Download PDF
Laryngorhinootologie 2018; 97(06): 405-409
DOI: 10.1055/a-0596-7714
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Veränderte Indikation zur Parotidektomie im nordwestlichen Brandenburg: Eine Longitudinaluntersuchung

Altered indication for parotidectomy in north-western Brandenburg: A longitudinal study
Achim M Franzen
1   Klinik für HNO-Heilkunde und Plastische Operation, Medizinische Hochschule Brandenburg, Campus Ruppiner-Kliniken, Neuruppin
,
Christiane Kaup Franzen
2   Praxis für Allgemeinmedizin, Neuruppin
,
Annekatrin Coordes
3   Klinik für Hals-, Nasen-, Ohrenheilkunde, Charité-Universitätsmedizin Berlin, Camupus Benjamin Franklin, Berlin
› Author Affiliations
Further Information

Publication History

Publication Date:
10 April 2018 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Hintergrund Kenntnisse über die Indikationen zu einer Parotidektomie basieren auf den Mitteilungen einzelner Kliniken, Tumor- und Krankenhausdatenbanken. Die Studie prüft die Hypothese, dass sich die Operationsindikation während der vergangenen Jahre verändert hat.

Material und Methoden Wir führten eine retrospektive Beobachtungsstudie der Patienten durch, die zwischen 1975 und 2016 (Einteilung in 4 Quartilen) in einem Ausbildungskranken haus einer Medizinischen Hochschule mit Schwerpunktversorgung eine Parotidektomie erhielten.

Ergebnisse 405 Männer und 366 Frauen wurden wegen eines benignen (600/78 %) oder malignen (116/15 %) Tumors oder einer Parotitis (55/7 %) operiert. Der Anteil der benignen Tumore blieb weitgehend konstant (78 %), der der malignen Tumore stieg (7 %–23 %) bei gleichzeitigem Abfall der Parotitiden (17 % – < 1 %). Bei den benignen Tumoren fiel der Anteil der pleomorphen Adenome (60 % –24 %), während Warthin Tumore häufiger auftraten (23 % –58 %). Unter den malignen Tumoren stieg der Anteil der Metastasen von 2/13 auf 31/49 (insbes. Plattenepithelkarzinomen der Haut).

Diskussion Die vorliegende Studie zeigt die sinkende Bedeutung der Parotitis als Indikation für eine Parotidektomie bedingt durch verbesserte nicht-chirurgische Verfahren. Die ansteigende Prävalenz von Warthin-Tumoren in der aktuellen Arbeit war mit einem steigenden Anteil der Raucher assoziiert. Der Anstieg der Malignome war auf die steigende Prävalenz von intraparotidealen Matastasen der Plattenepithelkarzinome der Haut zurückzuführen. Die Ergebnisse der histologischen Diagnosen basieren auf der Auswertung von Krankenakten und können bisher nicht durch die Auswertungen überregionaler Tumordatenbanken oder Krankenhausstatistiken (ICD- oder DRG-Bezug) generiert werden. Hierzu befürworten die Autoren die Einrichtung eines speziellen Speicheldrüsenregisters.

Abstract

Objective Knowledge about parotoidectomy indications is based on notifications to ENT departments and tumor databases. The study investigates the hypothesis that the surgical indication for parotoidectomy has changed over recent years.

Material and Methods We performed a retrospective observation study of patients who underwent parotidectomy between 1975 and 2016 (subdivided into 4 quartiles) in a teaching hospital of a medical university.

Results 405 men and 366 women underwent operation for benign tumors (600/78 %), malignant tumors (116/15 %) or parotitis (55/7 %). The proportion of benign tumors remained unchanged (78 %), whereas malignant tumors increased (7 % – 23 %) and parotitides decreased (17 % – < 1 %). In benign tumors, the proportion of pleomorphic adenomas decreased (60 % – 24 %), whereas Warthin tumors increased (23 % – 58 %). Among malignant tumors, the proportion of metastases increased from 2/13 to 31/49 (in particular squamous cell carcinomas of the skin).

Conclusions The present the study shows the decreasing importance of parotitis as an indication for parotidectomy due to improved non-surgical procedures. The increasing prevalence of Warthin tumors was associated with an increasing proportion of smokers. Increased number of malignant tumors was caused by an increased prevalence of intraparotidial matastases of cutaneous squamous cell carcinoma. The presented results are based on the evaluation of patient charts. Due to their ICD or DRG reference, histological findings cannot be generated by evaluating databases. For this purpose, a special salivary gland tumor database should be established.

