusion: Only a few studies, mostly concerning small patient numbers, have investigated hearing damage due to radiotherapy. So far there has been no consensus on the subject. However, in this systematic review we found a significant effect. Dose to the inner ear therefore deserves more attention, especially in dose escalation studies and inverse planning

  4. Evidence Suggesting that the Buccal and Zygomatic Branches of the Facial Nerve May Contain Parasympathetic Secretomotor Fibers to the Parotid Gland by Means of Communications from the Auriculotemporal Nerve.

    Science.gov (United States)

    Tansatit, Tanvaa; Apinuntrum, Prawit; Phetudom, Thavorn

    2015-12-01

    , supplying the branches of the parotid duct within the loop of the two main divisions of the parotid gland. A single cutaneous zygomatic branch arising from the auriculotemporal nerve in some specimens, the intraparotid communications with the zygomatic and the buccal trunks of the facial nerve, the retromandibular communications with the superficial temporal-maxillary periarterial plexuses, and the periductal autonomic plexus between the loop of the two main facial divisions lead to the suggestion that these communications of the auriculotemporal nerve convey the secretomotor to the zygomatic and buccal branches of the facial nerve. This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

  5. Sjogren's syndrome combined with MALT lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Han, Won Jeong; Cha, Sang Yun; Kim, Eun Kyung [Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Dankook University, Yongin (Korea, Republic of)

    2000-06-15

    Sjogren's syndrome is a chronic inflammatory disease that predominantly affects salivary, lacrimal, and other exocrine glands. We report a case of Sjogren's syndrome combined with MALT (mucose associated lymphoid tissue) lymphoma which occurred in the parotid gland. A 57-year-old female with the complaint of painful swelling and lymph node enlargement was referred to our department. Sialograms of both parotid glands showed globular collections of contrast material uniformly distributed throughout the parotid gland. Salivary scintigraphy showed decreased uptake of the parotid gland. CT scan showed larger, slightly more dense parotid gland than normal and honeycomb glandular appearance. Also, It showed discrete, slightly more enhanced round mass in the left parotid gland. Histopathological finding showed replacement of salivary gland parenchyma with dense small lymphocytic infiltration having the feature of epimyoepithelial islands. Kappa light chain restriction of interglandular plasma cell could be seen.

  6. The role of stem cells in the prevention and treatment of radiation-induced xerostomia in patients with head and neck cancer.

    Science.gov (United States)

    Nevens, Daan; Nuyts, Sandra

    2016-06-01

    Xerostomia is an important complication following radiotherapy (RT) for head and neck cancer. Current treatment approaches are insufficient and can only temporarily relieve symptoms. New insights into the physiopathology of radiation-induced xerostomia might help us in this regard. This review discusses the current knowledge of salivary gland stem cells in radiation-induced xerostomia and their value in the prevention and treatment of this complication. Salivary gland stem cell transplantation, bone marrow-derived cell mobilization, molecular regulation of parotid stem cells, stem cell sparing RT, and adaptive RT are promising techniques that are discussed in this study. © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  7. 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

  8. 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...

  9. Diseases of the salivary glands in infants and adolescents

    Science.gov (United States)

    2010-01-01

    Background Diseases of the salivary glands are rare in infants and children (with the exception of diseases such as parotitis epidemica and cytomegaly) and the therapeutic regimen differs from that in adults. It is therefore all the more important to gain exact and extensive insight into general and special aspects of pathological changes of the salivary glands in these age groups. Etiology and pathogenesis of these entities is still not yet fully known for the age group in question so that general rules for treatment, based on clinical experience, cannot be given, particularly in view of the small number of cases of the different diseases. Swellings of the salivary glands may be caused by acute and chronic inflammatory processes, by autoimmune diseases, by duct translocation due to sialolithiasis, and by tumors of varying dignity. Clinical examination and diagnosis has also to differentiate between salivary gland cysts and inflammation or tumors. Conclusion Salivary gland diseases are rare in childhood and adolescence. Their pattern of incidence differs very much from that of adults. Acute and chronic sialadenitis not responding to conservative treatment requires an appropriate surgical approach. The rareness of salivary gland tumors is particularly true for the malignant parotid tumors which are more frequent in juvenile patients, a fact that has to be considered in diagnosis and therapy. PMID:20156335

  10. Malignant epithelial tumours of the parotid gland

    International Nuclear Information System (INIS)

    Langezaal, O.A.M.

    1982-01-01

    By means of the present clinico-pathologic study the author has attempted, through analysis of the evolution in a group of 101 patients suffering from malignant epithelial tumors of the parotis, to obtain insight into the clinical and pathologic factors governing the prognosis. Furthermore it was tried to assess the value of the different modes of therapy, including radiotherapy. Starting from certain types of tumors defined according to the WHO classification of tumors of the salivary glands, chapter 2 presents the reports in the literature on the pathology, clinical description and prognosis of the individual types of tumors. The initial treatment of the tumors is analysed with the use of a number of factors discussed in chapter 3. The significance of tumor-associated factors ascertained by the clinician and the pathologist as well as of patient-associated factors is correlated with the tumor-free period; the treatment-associated factors are correlated with the period of time between therapy and the advent of a local recurrence. The tumor-free period, instead of the survival time, was chosen as a criterion because the survival time depends not only on the prognostic factors but also on collateral circumstances, such as different diseases and the effect of the treatment instituted for the local recurrence. (Auth.)

