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Enucleation performed on the parotid tumour ( pleomorphic adenoma ) is tie in with high recurrence rates of 8 % to 45%.(1 )
A 0.4 % rate of return is seen with total parotidectomy of the parotid gland.(1 )
Can Parotid Tumors Be Prevented?
Parotid tumors can either present as benign or malignant conditions that are slowly progressive . Parotid neoplasm have diverse histology due to epithelial and non - epithelial tissue paper involvement making it dispute to narrow down the outgrowth and extension . Their varied histologic appearances and conduct is a study of business concern , with a few neoplasm being sporadic in stock and character . The distinction between tumor type is difficult , mainly based on aspirate fabric via FNAC . Pleomorphic adenoma is get laid to be the most commonly pass off benign neoplasm is extremely capable of undergoing malignant transmutation , so it becomes a reason for concern.(3 )
There are two main theories of the formation of the salivary tumor with the neoplasm arising from a specific differentiated prison cell of origin within the salivary secretory organ being the predominant one . The excretory stem cells give ascent to mucoepidermoid cells that lead to pleomorphic adenoma , adenoid cystic carcinomas , adenocarcinomas , oncocytomas , and acinar cadre carcinomas.(3)The majority of the parotid tumour are benign , with the malignant tumors unremarkably submit after the 6th decade of life while the benign ones present in the 4th to 5th tenner of life . Most of the salivary gland tumors originate in the parotid secretor , whereas about 10 % happen in the submandibular secretor and 4 % in the underage salivary gland . The mortality rate charge per unit from salivary glands depend on the staging , with the intermediate five - year selection rate being around 70%.(3 )
The crusade of the parotid tumor remains unclear , so its prevention becomes tricky . A few survey are suggesting that potential risks agent could be the use of baccy , spare alcohol , and insalubrious feeding habit . However , we do n’t know for indisputable if avoiding these factors will prevent parotid tumor from go on . There has also been the incidence of increase hazard of parotid tumors in a few the great unwashed exposed to radiation beam , but still , a conclusive solution is not yet obtained.(2 )
Do Parotid Tumors Recur?
There are probability of parotid tumors to reoccur if the benign experimental condition goes on to transmute into a malignant disease . This change is mostly learn in the instance of pleomorphic adenoma , where the recurrence rates have been eminent . This return takes space in the form of multinodular recurrence rather than a uninodular one . The chances are in high spirits for recurrence if the first surgery perform was modified , as in the cause of extracapsular dissection or partial parotidectomy . However , a total parotidectomy is mostly the best-loved choice of discourse as there are few or no chances of recurrence with this method acting . While this surgical procedure decreases the rate of recurrence , but the danger of facial brass palsy is increase .
Another non - surgical subprogram to keep this recurrence is to offer radiotherapy to moderate local tumour , but this may still induce a malignant transformation in by and by years.(4 )
Usually , the approach for a benign parotid gland neoplasm is a total parotidectomy , while extra irradiation or chemotherapy for a malignant tumour . This adjuvant therapy helps in forbid metastasis and limiting the growth of cancer . The high - gradation tumor has more chances of metastasis into the surround reed organ and lymph nodes , so the addition lymph node resection and tissue paper is a must to foreclose a recurrence .
In the case of infiltration of the facial nerve , a revolutionary parotidectomy is point where role of the facial nerve that are infiltrate will be resected.(4 )
Post - operative attention , in full term of keeping promissory note of the recovery and adopt the clinician ’s advice , goes a farsighted manner . The patient should also carefully supervise and see for any warning signs that are indicative of recurrence , such as lapse of symptom . A regular follow - up should be done even after the surgery to ensure everlasting retrieval and tumour - complimentary glands.(2 )
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