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Elective Parotidectomy in the Management of Advanced Auricular Malignancies
Author(s) -
Osborne Ryan F.,
Shaw Travis,
Zandifar Hootan,
Kraus Dennis
Publication year - 2008
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/mlg.0b013e318182c30b
Subject(s) - medicine , parotidectomy , neck dissection , surgery , occult , parotid gland , metastasis , pathological , dissection (medical) , retrospective cohort study , radiology , carcinoma , cancer , facial nerve , pathology , alternative medicine
Objective: The purpose of this study is to determine whether elective parotidectomy is necessary in patients with clinically and radiographically N 0 parotid disease with isolated primary auricular nonmelanoma cutaneous malignancies. Auricular malignancies are typically managed by wedge resection or wide local excision. Although small lesions are easily managed by conservative excision, large bulky tumors, those with multifocal involvement, and recalcitrant lesions, often require more extensive resection including total auriculectomy, parotidectomy, and/or neck dissection. Study Design: A 10‐year retrospective case review from four tertiary university medical centers from 1992 to 2002. Methods: Information was retrospectively retrieved using a database of patients from the department of pathology. Seventy‐one charts were reviewed. Patients with a clinical history of advanced nonmelanoma auricular carcinoma undergoing elective parotidectomy and/or neck dissection with clinically and radiographically N 0 nodal disease were evaluated for the presence of occult parotid metastasis. All patients underwent parotidectomy in conjunction with a total auriculectomy for surgical extirpation of their primary auricular carcinoma. Parotid specimens were evaluated for histopathologic evidence of metastatic neoplastic disease. Results: Pathological examination showed no histological evidence of occult parotid metastasis in all 19 patients who underwent elective parotidectomy in the presence of clinically and radiographically N 0 nodal disease of the parotid or cervical regions. Conclusions: Parotidectomy may not be necessary in the surgical management of advanced auricularcarcinoma in the absence of clinically positive parotid disease or external auditory canal involvement.