  11. Sparing bilateral neck level IB in oropharyngeal carcinoma and xerostomia outcomes.

    Science.gov (United States)

    Tam, Moses; Riaz, Nadeem; Kannarunimit, Danita; Peña, Angela P; Schupak, Karen D; Gelblum, Daphna Y; Wolden, Suzanne L; Rao, Shyam; Lee, Nancy Y

    2015-08-01

    To assess whether sparing neck-level IB in target delineation of node-positive (N+) oropharyngeal carcinoma (OPC) can improve xerostomia outcomes without compromising locoregional control (LRC). A total of 125 N+ OPC patients with a median age of 57 years underwent chemoradiation between May 2010 and December 2011. A total of 74% of patients had T1-T2 disease, 26% T3-T4, 16% N1, 8% N2A, 48% N2B, 28% N2C; 53% base of tongue, 41% tonsil, and 6% other. Patients were divided into those who had target delineation sparing of bilateral level IB (the spared cohort) versus no sparing (the treated cohort). Sparing of contralateral high-level II nodes was also performed more consistently in the spared cohort. A prospective xerostomia questionnaire (patient reported) was given at each patient follow-up visit to this cohort of patients to assess late xerostomia. Clinical assessment (observer rated) at each patient follow-up visit was also recorded. The 2-year LRC for the spared and treated cohorts was 97.5% and 93.8%, respectively (median follow-up, 23.2 mo). No locoregional failures occurred outside of treatment fields. The spared cohort experienced significant benefits in patient-reported xerostomia summary scores (P=0.021) and observer-rated xerostomia scores (P=0.006). In addition, there were significant reductions in mean doses to the ipsilateral submandibular gland (63.9 vs. 70.5 Gy; Pxerostomia outcomes.

  12. Evaluation of an automatic segmentation algorithm for definition of head and neck organs at risk.

    Science.gov (United States)

    Thomson, David; Boylan, Chris; Liptrot, Tom; Aitkenhead, Adam; Lee, Lip; Yap, Beng; Sykes, Andrew; Rowbottom, Carl; Slevin, Nicholas

    2014-08-03

    The accurate definition of organs at risk (OARs) is required to fully exploit the benefits of intensity-modulated radiotherapy (IMRT) for head and neck cancer. However, manual delineation is time-consuming and there is considerable inter-observer variability. This is pertinent as function-sparing and adaptive IMRT have increased the number and frequency of delineation of OARs. We evaluated accuracy and potential time-saving of Smart Probabilistic Image Contouring Engine (SPICE) automatic segmentation to define OARs for salivary-, swallowing- and cochlea-sparing IMRT. Five clinicians recorded the time to delineate five organs at risk (parotid glands, submandibular glands, larynx, pharyngeal constrictor muscles and cochleae) for each of 10 CT scans. SPICE was then used to define these structures. The acceptability of SPICE contours was initially determined by visual inspection and the total time to modify them recorded per scan. The Simultaneous Truth and Performance Level Estimation (STAPLE) algorithm created a reference standard from all clinician contours. Clinician, SPICE and modified contours were compared against STAPLE by the Dice similarity coefficient (DSC) and mean/maximum distance to agreement (DTA). For all investigated structures, SPICE contours were less accurate than manual contours. However, for parotid/submandibular glands they were acceptable (median DSC: 0.79/0.80; mean, maximum DTA: 1.5 mm, 14.8 mm/0.6 mm, 5.7 mm). Modified SPICE contours were also less accurate than manual contours. The utilisation of SPICE did not result in time-saving/improve efficiency. Improvements in accuracy of automatic segmentation for head and neck OARs would be worthwhile and are required before its routine clinical implementation.

  13. Parotiditis crónicas recidivantes: Nuestra experiencia

    Directory of Open Access Journals (Sweden)

    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.

