Yıl: 2016 Cilt: 54 Sayı: 3 Sayfa Aralığı: 112 - 117 Metin Dili: Türkçe

Recurrent Parotid Pleomorphic Adenomas: Our Clinical Experience

Öz:
Amaç: Çalışmamızın amacı, reküren parotis pleomorfik adenomu nedeniyle tedavi edilen hasta serisinin klinik, cerrahi ve izlem özelliklerini sunarak güncel literatür eşliğinde tartışmaktır. Yöntemler: Reküren pleomorfik adenom nedeniyle kliniğimizde revizyon cerrahisi geçiren 11 hasta, lezyonlarının klinik ve radyolojik özellikleri, cerrahi tipi, fasiyal sinir yönetimi ve izlem süreci hakkında geriye dönük olarak analiz edildi. Bulgular: Olguların yedisi kadın, dördü erkekti ve yaş ortalaması 45 idi. Hastaların tümünün ilk cerrahileri kliniğimiz dışında gerçekleştirilmişti. Altı hastaya süperfisyel parotidektomi, beş hastaya ise fasiyal sinir korunarak total konservatif parotidektomi şeklinde revizyon cerrahileri uygulandı. İki hastada tümör tarafından tutulmuş olduğu saptanan fasiyal sinir dalları feda edildi. Bir hastaya, postoperatif histopatolojik incelemesinde komşu lenf damarlarında tümör hücreleri izlenmesi nedeniyle adjuvan radyoterapi uygulandı. Hastaların, ortalama 9,1 yıllık izlemlerinde rekürens ile karşılaşılmadı. Sonuç: Reküren parotis pleomorfik adenomlu olguların tedavisinde, tümörün boyutu, yerleşimi, çok odaklı yapısı ve fasiyal sinir ile ilişkisi göz önünde bulundurularak dikkatli cerrahi planlanmalıdır. Uygulanacak yöntem, güvenli cerrahi sınır sağlamayı amaçlamalıdır. Fasiyal sinirin, ancak direkt tutulum saptanan olgularda feda edilmesi düşünülmelidir. Bu hastalar postoperatif dönemde ek rekürenslerin erken dönemde saptanması açısından düzenli izlenmelidir.
Anahtar Kelime:

Parotisin Reküren Pleomorfik Adenomları: Klinik Deneyimimiz

Öz:
Objective: The aim of our study was to present our findings in a series of patients who were treated for recurrent parotid pleomorphic adenoma with their clinical, surgical, and follow-up information and to discuss them in light of the recent literature. Methods: Eleven patients who had revision surgery for recurrent pleomorphic adenoma at our institution were retrospectively analyzed for the clinical and radiological features of their lesions, surgery type, facial nerve management, and follow-up period. Results: Seven patients were females and four were males with an average age of 45 years. All patients underwent previous surgeries at other institutions. Revision surgery was performed with superficial parotidectomy in six patients and total conservative parotidectomy with preservation of the facial nerve in five patients. Two patients had lesions involving the facial nerve branches necessitating sacrifice of involved branches. One patientwas given adjuvant radiotherapy because of adjacentlymphatic vessel involvement with tumor cells. Duringthe mean follow-up period of 9.1 years, there were norecurrences in any of the patients.Conclusion: Management of patients with recurrent parotidpleomorphic adenomas must be carefully plannedaccording to the size, location, and multicentricity ofthe tumor and involvement of the facial nerve. Surgeryshould aim at reaching tumor-free surgical margins.Sacrifice of the facial nerve should be considered onlyin cases with direct involvement. In the postoperativeperiod, patients must be followed up regularly for earlydiagnosis of recurrences.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA KÜMÜŞ Ö, İKİZ A, SARIOĞLU S, ERDAĞ T (2016). Recurrent Parotid Pleomorphic Adenomas: Our Clinical Experience. Türk Otorinolarengoloji Arşivi, 54(3), 112 - 117.
Chicago KÜMÜŞ Özgür,İKİZ AHMET ÖMER,SARIOĞLU SÜLEN,ERDAĞ Taner Kemal Recurrent Parotid Pleomorphic Adenomas: Our Clinical Experience. Türk Otorinolarengoloji Arşivi 54, no.3 (2016): 112 - 117.
MLA KÜMÜŞ Özgür,İKİZ AHMET ÖMER,SARIOĞLU SÜLEN,ERDAĞ Taner Kemal Recurrent Parotid Pleomorphic Adenomas: Our Clinical Experience. Türk Otorinolarengoloji Arşivi, vol.54, no.3, 2016, ss.112 - 117.
AMA KÜMÜŞ Ö,İKİZ A,SARIOĞLU S,ERDAĞ T Recurrent Parotid Pleomorphic Adenomas: Our Clinical Experience. Türk Otorinolarengoloji Arşivi. 2016; 54(3): 112 - 117.
Vancouver KÜMÜŞ Ö,İKİZ A,SARIOĞLU S,ERDAĞ T Recurrent Parotid Pleomorphic Adenomas: Our Clinical Experience. Türk Otorinolarengoloji Arşivi. 2016; 54(3): 112 - 117.
IEEE KÜMÜŞ Ö,İKİZ A,SARIOĞLU S,ERDAĞ T "Recurrent Parotid Pleomorphic Adenomas: Our Clinical Experience." Türk Otorinolarengoloji Arşivi, 54, ss.112 - 117, 2016.
ISNAD KÜMÜŞ, Özgür vd. "Recurrent Parotid Pleomorphic Adenomas: Our Clinical Experience". Türk Otorinolarengoloji Arşivi 54/3 (2016), 112-117.