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Query: UMLS:C0030552 (paresis)
 5,831 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Surgery for benign parotid gland salivary neoplasms is associated with sequelae: scar and divot defect and complications, facial nerve paresis/paralysis and Frey's syndrome. These potential sequelae and complications are discussed with all patients prior to operation. We contacted 212 patients who had undergone surgery for benign parotid disease during 1988-1997, by postal questionnaire. We enquired about their perception and recollection of the information they had received pre-operatively and to document and comment upon what problems they had experienced in the early and late post-operative period. The usable return rate was 75.5 per cent (173/212). Most patients (90 per cent) were satisfied with the information they had received pre-operatively. The complication and/or sequelae rates for facial nerve palsy (temporary 26.3 per cent, permanent 1.9 per cent), Frey's syndrome (12.5 per cent) and sensory deficit about the cheek and ear (30.6 per cent), are comparable to other published studies.
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PMID:Patients' perspectives on the short- and long-term outcomes following surgery for benign parotid neoplasms. 1295 17

The authors studied 100 patients with salivary gland adenomas for a period of ten years (from 1989 to 1999). Different types of adenomas regarding their glandular localization, clinical presentation, the age and the sex of the patients were studied. Different diagnostic methods were applied: medical history, clinical examination, sonography, scintigraphy, tomodensitometry, sialography, express morphological diagnosis and permanent histological preparation. All patients were treated surgically: in 61% lateral parotidectomy was performed, in 1.4% - conservative parotidectomy and in 24% - enucleation. The authors report about 7.75% recurrence of pleomorphic adenoma and 6% malignization, mainly in the recurrences of the pleomorphic adenoma. In 22 of the patients a postoperative paresis was observed, in 18 of them it was transitory and gradually disappeared after 8 to 9 months. Auriculotemporal syndrome was observed in 4 of the patients.
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PMID:Clinical and statistical study of salivary gland adenoma. 1535 93

Patients operated on for parotid gland tumours were evaluated prospectively to study morbidity after this procedure. Nowadays, major complications such as recurrence of tumour and permanent facial nerve paresis are rare after primary surgery. Therefore, this study especially takes minor complications such as Frey's syndrome and sensory deficits into account. The study documents morbidity in 45 patients who completed a 1 year follow-up. Among those with primary benign tumours, we found no recurrences and no permanent paresis, nor did starch-iodine testing reveal any cases of Frey's syndrome. However, two patients who had previously been operated on multiple times did test positive for Frey's syndrome, as did two others after surgery for malignancy. Furthermore, we found that patients whose posterior branch of the great auricular nerve was sacrificed had a larger area of sensory deficit than those whose nerve was preserved. We conclude that the morbidity of parotid gland surgery can be reduced further by giving minor complications more attention.
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PMID:Morbidity of parotid gland surgery: results 1 year post-operative. 1650 39

Parotid neoplasms represent 3% of all head and neck tumours, and most are benign. Malignant tumours account for 14-25% of cases. Surgery is the treatment of choice, with options ranging from simple enucleation to radical parotidectomy. Sixteen patients presented with a history of a painless parotid lump. Diagnosis was achieved by ultrasound scan and MRI. Fifteen superficial parotidectomies and 1 nerve-sparing total parotidectomy were carried out. At histology, 10 pleomorphic adenomas, 4 Warthin's tumours, 1 lymphoepithelial cyst and 1 sebaceous adenocarcinoma were detected. In the single case of carcinoma, the 6 peri-glandular lymph nodes included in the specimen were metastasis-free. In 3 patients (20%) a transient paresis of the facial nerve was noted. The capsule appeared breached in only 1 case of pleomorphic adenoma. Four patients (26%) were diagnosed as suffering from Frey's syndrome. A salivary fistula was recorded in 2 patients (13%). During follow-up ranging from 3 to 96 months no tumour recurrence was recorded. Superficial parotidectomy seems to be the best choice of treatment for benign parotid tumours, since it allows complete excision of the tumour with sparing of the facial nerve. A radical procedure is, however, needed if malignancy is confirmed at frozen section.
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PMID:Superficial parotidectomy as first choice for parotid tumours. 1736 36