  14. A case of parotid tumor showing remarkable regression following hyperthermo-chemo-radiotherapy

    International Nuclear Information System (INIS)

    Fujimura, Takashi; Yonemura, Yutaka; Kamata, Toru

    1987-01-01

    A 72-year-old woman developed adenocarcinoma of the left parotid gland. Because of the excessive size of her tumor and the fact that she suffered from severe liver dysfunction, she was treated by hyperthermo-chemo-radiotherapy (HCR therapy). After ten sessions of radiofrequency hyperthermia with HEH 500 (13.56 MHz radiofrequency wave), 50-Gy irradiation from a linac and administration of 33.0 g of tegafur in suppository form, the tumor mass showed remarkable regression decreasing in size by as much as 84 % on computed tomography. Histologically, the tumor which was resected under local anesthesia, showed almost total necrosis. The multidisciplinary HCR therapy was well tolerated and effective as a therapy for cancer in this case. (author)

  15. Maintenance Therapy with Trastuzumab in Her2 Positive Metastatic Parotid Ductal Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Muhammad Shahid Iqbal

    2014-01-01

    Full Text Available Salivary ductal carcinomas (SDCs are extremely rare and aggressive malignancies, accounting for approximately 6% of all salivary gland malignancies. One distinct feature is their resemblance to ductal carcinomas of breast. A significant percentage of SDCs overexpress Her2 and the use of targeted therapy with trastuzumab can be considered in these patients. We report a rare case of long term disease control with trastuzumab in Her2 positive metastatic parotid ductal carcinoma. Our case also highlights that isolated brain metastasis should be managed aggressively to allow optimal local control when systemic disease is under remission with trastuzumab. We have also reviewed the published literature on the use of trastuzumab in SDCs.

  16. 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.

  17. Does radiation dose to the salivary glands and oral cavity predict patient-rated xerostomia and sticky saliva in head and neck cancer patients treated with curative radiotherapy?

    International Nuclear Information System (INIS)

    Jellema, Anke Petra; Doornaert, Patricia; Slotman, Ben J.; Rene Leemans, C.; Langendijk, Johannes A.

    2005-01-01

    Background and Purpose: To investigate the association between the mean salivary gland and oral cavity dose, with patient-rated moderate and severe xerostomia and sticky saliva. Patients and methods: One hundred and fifty-seven patients treated with bilateral irradiation for head and neck cancer were included. The parotid and submandibular glands and the oral cavity were delineated on plannings-CT scans. At baseline and 6 and 12 months self-reported xerostomia and sticky saliva were assessed using the EORTC QLQ-H and N35 questionnaire. Results: At 6 months a significant association between the mean parotid (MD par ) and mean submandibular dose (MD subm ) and xerostomia was observed (OR-MD par : 1.17; P=0.002 and OR-MD subm : 1.08; P=0.02). Between MD par and MD subm , a significant interaction term was present. No significant association was found with the oral cavity dose. Xerostomia was reversible depending on MD par and MD subm . Considering Sticky saliva, a significant association was found at 6 and 12 months with MD subm (OR: 1.03; P par and MD subm influence the risk of xerostomia in irradiated patients at 6 months. This probability as a function of the mean parotid dose significantly depended on the mean dose in the submandibular glands. Sticky saliva mainly depends on MD subm

  18. 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).

  19. Quantitative assessment of salivary gland function by radioisotopic scanning in a randomized trial of pilocarpine for prevention of radiation Induced Xerostomia

    International Nuclear Information System (INIS)

    Fard-Esfahani, A.; Modarress-Mosalla, M.; Haddad, P.; Eftekhari, M.; Saghari, M.

    2001-01-01

    Radioisotope scanning is the best method for objective assessment of salivary gland function. Thus, it was used in a randomized trial of concomitant pilocarpine for assessment of radiation-induced xerostomia, in addition to subjective evaluation by an approved questionnaire and objective standard xerostomia grading. Patients randomized in a placebo-controlled trial of pilocarpine concurrent with irradiation for prevention of radiation-induced xerostomia were evaluated by salivary gland scintigraphy immediately before and 6 months after the end of head and neck radiotherapy. Salivary gland function was measured by ejection fraction (E F) of Technetium-99 m pertechnetate. The mean values for pre-and post-radiotherapy scans were calculated and compared. Also post-radiotherapy scan findings in the two groups of pilocarpine and placebo were compared using the Student's t-test. In addition, comparison was made between the scan results and the subjective findings and objective grading s.Twenty patients underwent the pre-radiotherapy salivary scintigraphy, and also 20 post-radiotherapy scans were performed . Mean parotid E F was 60.85% in the pre-radiotherapy and 9.08% in the post-radiotherapy scans (p<0.01). The means for submandibular glands in the pre-and post-radiotherapy scans were 41% and 11.2%, respectively (p<0.01). Also the mean E F was 14.5% in the pilocarpine group and 3.65 in the placebo group for parotid glands (p=0.07) and 18.3% and 4.1% respectively for submandibular glands (p<0.05). The salivary scans confirmed the subjective and objective xerostomia findings. Salivary gland scintigraphy is a valuable method for evaluation of xerostomia after head and neck radiotherapy, quantitatively demonstrating the protective effect of pilocarpine compared to placebo on salivary glands

  20. 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

  1. Excretory function of salivary gland during static salivary scintigraphy using technetium-99m pertechnetate: a correlation study with salivary flow rate in sjogrens syndrome

    International Nuclear Information System (INIS)

    Jang, S. J.; Lee, W. W.; Lee, Y. J.; So, Y.; Jeong, J. G.; Lee, M. C.; Kim, S. E.

    2005-01-01

    Salivary scintigraphy is useful in the evaluation of xerostomia. To identify the relevant and clinically applicable parameter for the evaluation of xerostomia, we performed static salivary scintigraphy using Tc-99m and compared it with salivary flow rate in patients with xerostomia. Twenty-three female patients (age 51.2±10.4 years) who suffered from xerostomia were investigated. Nine patients were classified as Sjogrens syndrome (SS) by clinical criteria, and 14 patients were classified as non-Sjogrens syndrome. Un-stimulated salivary flow rate and simulated salivary flow rate were checked. Salivary scintigraphy was performed with injection of 25 mCi Tc-99m pertechnetate after injection anterior static image was obtained over face as basal uptake. ROIs were drawn over each salivary gland with background subtraction by square ROI drawn over skull. We used the mean data of right and left salivary glands for analysis. Percent excretion of salivary gland was calculated. Un-stimulated salivary flow rates(SFR) were different between groups (p 0.05): 5.88±4.07 ml/15 min in SS, and 10.31±6.49 ml/15 min in non-SS. The uptake value in submandibular gland revealed significant difference between the groups. The percent excretion of submandibular gland had positive correlation with un-stimulated salivary flow rate (r=0.534, p=0.009), and that of parotid gland was also positive correlation (r=0.437, p=0.037). The result of multiple regression analysis revealed only percent excretion of submandibular gland was single determinant of unstimulated SFR. Percent excretion of submandibular gland had positive correlation with un-stimulated SFR. Thus, excretory function of submandibular gland assessed by salivary scintigraphy appears more related with xerostomia than parotid gland

  2. 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

  3. Can thyroid parotid ratio replace radioactive iodine uptake as a new objective parameter in the evaluation of thyroid function in cases of hyperthyroidism? A comparative study

    International Nuclear Information System (INIS)

    Malhotra, G.; Seshadri, N.; Gupta, A.; Das, B.K.; Gambhir, S.; Pradhan, P.K.; Bhagat, J.K.

    2002-01-01

    Aim: Radioactive iodine uptake (RAIU) measurements are used to distinguish other causes of thyrotoxicosis from hyperthyroidism. However it is a cumbersome technique requiring patients' visit for two or more days. Thyroid to parotid ratio (TP ratio) which is a ratio of Technetium-99m pertechnetate counts in thyroid to those in parotid glands is a new objective parameter for evaluation of thyroid function. The aim of present study was to compare TP ratio with RAIU in patients of thyrotoxicosis. Materials and Methods: The study group comprised of 15 patients (13 males and 2 females) who were clinically and biochemically hyperthyroid. All of these patients underwent Tc-99m pertechnetate thyroid scintigraphy followed by RAIU on two separate occasions. The technetium thyroid scan was done 20 minutes after intravenous application of 185 MBq (5 mCi) of the radiotracer. Both anterior and oblique views of the neck region were acquired under a standard large field of view gamma camera with LEAP collimation. The TP ratio was calculated from anterior view by drawing the region of interest over the thyroid and two regions of interest over each parotid gland. The counts of thyroid region were compared with each parotid and average of two sides was taken as TP ratio. The radioactive iodine uptake was estimated at 2,4,24, and 48 hours after oral administration of 925 KBq (25 microcuries) of I-131 in all patients with a thyroid probe by the standard technique. Apart from this 10 controls (5 males and 5 females) who were clinically and biochemically euthyroid were also included in the study and they underwent same studies as the cases. All patients with nodular disease of thyroid, past history of thyroiditis and parotitis were excluded from the study. Results: The scintigraphic findings in all patients revealed a diffusely concentrating thyroid gland with no evidence of hot or cold areas. The RAIU and TP ratio in both cases and controls is presented.: S.E: Standard error. There was a

  4. FNAC AS A DIAGNOSTIC TOOL IN SALIVARY GLAND TUMOURS

    Directory of Open Access Journals (Sweden)

    Kalivarapu

    2016-03-01

    Full Text Available BACKGROUND FNAC of salivary gland tumours is an accurate, simple, rapid, inexpensive, well tolerated and harmless procedure. The success of FNAC depends on the adequacy of sample and high-quality preparation. FNAC of salivary gland neoplasms provides essential information in decision making and management. AIM OF THE STUDY Know the role of fine needle aspiration cytology in the diagnosis of benign and malignant lesions of salivary gland. MATERIAL AND METHODS This was a prospective study done at the tertiary care centre for a period of three years. A total number of 67 cases of clinically suspected salivary gland tumours were subjected to fine needle aspiration cytology and correlated with histopathology. RESULTS A total number of 67 cases, clinically suspected as salivary gland tumours were subjected to FNAC and compared with histopathology. The observations of the study were as follows: Most of the tumours were observed between the age group of 31-40 years. The commonest gland involved was the parotid gland, 56 cases of benign, 10 cases of malignant and one case of inconclusive diagnosis was made on FNAC. In the present study, FNAC showed Sensitivity of 66.6%, Specificity of 98%, Positive predictive value; 90.9%, Negative predictive value; 91%, Percentage of false negative cases 33.3%, Percentage of false positive cases 1.9% and Overall Diagnostic Accuracy of 91%. CONCLUSION FNAC is a very useful, simple, cheap, accurate and repeatable technique in the preoperative diagnosis of various salivary gland neoplasms. Overall, diagnostic accuracy was 91%, in cystic lesions of salivary glands, combined FNAC and histopathology is essential for diagnosis.

