Elective parotidectomy in the management of advanced auricular malignancies.
OBJECTIVE
The purpose of this study is to determine whether elective parotidectomy is necessary in patients with clinically and radiographically N0 parotid disease with isolated primary auricular nonmelanoma cutaneous malignancies. Auricular malignancies are typically managed by wedge resection or wide local excision. Although small lesions are easily managed by conservative excision, large bulky tumors, those with multifocal involvement, and recalcitrant lesions, often require more extensive resection including total auriculectomy, parotidectomy, and/or neck dissection.


METHODS
A 10-year retrospective case review from four tertiary university medical centers from 1992 to 2002.


METHODS
Information was retrospectively retrieved using a database of patients from the department of pathology. Seventy-one charts were reviewed. Patients with a clinical history of advanced nonmelanoma auricular carcinoma undergoing elective parotidectomy and/or neck dissection with clinically and radiographically N0 nodal disease were evaluated for the presence of occult parotid metastasis. All patients underwent parotidectomy in conjunction with a total auriculectomy for surgical extirpation of their primary auricular carcinoma. Parotid specimens were evaluated for histopathologic evidence of metastatic neoplastic disease.


RESULTS
Pathological examination showed no histological evidence of occult parotid metastasis in all 19 patients who underwent elective parotidectomy in the presence of clinically and radiographically N0 nodal disease of the parotid or cervical regions.


CONCLUSIONS
Parotidectomy may not be necessary in the surgical management of advanced auricularcarcinoma in the absence of clinically positive parotid disease or external auditory canal involvement.
Osborne
Ryan F
RF
Head and Neck Surgery (Oncology), Osborne Head and Neck Institute, Los Angeles, CA, USA. rfozborne@aol.com
Shaw
Travis
T
Zandifar
Hootan
H
Kraus
Dennis
D
D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000473:pathology / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D004424:Ear Canal / Q000473:pathology; D004428:Ear Neoplasms / Q000473:pathology / Q000601:surgery*; D004431:Ear, External / Q000473:pathology / Q000601:surgery; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D010306:Parotid Gland / Q000473:pathology / Q000601:surgery*; D010307:Parotid Neoplasms / Q000473:pathology / Q000556:secondary / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*