J Korean Assoc Oral Maxillofac Surg.  2012 Feb;38(1):38-43. 10.5125/jkaoms.2012.38.1.38.

Preoperative prediction of the location of parotid gland tumors using radiographic anatomical landmarks

Affiliations
  • 1Department of Oral and Maxillofacial Surgery, Kyungpook National University School of Dentistry, Daegu, Korea. vocaleo@knu.ac.kr
  • 2Department of Oral and Maxillofacial Radiology, Kyungpook National University School of Dentistry, Daegu, Korea.

Abstract

INTRODUCTION
The location of parotid gland tumors in the superficial or deep lobes can affect the time and difficulty of operations. Therefore, accurate preoperative evaluation of the tumor location is important for surgical outcomes.
MATERIALS AND METHODS
A total of 16 patients with parotid gland tumors and who underwent a parotidectomy between April 2003 and March 2011 were retrospectively reviewed in terms of demographic background, tumor location, surgical treatment, and treatment outcomes. Tumor location was estimated by four landmarks on contrast enhanced computerized tomography scans, which were Conn's arc, the facial nerve (FN) line, the Utrecht line, and the retromandibular vein. Tumor location was confirmed by relative position depending on the facial nerve during surgery. It was assumed positive since the tumor lies in the superficial lobe of the parotid gland, the sensitivity, specificity, positive predictive value, negative predictive value, and efficiency of each landmark were evaluated.
RESULTS
Our result revealed that the facial nerve line had a sensitivity of 83.3%, specificity of 100%, positive predictive value of 100%, negative predictive value of 71.4%, and efficiency of 87.5%. Some would be more efficient preoperative evaluation methods of the relationship of parotid gland tumors to the facial nerve than others.
CONCLUSION
In our study, the FN line was found to be the most reliable analysis method.

Keyword

Parotid neoplasms; Parotid gland; Parotid diseases; Computed tomography

MeSH Terms

Facial Nerve
Humans
Parotid Diseases
Parotid Gland
Parotid Neoplasms
Retrospective Studies
Sensitivity and Specificity
Veins

Figure

  • Fig. 1 Comparing with the Conn's arc (CA) (A), facial nerve (FN) line (B), Utrecht (U) line (C), and retromandibular vein (RV) (D) on the same computed tomography image. Clinical photo in operation room (E). CA, FN line, and RV predict that the tumor is in the superficial lobe. However, the U line predicted that the tumor is in the deep lobe. Compared with the clinical photo, the tumor was confirmed to be in the superficial lobe. The tumors and posterior belly of the digastric muscles are denoted by the dashed line.


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