We present our experience of 156 patients with parotid pleomorphic adenomas who were treated from 1995 to 2009 by partial superficial parotidectomy. In each case the main trunk of the facial nerve was identified and dissected. Only the division of the nerve adjacent to the tumour was dissected, and only the parotid tissue surrounding the tumour was excised. The results were satisfactory, as no patient developed permanent partial or total facial nerve paralysis, and transient paresis was noticed in only 23 patients (15%). Only one tumour recurred, and Frey syndrome developed in only 6 patients (4%). Enucleation was required in 55 patients (35%) because the tumour was so close to the branches of the facial nerve. Partial superficial parotidectomy is a safe treatment for parotid pleomorphic adenomas with relatively few postoperative complications. When it is done by experienced surgeons no permanent deficits are likely, it has low rates of recurrence, and gives excellent aesthetic results.
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PMID:Partial superficial parotidectomy as the method of choice for treating pleomorphic adenomas of the parotid gland. 2063 62

Botulinum toxin (Botox) is an exotoxin produced from Clostridium botulinum. It works by blocking the release of acetylcholine from the cholinergic nerve end plates leading to inactivity of the muscles or glands innervated. Botox is best known for its beneficial role in facial aesthetics but recent literature has highlighted its usage in multiple non-cosmetic medical and surgical conditions. This article reviews the current evidence pertaining to Botox use in the head and neck. A literature review was conducted using The Cochrane Controlled Trials Register, Medline and EMBASE databases limited to English Language articles published from 1980 to 2012. The findings suggest that there is level 1 evidence supporting the efficacy of Botox in the treatment of spasmodic dysphonia, essential voice tremor, headache, cervical dystonia, masticatory myalgia, sialorrhoea, temporomandibular joint disorders, bruxism, blepharospasm, hemifacial spasm and rhinitis. For chronic neck pain there is level 1 evidence to show that Botox is ineffective. Level 2 evidence exists for vocal tics, trigeminal neuralgia, dysphagia and post-laryngectomy oesophageal speech. For stuttering, 'first bite syndrome', facial nerve paresis, Frey's syndrome, oromandibular dystonia and palatal/stapedial myoclonus the evidence is level 4. Thus, the literature highlights a therapeutic role for Botox in a wide range of non-cosmetic conditions pertaining to the head and neck (mainly level 1 evidence). With ongoing research, the spectrum of clinical applications and number of people receiving Botox will no doubt increase. Botox appears to justify its title as 'the poison that heals'.
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PMID:An evidence-based review of botulinum toxin (Botox) applications in non-cosmetic head and neck conditions. 2347 31

We conducted a retrospective study to analyze the role of the cervical and lateral skull base approaches in the surgical excision of parapharyngeal space (PPS) tumors. Our study population was made up of 34 patients-15 males and 19 females, aged 13 to 73 years (mean: 50.6)-who had presented to us with a PPS tumor during a 9-year period. The 34 cases included 23 benign tumors and 11 malignancies. The 23 benign tumors consisted of 11 pleomorphic adenomas, 5 schwannomas, 2 paragangliomas, 2 Warthin tumors, 1 oncocytoma, 1 hamartoma, and 1 osteochondroma. The 11 malignancies included 3 cases of recurrent nasopharyngeal carcinoma, 2 cases of mucoepidermoid carcinomas, and 1 case each of carcinoma ex pleomorphic adenoma, liposarcoma, lymph node metastasis from nasopharyngeal carcinoma, lymph node metastasis from follicular thyroid carcinoma, rhabdomyosarcoma, and cranial nerve (CN) X neurofibrosarcoma. Among the benign tumors, 14 were removed via the transparotid approach, 3 via the transcervical approach, 3 via the transcervical-transparotid approach, 2 via the petro-occipital-trans-sigmoid approach, and 1 via the Fisch type A infratemporal fossa approach. During postoperative follow-up, 5 of the 23 patients with a benign tumor exhibited facial nerve paresis, 2 developed CN IX to XII palsy, and 1 each developed Frey syndrome and CN X palsy. In the malignant tumor group, 4 of the 11 patients were treated via the transcervical-transparotid approach, 3 via the Fisch type C infratemporal fossa approach, 3 via the transcervical-transmandibular approach, and 1 via the transcervical-lateral petrosectomy approach. The neural deficits observed during the postoperative period were more extensive among the patients with a malignant tumor. We conclude that the transparotid and transcervical approaches were adequate for excising most benign tumors. For malignant tumors, large tumors, and tumors with skull base involvement and transcranial extension, the transparotid-transcervical, transcervical-transmandibular, infratemporal fossa, and petro-occipital-trans-sigmoid approaches were necessary.
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PMID:Surgical management of parapharyngeal space tumors: The role of cervical and lateral skull base approaches. 2792 99