  5. Modeling of Salivary Production Recovery After Radiotherapy Using Mixed Models: Determination of Optimal Dose Constraint for IMRT Planning and Construction of Convenient Tools to Predict Salivary Function

    International Nuclear Information System (INIS)

    Ortholan, Cecile; Chamorey, Emmanuel Phar; Benezery, Karen; Thariat, Juliette; Dassonville, Olivier; Poissonnet, Gilles; Bozec, Alexandre; Follana, Philippe; Peyrade, Frederique; Sudaka, Anne; Gerard, Jean Pierre; Bensadoun, Rene Jean

    2009-01-01

    Purpose: The mathematical relationship between the dose to the parotid glands and salivary gland production needs to be elucidated. This study, which included data from patients included in a French prospective study assessing the benefit of intensity-modulated radiotherapy (RT), sought to elaborate a convenient and original model of salivary recovery. Methods and Materials: Between January 2001 and December 2004, 44 patients were included (35 with oropharyngeal and 9 with nasopharyngeal cancer). Of the 44 patients, 24 were treated with intensity-modulated RT, 17 with three-dimensional conformal RT, and 2 with two-dimensional RT. Stimulated salivary production was collected for ≤24 months after RT. The data of salivary production, time of follow-up, and dose to parotid gland were modeled using a mixed model. Several models were developed to assess the best-fitting variable for the dose level to the parotid gland. Results: Models developed with the dose to the contralateral parotid fit the data slightly better than those with the dose to both parotids, suggesting that contralateral and ipsilateral parotid glands are not functionally equivalent even with the same dose level to the glands. The best predictive dose-value variable for salivary flow recovery was the volume of the contralateral parotid gland receiving >40 Gy. Conclusion: The results of this study show that the recommendation of a dose constraint for intensity-modulated RT planning should be established at the volume of the contralateral parotid gland receiving >40 Gy rather than the mean dose. For complete salivary production recovery after 24 months, the volume of the contralateral parotid gland receiving >40 Gy should be <33%. Our results permitted us to establish two convenient tools to predict the saliva production recovery function according to the dose received by the contralateral parotid gland

  6. Effect of P2X(7) receptor knockout on exocrine secretion of pancreas, salivary glands and lacrimal glands.

    Science.gov (United States)

    Novak, Ivana; Jans, Ida M; Wohlfahrt, Louise

    2010-09-15

    The purinergic P2X(7) receptors are expressed in different cell types where they have varied functions, including regulation of cell survival. The P2X(7) receptors are also expressed in exocrine glands, but their integrated role in secretion is unclear. The aim of our study was to determine whether the P2X(7) receptors affect fluid secretion in pancreas, salivary glands and tear glands. We monitored gland secretions in in vivo preparations of wild-type and P2X(7)(-/-) (Pfizer) mice stimulated with pilocarpine. In cell preparations from pancreas, parotid and lacrimal glands we measured ATP release and intracellular Ca(2+) activity using Fura-2. The data showed that pancreatic secretion and salivary secretions were reduced in P2X(7)(-/-) mice, and in contrast, tear secretion was increased in P2X(7)(-/-) mice. The secretory phenotype was also dependent on the sex of the animal, such that males were more dependent on the P2X(7) receptor expression. ATP release in all cell preparations could be elicited by carbachol and other agonists, and this was independent of the P2X(7) receptor expression. ATP and carbachol increased intracellular Ca(2+) activity, but responses depended on the gland type, presence of the P2X(7) receptor and the sex of the animal. Together, these results demonstrate that cholinergic stimulation leads to release of ATP that can via P2X(7) receptors up-regulate pancreatic and salivary secretion but down-regulate tear secretion. Our data also indicate that there is an interaction between purinergic and cholinergic receptor signalling and that function of the P2X(7) receptor is suppressed in females. We conclude that the P2X(7) receptors are important in short-term physiological regulation of exocrine gland secretion.

