Warthin's tumour of the parotid gland: our experience

Benign tumours account for approximately 60-80% of parotid neoplasms and among these, Warthin's tumour is the second most common benign neoplasm accounting for approximately 15% of all parotid epithelial tumours. The medical records of 100 consecutive patients with Warthin's tumour of the parotid gland admitted for treatment at the Department of Head and Neck Surgery and Otorhinolaryngology, Hospital A. C. Camargo, Sao Paulo, Brazil, between 1983 and 2011 were retrospectively analyzed. The surgical procedures included 104 (96%) subtotal parotidectomies and 4 (3.7%) total parotidectomies. One hundred and eight parotidectomies were performed in 100 patients with Warthin's tumour. Postoperative complications occurred in 67 (62.3%) of surgical procedures, and facial nerve dysfunction was the most frequent complication, occurring in 51 of 108 surgeries (47.2%). The marginal mandibular branch of the facial nerve was affected in 46 of the 48 cases (95.8%) of facial nerve dysfunction. Frey's syndrome was diagnosed in the late postoperative period in 19 patients (17.6%). We conclude that either superficial or total parotidectomy with preservation of facial nerve are the treatment of choice for Warthin's tumour with no case of recurrence seen after long-term follow-up. Facial nerve dysfunction and Frey's syndrome were the main complications associated with this surgery. Thus, if on one hand total parotidectomy is an appropriate radical resection of parotid parenchyma reducing, in theory, the risk of recurrence, on the other hand superficial parotidectomy is also a radical and efficient method with lower morbidity in terms of facial nerve dysfunction and Frey's syndrome.33639339

Fluorescence spectroscopy for the detection of potentially malignant disorders of the oral cavity: analysis of 30 cases

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Oral cancer is a major health problem worldwide and although early diagnosis of potentially malignant and malignant diseases is associated with better treatment results, a large number of cancers are initially misdiagnosed, with unfortunate consequences for long-term survival. Fluorescence spectroscopy is a noninvasive modality of diagnostic approach using induced fluorescence emission in tumors that can improve diagnostic accuracy. The objective of this study was to determine the ability to discriminate between normal oral mucosa and potentially malignant disorders by fluorescence spectroscopy. Fluorescence investigation under 408 and 532 nm excitation wavelengths was performed on 60 subjects, 30 with potentially malignant disorders and 30 volunteers with normal mucosa. Data was analyzed to correlate fluorescence patterns with clinical and histopathological diagnostics. Fluorescence spectroscopy used as a point measurement technique resulted in a great variety of spectral information. In a qualitative analysis of the fluorescence spectral characteristics of each type of injury evaluated, it was possible to discriminate between normal and abnormal oral mucosa. The results show the potential use of fluorescence spectroscopy for an improved discrimination of oral disorders.241Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)INCITOFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)FAPESP [07/57126-5, 09/12938-8]CNPq [477439/2007-1

Analysis of surgical margins in oral cancer using in situ fluorescence spectroscopy

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Oral cancer is a public health problem with high prevalence in the population. Local tumor control is best achieved by complete surgical resection with adequate margins. A disease-free surgical margin correlates with a lower rate of local recurrence and a higher rate of disease-free survival. Fluorescence spectroscopy is a noninvasive diagnostic tool that can aid in real-time cancer detection. The technique, which evaluates the biochemical composition and structure of tissue fluorescence, is relatively simple, fast and, accurate. Objectives: This study aimed to compare oral squamous cell carcinoma lesions to surgical margins and the mucosa of healthy volunteers by fluorescence spectroscopy. Materials and methods: The sample consisted of 56 individuals, 28 with oral squamous cell carcinoma and 28 healthy volunteers with normal oral mucosa. Thirty six cases (64.3%) were male and the mean age was 60.9 years old. The spectra were classified and compared to histopathology to determine fluorescence efficiency for diagnostic discrimination of tumors. Results: In the analysis of the other cases we observed discrimination between normal mucosa, injury and margins. At two-year follow up, three individuals had local recurrence, and in two cases investigation fluorescence in the corresponding area showed qualitative differences in spectra between the recurrence area and the area without recurrence at the same anatomical site in the same patient. Conclusion: In situ analysis of oral mucosa showed the potential of fluorescence spectroscopy as a diagnostic tool that can aid in discrimination of altered mucosa and normal mucosa. (c) 2014 Elsevier Ltd. All rights reserved.506593599Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)ALNF scholarship [140493/2011-5]INCITOFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)FAPESP [98/14270-8, 07/57126-5, 11/10802-1]CNPq [477439/2007-1]ALNF scholarship [140493/2011-5