Otolaryngologie : accès libre

Abstrait

Parotid Lesions in Children Undergoing Parotidectomy. The Children?s Memorial Hospital Experience

Sundip Patel,Jeffrey Rastatter*,John Maddalozzo

Objective: Evaluate the demographics, presentation, workup, surgical outcomes and pathology of pediatric parotid masses.
Study design: Consecutive retrospective review.
Setting: Urban pediatric tertiary care hospital.
Subjects and methods: Retrospective review of medical charts was performed on all patients undergoing a parotidectomy at Children’s Memorial Hospital; Chicago, Illinois from March 1998 to March 2011.
Results: N=54. All but 2 patients presented with a facial/neck mass or swelling. Mean age was 9.7 years. 28 (52%) were male, 26 (48%) were female. Twelve (22%) patients had a pre-operative fine needle aspiration, 3 (6%) had an open biopsy; 2 by outside surgeons. All but one patient had a fully functioning facial nerve pre-operatively. Thirty-eight (70%) had a superficial parotidectomy, 12 (22%) had a total parotidectomy, 4 (7%) had a near total parotidectomy. Benign pathology was most common: n=45 (83%). The most common of which were pleomorphic adenoma (n=8) and lymphatic malformation (n=9). The most common malignant pathology was acinic cell carcinoma; n=3. Short term
complications included generalized facial nerve paresis (n=7, 13%), marginal mandibular paresis (n=11, 20%), seroma (n=4, 7%) and wound dehiscence, hematoma and infection, all occurring in 1 patient.
Conclusion: Parotid masses are an uncommon finding in children. A wide spectrum of pathology was seen in our cohort with the majority being benign pathology; however malignancy was not uncommonly seen. The most common complication was temporary facial nerve paresis. Children with parotid masses can be treated successfully with little long term morbidity with appropriate pre-operative workup and surgical excision in the hands of experienced pediatric head and neck surgeons.