By Victor-Vlad Costan
This broadly illustrated ebook goals to systematize the choice of treatment plans in sufferers with parotid tumors that reach past the borders of the parotid tissue and consequently current specific difficulties for the medical professional. Reconstruction of the postoperative disorder is mainly tricky in such circumstances as a result of complexity and density of the anatomical constructions within the lateral quarter of the pinnacle and neck and in addition the final of such a lot sufferers, who are usually aged and to have accompanying problems. the trouble within the administration of prolonged parotid tumors is elevated via the necessity to sacrifice the facial nerve, whether in simple terms in part. The booklet presents transparent standards to help within the collection of therapy, from the easiest innovations concerning use of neighborhood flaps to the main refined ones. it is going to support the medical professional in making sure that the sufferer achieves the very best caliber of lifestyles, it doesn't matter what the patient’s age or the linked comorbidities.
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Additional info for Management of Extended Parotid Tumors
Costan et al. well as prognosis. Lymphatic metastasis to the parotid gland should raise suspicion to the possible presence of occult nodal disease in the neck, and a neck dissection may be considered in addition to the parotidectomy. If haematogenous metastasis to the parotid gland from a distant site is suspicioned, further neck dissection would not be necessary considering the spreading route. Knowledge of the main pathways of spread to the parotid gland from local and distant sites allows the surgeon to formulate an initial clinical suspicion and choose an appropriate treatment plan.
In the absence of evidence of previous malignancy that could metastasise to the parotid gland, it is the histology of the surgical specimen that raises suspicion of parotid metastasis, and in such a case, a full body investigation must be carried out in search of a primary tumour. The search should not be limited to the territory known to drain into the parotid lymph nodes since it is a known fact that distant metastasis can also be encountered here and both lymphatic and haematogenous pathways are possible.
Desmoplastic MM, either amelanotic or pigmented, is the most rare type and usually develops on a premalignant lesion. It has a high rate of local recurrence after treatment, but a lower metastatic potential. It may spread through perineural involvement. The presence of melanocytes in the glandular acinary and ductal cells suggests the possibility of a primitive parotid melanoma. The epicenter of a primitive parotid melanoma is the glandular tissue and does not include lymph nodes in the tumor mass .