Evaluation of benign tumors of large salivary glands according to the new classification of the European Salivary Gland Society

Abstract

Introduction: Tumors of large salivary glands constitute about 2-3% of all head and neck tumors. Their incidence is statistically greater in males than in females, with the first symptoms usually appearing between the 4th and 7th decade of life. Material and methods: The aim of the study was to assess the usefulness of the new classification proposed by ESGS in comparison with the divisions of procedures previously valid in the literature, making a retrospective analysis of patients operated due to benign tumors of large salivary glands in the Department of Otolaryngology, Head and Neck Oncology of the Medical University of Lodz in 2012-2020. The retrospective examination was based on the material consisting of: surgical protocols, histopathological results, imaging results and clinical observations. Results: The material includes 283 patients (141 women and 142 men): 249 patients with parotid gland tumor and 34 patients with submandibular gland tumor. The most common histopathological diagnosis was pleomorphic adenoma, which was found in 105 patients (42.17%) and adenolymphoma diagnosed in 94 patients (37.75%). The most common type of surgery was superficial parotidectomy including total superficial parotidectomy in 86 patients (34.54%) and partial superficial parotidectomy in 49 cases (19.68%). Then, according to the frequency of surgery, extracapsular tumor dissection (ECD) was performed (91 patients - 36.55%). According to the ESGS classification, in most cases parotidectomy I, II (37.34% of all parotidectomies) and parotidectomy II (28.49%) were performed. In case of ECD, all tumors were located at level II. Conclusions: In summary, the new classification is aimed at unifying, but also simplifying the current nomenclature, reducing the existing nomenclature errors. By determining the exact location and extent of the tumor within the parotid gland, it facilitates postoperative monitoring of patients by ENT doctors and those of other specialties. Key words: ESGS classification, parotid gland, parotidectomy, extracapsular tumor dissection