Diagnostic and therapeutic modalities for 287 malignant and benign salivary tumors: A cohort study.

BACKGROUND: Salivary gland tumors (SGT's), 3-10% of head/neck tumors, exhibit a striking range of morphological diversity. This minimally symptomatic disease can be challenging to diagnose, and therapeutic policy is still controversial. METHODS: We compared benign and malignant cohorts according to diagnostic modality utilized and therapeutic modality administered over 20 years in a single medical center. RESULTS: Of 287 cases, 216 had benign tumors and 71 had malignant tumors. Treatment was surgery-based in 99% of cases, often accompanied by radiotherapy and/or chemotherapy. Rates of imaging and biopsy for diagnosis were significantly higher in malignant than benign tumors. Fine-needle aspiration (FNA) was used in 90.3% of benign tumors. Of 71 malignant tumors, 69 underwent surgery to fully remove the malignant tumor. Adjuvant therapy included 22 neck dissections (30%), 28 radiotherapy (39.4%), 12 chemotherapy (16.9%) and 10 combined radio-chemotherapy (14.1%). Partial parotidectomy, submandibular sialoadenectomy and local excision were used in 78.1%, 8.3% and 6.9% of benign cases. Total parotidectomy, sub-total maxillectomy and wide excision were used in 16.9%, 12.7% and 22.6% of malignant cases. DISCUSSION: Diagnostic and therapeutic modalities for treatment of salivary tumor at our hospital are presented and discussed with respect to others. A paradigm of therapy administered in our institute is presented.

Benign and Malignant Salivary Gland Tumors - Clinical and Demographic Characteristics.

AIM: To examine the demographic, ethnic, and clinical characteristics of salivary benign and malignant tumors for better etiological understanding. PATIENTS AND METHODS: We examined medical records of 287 primary salivary gland tumor patients. RESULTS: Overall, 216 tumors were benign and 71 malignant. The mean age at diagnosis was 56.4 years for those with malignant tumors and 48.5 years for those with benign, a highly significant difference (p=0.001). Females had 45% of malignant tumors and 59% of benign, a significant difference (p=0.037). Ethnic origin, alcohol consumption and cigarette smoking rates were not significantly different (p>0.05) between groups. A total of 87% of benign and 55% of malignant tumors were in the parotid glands, a highly significant predilection (p<0.0001), sublocated mostly in the superfacial lobe; 36.6% of malignant tumors and 4.7% of benign (p<0.0001) were in the minor salivary glands, mostly in the hard palate. CONCLUSION: Baseline clinical, demographic and locational aspects of benign and malignant tumors are substantiated.

Blast injury of the ear in a confined space explosion: auditory and vestibular evaluation.

BACKGROUND: The ear is the most frequent organ affected during an explosion. Recognition of possible damage to its auditory and vestibular components, and particularly the recovery time of the incurred damage, may help in planning the optimal treatment strategies for the otologic manifestations of blast injury and preventing deleterious consequences. OBJECTIVE: To report the results of the oto-vestibular initial evaluation and follow-up of 17 survivors of a suicide terrorist attack on a municipal bus. METHODS: These 17 patients underwent periodic ear inspections and pure tone audiometry for 6 months. Balance studies, consisting of electronystagmography and computerized dynamic posturography were performed at the first time possible. RESULTS: Complaints of earache, aural fullness and tinnitus resolved, whereas dizziness persisted in most of the patients. By the end of the follow-up, 15 (55.6%) of the eardrum perforations had healed spontaneously. Hearing impairment was detected in 33 of the 34 tested ears. Recovery of hearing was complete in 6 ears and partial in another 11. ENG and CDP were performed in 13 patients: 5 had abnormal results on CDP while the ENG was normal in all the patients. Of the seven patients who complained of vertigo, only one improved and was free of symptoms 1 month after the explosion. CONCLUSION: Exposure to a high powered explosion in a confined space may result in severe auditory and vestibular damage. Awareness of these possible ear injuries may prevent many of the deleterious consequences of such injuries.