Tumors of the infantile parotid gland

Introduction:

Tumors of the regio parotidea are rare in infancy. In addition to mucoepidermoid carcinomas, mesenchymal tumors such as hemangiomas and lymphangiomas are more common. These entities show a large regression tendency, which is why surgical therapy is less often required at this age. The particular difficulty lies in the protection of the facial nerve, which is much finer here than in adults.

Method and results on 2 case studies.

Here are 2 young girls between 1.5 – 2 years presented with tumors of the parotid. The first child had congenital melanoma of the scalp on the with intraparotideal and cervical lymph node metastases. In addition to primary tumor surgery, a complete parotidectomy with ipsilateral neck dissection was performed.

The second child underwent a lateral parotidectomy with fistula extirpation in an dermatoid cyst with fistula formation. Both children had an unproblematic healing process. None of the children developed a saliva fistula. Postoperatively, there were no complications other than a temporary mild weakness of the marging brach of facial nerve in both children.

Conclusion:

In theory, parotid surgery in infants is technically similar to that in adults. In children, however, the facial nerve is much thinner. In addition, congenital malformations may be more common and pathologies often have a close relationship with the facial nerve. Here it is essential to use an intraoperative neuromonitoring and to work with the microscope or the lupe glasses to avoid injury to the much finer nerve. Also, a more careful hemostasis is necessary because in children a hemodynamically relevant blood loss occurs much faster.

Publication History

Publication Date:
18 April 2018 (online)