Manejo quirúrgico de los tumores benignos de glándula parótida y sus complicaciones. Hospital Teodoro Maldonado Carbo 2015-2017
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2018
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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Los tumores parotídeos son en su mayoría benignos, pero su evaluación y tratamiento requieren un conocimiento profundo de la anatomía y patología relevantes. El tratamiento quirúrgico de los tumores benignos está dirigido a la eliminación completa de la masa con preservación del nervio facial. Objetivo: Analizar el manejo quirúrgico de los tumores benignos de glándula parótida y sus complicaciones en pacientes del Hospital Teodoro Maldonado Carbo durante el periodo 2015-2017. Metodología: El estudio será tipo observacional, analítico, retrospectivo y de corte transversal, que incluirá a 42 pacientes con tumores benignos de glándula parótida de la Consulta Externa de Otorrinolaringología del Hospital Regional IESS Nº 2 Teodoro Maldonado Carbo captados desde el periodo del 1 de enero del 2015 hasta 31 de diciembre del 2017. La gestión de datos se realizó en hojas de cálculo de Microsoft Excel 2010, donde se realizará el procesamiento de datos y el análisis estadístico se realizará con el programa SPSS versión 21.Resultados: El grupo etario predominante fue el de entre 41-60 años de edad (50%), el sexo masculino con el 60% (19) representó el de mayor proporción. La mayor parte de pacientes pertenecen a la provincia del Guayas (90%), especialmente de zonas urbanas (86%). El adenoma pleomorfo representó (57%) más de la mitad de los casos analizados, seguidos en orden de frecuencia por el quiste linfoepitelial (17%) y los tumores mixtos con el 7%. El 93% requirió de parotidectomía superficial y el 33% (14) desarrolló complicaciones postquirúrgicas, siendo la parálisis facial la más frecuente con el 57%, especialmente la de grado II (63%). El 19% (8) presentó secuelas postquirúrgicas, la parálisis facial (75%) y la parestesia de hemicara (38%) predominaron. El principal factor de riesgo asociado fue el consumo de cigarrillos que estadísticamente se demostró que aumenta el riesgo para desarrollar complicaciones. Conclusión: La parotidectomía superficial de tumores benignos de glándula parótida ofrece mayor seguridad por su menor frecuencia de complicaciones y secuelas en relación a la cirugía radical. Palabras clave: tumor, anatomía, nervio
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Parotid tumors are mostly benign, but their evaluation and treatment require a thorough knowledge of the relevant anatomy and pathology. Surgical treatment of benign tumors is directed at complete removal of the mass with preservation of the facial nerve. Objective: To analyze the surgical management of benign tumors of the parotid gland and its complications in patients of the Hospital Teodoro Maldonado Carbo during the period 2015-2017. Methodology: The study will be an observational, analytical, retrospective and cross-sectional type, which will include 50 patients with benign tumors of the parotid gland of the Otorhinolaryngology External Consultation of the IESS Regional Hospital No. 2 Teodoro Maldonado Carbo collected from the period of January 1 from 2015 to December 31, 2016. Data management was done in Microsoft Excel 2010 spreadsheets, where data processing will be performed and statistical analysis will be performed with the SPSS version 21 program. Results: The predominant age group was between 41-60 years of age (41.7%), the male sex with 52.8% (19) represented the highest proportion. The majority of patients belong to the province of Guayas (88.9%), especially in urban areas (83.3%). The pleomorphic adenoma represented (50%) half of the cases analyzed, followed in order of frequency by the lymphoepithelial cyst (16.7%) and the mixed tumors with 8.3%. 91.7% required conservative surgery and 36.1% (13) developed postsurgical complications, with facial paralysis being the most frequent with 62%, especially grade II (63%). 22.8% (8) presented postoperative sequelae, facial paralysis (75%) and paresthesia of the hemiface(38%) predominated. The main risk factor associated was the use of drain with 72.2%. The consumption of corticosteroids, radical surgery and the use of drainage increase the risk to develop complications. Conclusion: The superficial parotidectomy of benign tumors of the parotid gland offers greater security due to its lower frequency of complications and sequelae in relation to radical surgery. Keywords: tumor, anatomy, nerve.
Parotid tumors are mostly benign, but their evaluation and treatment require a thorough knowledge of the relevant anatomy and pathology. Surgical treatment of benign tumors is directed at complete removal of the mass with preservation of the facial nerve. Objective: To analyze the surgical management of benign tumors of the parotid gland and its complications in patients of the Hospital Teodoro Maldonado Carbo during the period 2015-2017. Methodology: The study will be an observational, analytical, retrospective and cross-sectional type, which will include 50 patients with benign tumors of the parotid gland of the Otorhinolaryngology External Consultation of the IESS Regional Hospital No. 2 Teodoro Maldonado Carbo collected from the period of January 1 from 2015 to December 31, 2016. Data management was done in Microsoft Excel 2010 spreadsheets, where data processing will be performed and statistical analysis will be performed with the SPSS version 21 program. Results: The predominant age group was between 41-60 years of age (41.7%), the male sex with 52.8% (19) represented the highest proportion. The majority of patients belong to the province of Guayas (88.9%), especially in urban areas (83.3%). The pleomorphic adenoma represented (50%) half of the cases analyzed, followed in order of frequency by the lymphoepithelial cyst (16.7%) and the mixed tumors with 8.3%. 91.7% required conservative surgery and 36.1% (13) developed postsurgical complications, with facial paralysis being the most frequent with 62%, especially grade II (63%). 22.8% (8) presented postoperative sequelae, facial paralysis (75%) and paresthesia of the hemiface(38%) predominated. The main risk factor associated was the use of drain with 72.2%. The consumption of corticosteroids, radical surgery and the use of drainage increase the risk to develop complications. Conclusion: The superficial parotidectomy of benign tumors of the parotid gland offers greater security due to its lower frequency of complications and sequelae in relation to radical surgery. Keywords: tumor, anatomy, nerve.
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Glándula parótida, Manejo quirúrgico, Parotidectomía, Tumores benignos, Hospital de Especialidades Dr. Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador