Sequential alterations of Stensen's duct and parotid gland after radical surgeries in buccal cancer

Shih-Lung Chen; Shy-Chyi Chin; Chi-Kuang Young; Huei-Tzu Chien; Chun-Ta Liao; Chung-Kang Tsao; Chung-Jan Kang; Shiang-Fu Huang

doi:10.1016/j.oraloncology.2019.06.028

Sequential alterations of Stensen's duct and parotid gland after radical surgeries in buccal cancer

Oral Oncol. 2019 Sep:96:15-20. doi: 10.1016/j.oraloncology.2019.06.028. Epub 2019 Jul 3.

Authors

Shih-Lung Chen¹, Shy-Chyi Chin², Chi-Kuang Young³, Huei-Tzu Chien⁴, Chun-Ta Liao¹, Chung-Kang Tsao⁵, Chung-Jan Kang¹, Shiang-Fu Huang⁶

Affiliations

¹ Department of Otolaryngology & Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan.
² School of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou, Taiwan.
³ School of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Otolaryngology, Chang Gung Memorial Hospital, Keelung, Taiwan.
⁴ Department of Public Health, Chang Gung University, Taoyuan, Taiwan; Department of Nutrition and Health Sciences, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
⁵ School of Medicine, Chang Gung University, Taoyuan, Taiwan; Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan.
⁶ Department of Otolaryngology & Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan; Department of Public Health, Chang Gung University, Taoyuan, Taiwan. Electronic address: shiangfu.huang@gmail.com.

PMID: 31422207
DOI: 10.1016/j.oraloncology.2019.06.028

Abstract

Objectives: The marsupialization of Stensen's duct after buccal cancer excision and free flap reconstruction has seldom been reported. In this study, we evaluated the alteration in Stensen's duct and parotid gland, without marsupialization or relocation, between the time of surgery and 24 months postoperatively to determine whether ductal management is needed in patients with buccal squamous cell carcinoma (BSCC).

Methods: Eighty-five patients with BSCC receiving primary radical surgery and free flap reconstruction were recruited. Alterations in Stensen's duct and parotid gland were assessed by computed tomography during the postoperative period.

Results: The 81 males and 4 females enrolled in study had a tumor status of cT2 (n = 52, 61%) or cT3 (n = 33, 39%). In total, 52 (61%) patients received surgery alone, and 33 (39%) received adjuvant concurrent chemoradiotherapy (CCRT) postoperatively. Stensen's duct on the affected side was significantly dilated compared to the non-affected side (p < 0.001). The difference in diameter of Stensen's duct between the surgery plus CCRT group and the surgery alone group was not significant (p > 0.05), indicating that changes in parotid gland occurred mainly due to surgery. In both the surgery and surgery plus CCRT groups, inflammation of parotid gland had regressed by 24 months.

Conclusions: Stensen's duct in BSCC dilatation peaked in the 3rd month after surgery. Changes in parotid gland on the surgically treated side regressed into fatty change by 24 months after surgery.

Keywords: Buccal cancer; Parotid gland; Radical excision; Sialocele; Stensen’s duct.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Female
Humans
Male
Middle Aged
Mouth Neoplasms / complications*
Mouth Neoplasms / pathology
Parotid Gland / pathology*
Retrospective Studies
Salivary Ducts / pathology*