  7. Effect of P2X7 receptor knockout on exocrine secretion of pancreas, salivary glands and lacrimal glands

    Science.gov (United States)

    Novak, Ivana; Jans, Ida M; Wohlfahrt, Louise

    2010-01-01

    The purinergic P2X7 receptors are expressed in different cell types where they have varied functions, including regulation of cell survival. The P2X7 receptors are also expressed in exocrine glands, but their integrated role in secretion is unclear. The aim of our study was to determine whether the P2X7 receptors affect fluid secretion in pancreas, salivary glands and tear glands. We monitored gland secretions in in vivo preparations of wild-type and P2X7−/− (Pfizer) mice stimulated with pilocarpine. In cell preparations from pancreas, parotid and lacrimal glands we measured ATP release and intracellular Ca2+ activity using Fura-2. The data showed that pancreatic secretion and salivary secretions were reduced in P2X7−/− mice, and in contrast, tear secretion was increased in P2X7−/− mice. The secretory phenotype was also dependent on the sex of the animal, such that males were more dependent on the P2X7 receptor expression. ATP release in all cell preparations could be elicited by carbachol and other agonists, and this was independent of the P2X7 receptor expression. ATP and carbachol increased intracellular Ca2+ activity, but responses depended on the gland type, presence of the P2X7 receptor and the sex of the animal. Together, these results demonstrate that cholinergic stimulation leads to release of ATP that can via P2X7 receptors up-regulate pancreatic and salivary secretion but down-regulate tear secretion. Our data also indicate that there is an interaction between purinergic and cholinergic receptor signalling and that function of the P2X7 receptor is suppressed in females. We conclude that the P2X7 receptors are important in short-term physiological regulation of exocrine gland secretion. PMID:20643770

  8. Clinical characteristics of pleomorphic adenoma of salivary glands among Jordanian patients

    International Nuclear Information System (INIS)

    Khtoum, N. A.; Qubilat, A. R.; Zaidaneen, S. A.; Sarhan, M. A.; Qudah, A. A.

    2013-01-01

    Objective: To evaluate the incidence of salivary gland pleomorphic adenoma in Jordanian patients. Methods: The retrospective study involved histopathological reports of 62 patients diagnosed to have pleomorphic adenoma from salivary glands between 2000 and 2008 at King Hussein Medical Centre and the peripheral military hospitals of the Royal Medical Services, Jordan. The files were evaluated. Special attention was given to the distribution of the tumour to major and minor categories. Age, gender and treatment pattern were also noted. Quantitative and categorical variables were worked out for statistical analysis. Results: Out of the 62 cases, 32 (51.6%) occurred in men, with a male-to-female ratio of 1.06:1. The mean age was 40.4+-12 years (range: 8 to 80 years) with peak incidence in the 4th decade of life. The primary tumours were predominantly located in the parotid gland (n=40; 64%), followed by pleomorphic adenoma of the minor salivary glands (n=11; 17%), the submandibular gland (n=10; 16.12%) and the sublingual gland (n=1; 1.6%). Painless swelling was the first finding in 49 (79%), followed by pressure sensation in 10 (16%) and pain in 3 (5%) patients. Conclusion: Pleomorphic adenoma of salivary glands had similar characteristics with patients of most previously published research studies in other countries except that there was no significant difference regarding gender distribution in Jordanian patients. (author)

  9. 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

  10. Acinic cell carcinoma of the parotid in children

    Energy Technology Data Exchange (ETDEWEB)

    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.

  11. CT-sialographic evaluation of 19 cases of alivary gland tumors

    Energy Technology Data Exchange (ETDEWEB)

    Yamazaki, Tadashi [Komoro Kousei General Hospital, Nagano (Japan)

    1999-09-01

    Sixteen patients with parotid gland tumors and 3 patients with submandibular gland tumors were evaluated by CT sialography. The 19 patients were 5 to 78 years old, mean age: 57.3 years. CT sialography was performed preoperatively, and postoperative histological examination indicated that the tumors were benign in 13, a cyst in 1, malignant tumors in 4, and a malignant lymphoma in 1 patient. The tumorous lesion detection rate by CT sialography was 100%. The major duct was visualized in all patients, and the examination was informative about the special relationship between the tumor and the facial nerve. No sign of malignancy was noted in an epithelialmyoepithelial carcinoma of 10 mm in diameter on CT sialography. In 2 patients adhesion to surrounding tissues observed intraoperatively was judged to be benign tumors by CT sialography. The marginal morphology of the tumor and the presence or absence of low density areas and punctuate leakage in the interior of the tumor were useful for the judgement of malignancy of salivary gland tumors. CT sialography, which provides diverse information on the location and morphology of the tumor, should be performed early for the diagnosis of salivary gland tumors. (author)

  12. Long-term repair of salivary function after radiotherapy for head and neck tumors

    International Nuclear Information System (INIS)

    Kaneko, M.; Shirato, H.; Nishiyama, N.; Nishioka, T.; Kitahara, T.; Oomori, K.; Arimoto, T.; Miyasaka, K.; Nakamura, M.

    1996-01-01

    Purpose: To investigate the late repair of salivary function after irradiation of whole parotid glands, long-term follow-up of salivary function has been performed by using radioisotope (RI) sialography. Methods and Material: RI sialography using 99m Tc-pertechnetate was performed more than two times in 26 patients with a nasopharyngeal or oropharyngeal tumor in whom bilateral whole parotid glands were included in the irradiation field. The average dose to the parotid gland was estimated using the dose-volume-histogram reduction method. The parotid gland function was estimated using the secretion ratio (SR) of RI after acid stimulation. SR was measured before and 2 months to 5 years after the radiotherapy sequentially in the same patients. Results: In nine patients with a dose to the parotid gland between 55 and 70 Gy, or time-dose-factor (TDF), between 88 and 126, SR measured more than two months after radiotherapy was less than 10% and no recovery was seen. In 13 out of 17 patients with a dose to the parotid gland between 30 and 52 Gy, or TDF value between 46 and 80, SR was less than 10% in the first 6 months. Then it recovered to be more than 15% one to two years later. Duration between the start of radiotherapy and the SR recovery was between 7 and 18 months. Symptomatic recovery of xerostomia significantly correlated with the sialographic recovery. Conclusion: Parotid function decreased in the first 6 months after irradiation of the whole glands more than 30 Gy with no exception. However, when the total dose to the parotid glands is less than 52 Gy, or the TDF value is less than 80, partial recovery of parotid function may occur one to two years after the irradiation. This suggests that, even for the treatment where the whole parotid gland must be in the radiation field, reduction of dose to the parotid glands using 3-D treatment planning may be beneficial to reduce xerostomia

  13. Punch Biopsy Results in Misdiagnosis of Pilomatrixoma

    Directory of Open Access Journals (Sweden)

    Metin Temel

    2017-03-01

    Full Text Available Punch biopsy results in misdiagnosis of clinically unsuspected giant pilomatrixoma located over the parotid gland. This study presents a case of pilomatrixoma that was misdiagnosed as a malignant epithelial tumor using punch biopsy. A 25-year-old male was admitted to our clinic for the evaluation of a mass measuring 7×8×8 cm located over the parotid gland. The patient had previously undergone punch biopsy at another clinic because of a lesion in the parotid gland. Punch biopsy revealed a malignant epithelial tumor. The patient underwent excisional biopsy at our clinic. After the biopsy, the residual skin defect was treated using full-thickness skin grafts. The facial nerve and parotid gland were preserved during the biopsy. Histopathological examination of the excisional biopsy material revealed pilomatrixoma. Punch biopsy may result in misdiagnosis of skin lesions in the parotid gland. A differential diagnosis for benign tumors such as pilomatrixoma is essential prior to an aggressive surgical intervention of the parotid gland.

  14. Assessment of PlanIQ Feasibility DVH for head and neck treatment planning.

    Science.gov (United States)

    Fried, David V; Chera, Bhishamjit S; Das, Shiva K

    2017-09-01

    Designing a radiation plan that optimally delivers both target coverage and normal tissue sparing is challenging. There are limited tools to determine what is dosimetrically achievable and frequently the experience of the planner/physician is relied upon to make these determinations. PlanIQ software provides a tool that uses target and organ at risk (OAR) geometry to indicate the difficulty of achieving different points for organ dose-volume histograms (DVH). We hypothesized that PlanIQ Feasibility DVH may aid planners in reducing dose to OARs. Clinically delivered head and neck treatments (clinical plan) were re-planned (re-plan) putting high emphasis on maximally sparing the contralateral parotid gland, contralateral submandibular gland, and larynx while maintaining routine clinical dosimetric objectives. The planner was blinded to the results of the clinically delivered plan as well as the Feasibility DVHs from PlanIQ. The re-plan treatments were designed using 3-arc VMAT in Raystation (RaySearch Laboratories, Sweden). The planner was then given the results from the PlanIQ Feasibility DVH analysis and developed an additional plan incorporating this information using 4-arc VMAT (IQ plan). The DVHs across the three treatment plans were compared with what was deemed "impossible" by PlanIQ's Feasibility DVH (Impossible DVH). The impossible DVH (red) is defined as the DVH generated using the minimal dose that any voxel outside the targets must receive given 100% target coverage. The re-plans performed blinded to PlanIQ Feasibilty DVH achieved superior sparing of aforementioned OARs compared to the clinically delivered plans and resulted in discrepancies from the impossible DVHs by an average of 200-700 cGy. Using the PlanIQ Feasibility DVH led to additionalOAR sparing compared to both the re-plans and clinical plans and reduced the discrepancies from the impossible DVHs to an average of approximately 100 cGy. The dose reduction from clinical to re-plan and re-plan to

  15. Abnormal gallium scan patterns of the salivary gland in pulmonary sarcoidosis

    International Nuclear Information System (INIS)

    Mishkin, F.S.; Tanaka, T.T.; Niden, A.H.

