Tumors of the parotid salivary gland are difficult in treatment, because there is a danger of iatrogenic damage of branches of the facial nerve, glossopharyngeal and sublingual nerves, as well as neck plexus during the parotid gland tumors resection.
Purpose of the work is studying diagnostical information value of complex research components: RCT, MRI, US, sialogram and cytology of punctate of the parotid salivary gland tumors, their topical and differential diagnosis, as well as topical imaging of the trunk and branches of the facial nerve (the level of involving them into the tumor process) as compared to the perioperative imaging.
Material and methods. During the period 2005–2011 we observed 32 patients with the tumors of the lower pole and pharyngeal process of parotid salivary gland (parapharyngeal space), which had surgical treatment in the laryngeal-oncologic department of the Odessa Municipal Hospital N 11; 13 (40.6%) of 32 patients had relapse of the disease. The patients obtained a complex diagnostics at the pre-hospital period: US, MRI and RCT of the parotid salivary gland and parapharyngeal space, sialogram and cytology of tumor punctate.
Results of research. Sialograms of all the patients revealed defect of filling and expansion and displacement of channels, which was an evidence of not only a tumor, but also the inflammatory process in the gland. Vascular-nervous structures were not visualized. US and MRI detected tumors in 32 (100%) patients. RCT revealed well the tumor formations in all patients, but no patients were visualized the branches of the facial nerve; 6 (18.8%) patients were succeeded to visualize the vagus nerve on the neck in the parapharyngeal space.
Perioperative diagnostics. During the operation 100% of patients were succeeded to detect the trunk of the facial nerve and only 29 (90.6%) patients were detected and traced all its branches; the tumor invaded in the branch of the facial nerve in 6 (18.8%) cases. The postoperative period was accompanied by mimic muscles paresis, which remained in the mild degree in 5 months in spite of conducted rehabilitation measures.
Results. At the perioperative period we succeeded to image the trunk and branches of the facial nerve at all patients. The analysis of postoperative complications showed that 19 (59.4 %) patients had the phenomena of paresis of mimic muscles on the side of the operation, which disappeared at different terms after conducting rehabilitation treatment.