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Non‑standardized or conservative procedures are employed when parotid tumors involving the facial nerve or parotid carcinoma are misdiagnosed as benign parotid tumors prior to or during surgery. Remedial measures are usually required when the pathological diagnosis of a malignant parotid tumor is confirmed following surgery. The aim of the present study was to systematically evaluate reoperation subsequent to treatment with non‑standardized procedures for malignant parotid tumors, and to explore the preoperative diagnoses, the primary procedure selection and the necessity of reoperation following non‑standardized procedures in malignant parotid tumors. A total of 30 patients who met the inclusion criteria, were diagnosed with a malignant parotid tumor and underwent reoperation following the use of a non‑standardized procedure were included in the present study. Surgical conditions and clinical data were analyzed. Among the patients with a malignant parotid tumor who underwent reoperation subsequent to a non‑standardized procedure, the incidence of residual tumor, as confirmed by pathological examination, was 63.3% (19/30). The intact facial nerve preservation rate was 83.3% (25/30), the facial nerve branch resection rate was 6.7% (2/30), the facial partial nerve resection rate was 6.7% (2/30) and the facial nerve resection rate was 3.3% (1/30). In total, 3 patients underwent facial nerve reconstruction, 3 patients underwent a local flap repair of skin defects in the parotid region and 3 patients underwent pectoralis major muscle flap repair. The current findings indicate that the qualitative diagnosis of malignant parotid tumors prior to surgery is difficult, there is a high incidence of residual tumor following non‑standardized procedures, and that reoperation in a timely manner is required in such cases. [ABSTRACT FROM AUTHOR]

Intramuscular hemangiomas (IMHs) of the masseter muscle are extremely rare in the head and neck region and, thus, are often misdiagnosed as parotid tumors prior to surgery. Excisional resection remains the standard treatment for IMH. Since these tumors are located on the proximal side of the facial nerve, it is important to preserve the facial nerve during surgery. This study reports the case of a 57-year-old male who presented with a progressive tender swelling on the right side of the face, which had been present for >6 months. Computed tomography of the neck revealed a heterogeneous highly-vascularized mass located in the superficial layer of the masseter muscle. The patient subsequently underwent surgical resection via a collar incision, and pathological examination revealed a cavernous IMH. During the one-year follow-up period, the patient exhibited a good prognosis, and one-year magnetic resonance imaging revealed no local recurrence. [ABSTRACT FROM AUTHOR]

The aim of the present study was to compare the outcomes of superficial parotidectomy (SP) and partial superficial parotidectomy (PSP) in treating benign parotid tumors. Individuals who had undergone SP or PSP between 2005 and 2008 were enrolled, the medical records were reviewed, and a questionnaire was created and mailed to the patients. For the statistical analysis, χ² and non-parametric Mann-Whitney tests were used to analyze the variables. In total, 320 patients were included in the present study. Within the PSP group, immediate facial nerve weakness occurred in six patients (7.6%), and Frey's syndrome occurred in five (6.3%). Despite this, facial nerve function recovered fully during the follow-up, and recurrence was not identified. Within the SP group, Frey's syndrome occurred in 38 patients (15.8%), immediate facial nerve weakness in 55 patients (22.8%) and permanent facial nerve dysfunction in two patients (0.8%). However, no recurrence was evident. In total, 216 (67.5%) patients returned the questionnaire. Those with PSP demonstrated improved scores in the domains of appearance, facial contours, facial nerve function and Frey's syndrome. Compared with SP, PSP not only decreased the incidence of Frey's syndrome and transient facial nerve weakness, but also improved quality of life outcomes and guaranteed a low recurrence rate. [ABSTRACT FROM AUTHOR]

Characterization of parotid tumors is important for treatment planning and prognosis, and parotid tumor discrimination has recently been developed at the molecular level. The aim of the present study was to establish a machine learning (ML) predictive model based on multiparametric traditional multislice CT (MSCT) radiomic and clinical data analysis to improve the accuracy of differentiation among pleomorphic adenoma (PA), Warthin tumor (WT) and parotid carcinoma (PCa). A total of 345 patients (200 with WT, 91 with PA and 54 with PCa) with pathologically confirmed parotid tumors were retrospectively enrolled from five independent institutions between January 2010 and May 2019. A total of 273 patients recruited from institutions 1, 2 and 3 were randomly assigned to the training model; the independent validation set consisted of 72 patients treated at institutions 1, 4 and 5. Data were investigated using a linear discriminant analysis-based ML classifier. Feature selection and dimension reduction were conducted using reproducibility testing and a wrapper method. The diagnostic accuracy of the predictive model was compared with histopathological findings as reference results. This classifier achieved a satisfactory performance for the discrimination of PA, WT and PCa, with a total accuracy of 82.1% in the training cohort and 80.5% in the validation cohort. In conclusion, ML-based multiparametric traditional MSCT radiomics can improve the accuracy of differentiation among PA, WT and PCa. The findings of the present study should be validated by multicenter prospective studies using completely independent external data. [ABSTRACT FROM AUTHOR]