    1978-01-01

    The findings of gallium imaging suggest that parotid abnormalities in sarcoidosis are common. Correlation with lung and mediastinal uptake suggests that this represents an early disease state and that it responds to steroid administration. That the findings after therapy do not simply represent suppression of the uptake mechanism for gallium is supported by objective improvement in pulmonary function as well as symptomatic relief. Salivary gland accumulation of gallium citrate occurred in one third of our control group patients--in those who had collagen disease and presumably either were alcoholic or had infectious parotitis. This may also be seen in lymphoma and after radiation therapy. Although the combination of salivary gland, pulmonary, and hilar concentration of gallium is not specific, in the appropriate clinical setting the pattern may be helpful in suggesting the correct diagnosis

  16. Abnormal gallium scan patterns of the salivary gland in pulmonary sarcoidosis

    Energy Technology Data Exchange (ETDEWEB)

    Mishkin, F.S.; Tanaka, T.T.; Niden, A.H.

    1978-12-01

    The findings of gallium imaging suggest that parotid abnormalities in sarcoidosis are common. Correlation with lung and mediastinal uptake suggests that this represents an early disease state and that it responds to steroid administration. That the findings after therapy do not simply represent suppression of the uptake mechanism for gallium is supported by objective improvement in pulmonary function as well as symptomatic relief. Salivary gland accumulation of gallium citrate occurred in one third of our control group patients--in those who had collagen disease and presumably either were alcoholic or had infectious parotitis. This may also be seen in lymphoma and after radiation therapy. Although the combination of salivary gland, pulmonary, and hilar concentration of gallium is not specific, in the appropriate clinical setting the pattern may be helpful in suggesting the correct diagnosis.

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

    Science.gov (United States)

    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.

  18. Classification of parotidectomy: a proposed modification to the European Salivary Gland Society classification system.

    Science.gov (United States)

    Wong, Wai Keat; Shetty, Subhaschandra

    2017-08-01

    Parotidectomy remains the mainstay of treatment for both benign and malignant lesions of the parotid gland. There exists a wide range of possible surgical options in parotidectomy in terms of extent of parotid tissue removed. There is increasing need for uniformity of terminology resulting from growing interest in modifications of the conventional parotidectomy. It is, therefore, of paramount importance for a standardized classification system in describing extent of parotidectomy. Recently, the European Salivary Gland Society (ESGS) proposed a novel classification system for parotidectomy. The aim of this study is to evaluate this system. A classification system proposed by the ESGS was critically re-evaluated and modified to increase its accuracy and its acceptability. Modifications mainly focused on subdividing Levels I and II into IA, IB, IIA, and IIB. From June 2006 to June 2016, 126 patients underwent 130 parotidectomies at our hospital. The classification system was tested in that cohort of patient. While the ESGS classification system is comprehensive, it does not cover all possibilities. The addition of Sublevels IA, IB, IIA, and IIB may help to address some of the clinical situations seen and is clinically relevant. We aim to test the modified classification system for partial parotidectomy to address some of the challenges mentioned.

  19. The dilemma of parotid gland and pharyngeal constrictor muscles preservation—Is daily online image guidance required? A dosimetric analysis

    Energy Technology Data Exchange (ETDEWEB)

    Duffy, Olivia; Forde, Elizabeth; Leech, Michelle, E-mail: leechm@tcd.ie

    2017-04-01

    With margin reduction common in head and neck radiotherapy, it is critical that the dosimetric effects of setup deviations are quantified. With past studies focusing on the quantification of positional and volumetric changes of organs at risk (OARs), this study aimed to measure the dose delivered to these the parotid gland (PG) and pharyngeal constrictor muscles (PCMs) using cone beam computed tomography (CBCT). Furthermore, this investigation sought to establish a potential time trend of change in dose delivered to target volumes secondary to ascertaining the need for daily image guidance (IG) to reduce the dose burden to these important OARs. Intensity modulated radiotherapy (IMRT) plans for 5 locally advanced head and neck patients' plans were created and mapped to weekly CBCTs. Each plan was recalculated without heterogeneity correction allowing for dosimetric comparison. Dosimetric endpoints recorded to assess the effect of positional variation were as per ICRU 83 and included D{sub 95} and D{sub 98} for the target volumes, mean dose (MD) and V{sub 30} {sub Gy} for the PGs, and V{sub 50} {sub Gy} and MD for the PCMs. Results were deemed statistically significant if p < 0.05. No significant time trends were established for these OARs. A significant decrease in V{sub 50} {sub Gy} was observed for all PCMs (p < 0.001) on all CBCTs relative to the original plan. Regarding target volumes, a highly significant decrease in MD (MD = 20 Gy, CI: −20.310 to −19.820) in D{sub 98} of the high-dose planning target volume (PTV [70 Gy]; PTVD{sub 98%} = 70 Gy) for case 3 was found (p ≤ 0.001). A nonpredictable, yet significant dosimetric effect was found. A clinically acceptable balance must be achieved between OAR dosimetry and target coverage as can be achieved by frequent IG.

  20. 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)