Botulinum toxin (Botox) is an exotoxin produced from Clostridium botulinum. It blocks the release of acetylcholine from the cholinergic nerve end plates resulting in inactivity of the muscles or glands innervated. The efficacy of Botox in facial aesthetics is well established; however, recent literature has highlighted its utilization in multiple non-cosmetic medical and surgical conditions. The present article reviews the current evidence pertaining to Botox use in the non-cosmetic head and neck conditions. A literature search was conducted using MEDLINE, EMBASE, ISI Web of Science and the Cochrane databases limited to English Language articles published from January 1980 to December 2014. The findings showed that there is level 1 evidence supporting the efficacy of Botox in the treatment of laryngeal dystonia, headache, cervical dystonia, masticatory myalgia, sialorrhoea, temporomandibular joint disorders, bruxism, blepharospasm, hemifacial spasm and rhinitis. For chronic neck pain there is level 1 evidence to show that Botox is ineffective. Level 2 evidence exists for vocal tics and trigeminal. For stuttering, facial nerve paresis, Frey's syndrome and oromandibular dystonia the evidence is level 4. Thus, there is compelling evidence in the published literature to demonstrate the beneficial role of Botox in a wide range of non-cosmetic conditions pertaining to the head and neck (mainly level 1 evidence). With more and more research, the range of clinical applications and number of individuals getting Botox will doubtlessly increase. Botox appears to justify its title as 'the poison that heals'.
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PMID:The therapeutic usage of botulinum toxin (Botox) in non-cosmetic head and neck conditions - An evidence based review. 2822 58

Objective:The aim of this study is to systematically assess the clinical outcomes of extracapsular dissection (ECD) and superficial parotidectomy (SP), and to provide evidences for the clinical decision for treatment of parotid gland benign tumors. Method:Relevant studies that compared the outcomes of extracapsular dissection and superficial parotidectomy for the parotid benign tumors were searched in Pubmed, CNKI and Wangfang data databases, and Meta-analysis was performed using software RevMan 5.0. Result:Fifteen studies were selected for the Meta-analysis. A total of 2 929 participants were included in those studies, of which 1 796 underwent ECD and 1 133 underwent SP. The recurrence rates for ECD and SP were 1.29% (23 of 1 776 cases) and 1.48% (16 of 1 081 cases), respectively. There were no statistically significant in recurrence rate between ECD and SP. The rates of transient facial nerve paresis for ECD and SP were 5.48% (74 of 1 350) and 22.94% (139 of 606), that of permanent facial nerve paralysis were 0.66% (8 of 1 221) and 2.71% (15 of 554). The incidences of Frey's syndrome in ECD group and SP group were 1.91% (26 of 1 360) and 16.71% (111 of 664), that of fistula in were 0.53% (5 of 946) and 2.96% (10 of 338). ECD could reduce the risk for complications compared with SP. Conclusion:This systematic review with Meta-analysis suggests that ECD has a similar recurrence rate as SP with fewer postoperative complications. ECD may be considered as an alternative surgical modality for select benign parotid tumor.
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PMID:[Extracapsular dissection versus superficial parotidectomy for treatment of parotid benign tumors: evidence based medicine analysis]. 2977 3


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