Schlüsselwörter

Parotidektomie - Indikation - Datenbank - Speicheldrüsenregister - Metastasen

Key words

parotidectomy - indication - database - salivary gland - metastases
 

  • References

  • 1 Li LJ. et al. Clinical analysis of salivary gland tumor cases in West China in past 50 years. Oral Oncol 2008; 44 (02) 187-92
    CrossrefPubMedGoogle Scholar
  • 2 Ethunandan M, Pratt CA, Macpherson DW. Changing frequency of parotid gland neoplasms – analysis of 560 tumours treated in a district general hospital. Ann R Coll Surg Engl 2002; 84 (01) 1-6
    PubMedGoogle Scholar
  • 3 Kroll T. et al. Short-term outcome and patient satisfaction after sialendoscopy. Eur Arch Otorhinolaryngol 2013; 270 (11) 2939-45
    CrossrefPubMedGoogle Scholar
  • 4 Koch M. et al. Long-term results and subjective outcome after gland-preserving treatment in parotid duct stenosis. Laryngoscope 2014; 124 (08) 1813-8
    CrossrefPubMedGoogle Scholar
  • 5 Zenk J. et al. Chronic recurrent parotitis. HNO 2010; 58 (03) 237-43
    CrossrefPubMedGoogle Scholar
  • 6 Harbison JM. et al. Chronic parotitis: a challenging disease entity. Ear Nose Throat J 2011; 90 (03) E13-6
    PubMedGoogle Scholar
  • 7 Tian Z. et al. Salivary gland neoplasms in oral and maxillofacial regions: a 23-year retrospective study of 6982 cases in an eastern Chinese population. Int J Oral Maxillofac Surg 2010; 39 (03) 235-42
    CrossrefPubMedGoogle Scholar
  • 8 de Oliveira FA. et al. Salivary gland tumor: a review of 599 cases in a Brazilian population. Head Neck Pathol 2009; 3 (04) 271-5
    CrossrefPubMedGoogle Scholar
  • 9 Patel DK, Morton RP. Demographics of benign parotid tumours: Warthin’s tumour versus other benign salivary tumours. Acta Otolaryngol 2016; 136 (01) 83-6
    CrossrefPubMedGoogle Scholar
  • 10 Moeller K. et al. Parotidectomy and submandibulectomy for benign diseases in Thuringia, Germany: a population-based study on epidemiology and outcome. Eur Arch Otorhinolaryngol 2013; 270 (03) 1149-55
    CrossrefPubMedGoogle Scholar
  • 11 Yoo GH. et al. Warthin’s tumor: a 40-year experience at The Johns Hopkins Hospital. Laryngoscope 1994; 104 (07) 799-803
    PubMedGoogle Scholar
  • 12 Luers JC. et al. The incidence of Warthin tumours and pleomorphic adenomas in the parotid gland over a 25-year period. Clin Otolaryngol 2016; 41 (06) 793-797
    CrossrefPubMedGoogle Scholar
  • 13 Mantsopoulos K. et al. Evolution and changing trends in surgery for benign parotid tumors. Laryngoscope 2015; 125 (01) 122-7
    CrossrefPubMedGoogle Scholar
  • 14 Witt RL, Iacocca M, Gerges F. Contemporary diagnosis and management of Warthin’s tumor. Del Med J 2015; 87 (01) 13-6
    PubMedGoogle Scholar
  • 15 Ciuman RR. et al. Outcome, general, and symptom-specific quality of life after various types of parotid resection. Laryngoscope 2012; 122 (06) 1254-61
    CrossrefPubMedGoogle Scholar
  • 16 Teymoortash A, Krasnewicz Y, Werner JA. Clinical features of cystadenolymphoma (Warthin’s tumor) of the parotid gland: a retrospective comparative study of 96 cases. Oral Oncol 2006; 42 (06) 569-73
    CrossrefPubMedGoogle Scholar
  • 17 Podlesak T, Doleckova V, Sibl O. Malignancy of a cystadenolymphoma of the parotid gland. Eur Arch Otorhinolaryngol 1992; 249 (04) 233-5
    CrossrefPubMedGoogle Scholar
