Putten, T.S. van (2017) 12 years of benign parotid gland surgery at a non-academic hospital in the Netherlands :A retrospective study concerning incidence of parotid gland tumours, evaluation of unintentionally treated malignancies and complications of surgery. thesis, Medicine.
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Abstract
Background and objectives: incidence of parotid gland tumours varies greatly in literature worldwide and there is no concrete literature regarding the incidence of parotid gland tumours in the Netherlands specifically. Firstly, this study intends to find more information regarding the incidence of parotid gland tumours in the adherence area of a large peripheral hospital. To improve quality of care of the Dutch head and neck oncology, the Dutch workgroup head and neck tumours (NWHHT) strive towards evaluation and treatment of head and neck malignancies (malignant parotid gland tumours included) by head and neck oncology workgroups in specialised medical centres to maintain and improve expertise. However, it has occurred that patients with malignant parotid gland tumours underwent parotid gland surgery at the Deventer hospital due to benign aspect during presentation and after diagnostics. Secondly, we wondered how many cases underwent unintentional parotid gland surgery, where in the diagnostic process a malignant parotid gland tumour was mistakenly marked as benign and how this might be prevented in the future. Lastly, complications of parotid gland surgery are diverse and well described in literature. This study’s third objective is to find out how many complications occurred after parotid gland surgery at the ENT department of the Deventer hospital. Method: this is a retrospective study on 126 cases that underwent parotid gland surgery, performed by 2 ENT surgeons. Data regarding incidence, unintentional treatment of malignant parotid gland tumours and postsurgical complications of parotid gland tumours that presented at the ENT (ear nose throat) department of the Deventer hospital were collected and compared to literature. Results: incidence of parotid gland tumours that presented at the ENT department of the Deventer hospital varied in the years 2007 to 2015 from 5.3 – 9.5 per 100.000 inhabitants per year. 4% of the cases that underwent parotid gland surgery at the ENT department of the Deventer hospital, was unintentionally operated on a malignancy and should have been referred to a head and neck oncology centre. Temporary paraesthesia of (part of) the ear was found in 38% of all cases, temporary facial nerve dysfunction in 23%, postsurgical infection in 9%, salivary fistula in 6%, postsurgical haematoma in 5%, permanent paraesthesia of (part of) the ear in 4%, sialocele in 4%, Frey’s syndrome in 2% and permanent facial nerve dysfunction was found in less than 1% of all cases. Conclusion: incidence of parotid gland tumours in the adherence area of the Deventer hospital is higher than the estimated incidence in the Netherlands and higher for malignant parotid gland tumours compared to other literature. It is unknown what caused this increase. Our theory is that the increase is either caused by a true increase of parotid gland tumours in the population when compared to other Dutch literature, or is due to different data collection methods. More research on a national scale is required to assess the true incidence of parotid gland tumours in the Netherlands, and to put our findings in perspective. A nationwide registry system for parotid gland tumours specifically without the limitations we found could be an option. The amount of unintentionally treated malignant parotid gland tumours is considered acceptable by us. More attention regarding the assessment of the MRI reports is advised to prevent this in the future. Complication rates of parotid gland surgery by the ENT department are within the range found in literature and sometimes even lower. Therefore, we conclude that parotid gland surgery is performed adequately by the ENT department of the Deventer hospital.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Laan, T. van der and ENT surgeon, supervisor and Bom, S.J.H. and ENT surgeon, supervisor and Deventer Ziekenhuis and Ear, nose |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:43 |
| Last Modified: | 25 Jun 2020 10:43 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/412 |
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