  • 18 Thompson AS, Bryant Jr HC. Histogenesis of papillary cystadenoma lymphomatosum (Warthin’s tumor) of the parotid salivary gland. Am J Pathol 1950; 26 (05) 807-49
    PubMedGoogle Scholar
  • 19 Chaudhry AP, Gorlin RJ. Papillary cystadenoma lymphomatosum (adenolymphoma); a review of the literature. Am J Surg 1958; 95 (06) 923-31
    CrossrefPubMedGoogle Scholar
  • 20 Eveson JW, Cawson RA. Warthin’s tumor (cystadenolymphoma) of salivary glands. A clinicopathologic investigation of 278 cases. Oral Surg Oral Med Oral Pathol 1986; 61 (03) 256-62
    CrossrefPubMedGoogle Scholar
  • 21 Chulam TC. et al. Warthin’s tumour of the parotid gland: our experience. Acta Otorhinolaryngol Ital 2013; 33 (06) 393-7
    Google Scholar
  • 22 Sadetzki S. et al. Smoking and risk of parotid gland tumors: a nationwide case-control study. Cancer 2008; 112 (09) 1974-82
    CrossrefPubMedGoogle Scholar
  • 23 Kotwall CA. Smoking as an etiologic factor in the development of Warthin’s tumor of the parotid gland. Am J Surg 1992; 164 (06) 646-7
    CrossrefPubMedGoogle Scholar
  • 24 de Ru JA. et al. Warthin’s tumour and smoking. B-ENT 2005; 1 (02) 63-6
    PubMedGoogle Scholar
  • 25 Klussmann PJ. et al. High risk for bilateral Warthin tumor in heavy smokers – review of 185 cases. Acta Otolaryngol 2006; 126 (11) 1213-7
    CrossrefPubMedGoogle Scholar
  • 26 Mortensen KS. et al. [Salivary gland tumors in the County of Funen, 1984–2003]. Ugeskr Laeger 2008; 170 (07) 545-8
    PubMedGoogle Scholar
  • 27 Bergersen PJ, Kennedy PJ, Kneale KL. Metastatic tumours of the parotid region. Aust N Z J Surg 1987; 57 (01) 23-6
    CrossrefPubMedGoogle Scholar
  • 28 Bron LP. et al. Primary and metastatic cancer of the parotid: comparison of clinical behavior in 232 cases. Laryngoscope 2003; 113 (06) 1070-5
    CrossrefPubMedGoogle Scholar
  • 29 Audet N. et al. Cutaneous metastatic squamous cell carcinoma to the parotid gland: analysis and outcome. Head Neck 2004; 26 (08) 727-32
    CrossrefPubMedGoogle Scholar
  • 30 Boukheris H. et al. Incidence of carcinoma of the major salivary glands according to the WHO classification, 1992 to 2006: a population-based study in the United States. Cancer Epidemiol Biomarkers Prev 2009; 18 (11) 2899-906
    CrossrefPubMedGoogle Scholar
  • 31 Jensen JE, Schlattmann P, Guntinas-Lichius O. Inpatient Salivary Gland Surgery in Germany: A DRG-Based Nationwide Analysis, 2007–2011. Laryngo-Rhino-Otol 2016; 95 (09) 620-626
    PubMedGoogle Scholar
  • 32 Bradley PJ, McGurk M. Incidence of salivary gland neoplasms in a defined UK population. Br J Oral Maxillofac Surg 2013; 51 (05) 399-403
    CrossrefPubMedGoogle Scholar
  • 33 Ellis GL, Auclair PL. Tumors of the salivary glands. Primary squamous cell carcinoma., in AFIP Atlas of Tumor pathology, series 4. 2008. ARP Press; Silver Spring, Maryland, US: 289-95
    Google Scholar
  • 34 Chen MM. et al. Prognostic factors for squamous cell cancer of the parotid gland: an analysis of 2104 patients. Head Neck 2015; 37 (01) 1-7
    CrossrefPubMedGoogle Scholar
  • 35 Wierzbicka M. et al. Epidemiology of non-malignant salivary gland tumours based on 675 cases. Otolaryngol Pol 2010; 64 (05) 281-7
    CrossrefPubMedGoogle Scholar
  • 36 Grant D, Bradley P. Epidemiology of malignant salivary gland neoplasms. Salivary Gland Disorders and Diseases: Diagnosis and Management. 2011: 247-51
    PubMedGoogle Scholar