title: Charcoal Suspension Tattoo: A New Technique for Intraoperative Detection of Small Tumors of the Parotid Gland.
abstract: OBJECTIVE
  The current surgical trend in the treatment of pleomorphic adenomas of the parotid gland is to limit the extent of resection. This raises the need to correctly identify the mass within the normal parenchyma so as to avoid dissecting the entire superficial lobe of the gland. We describe ultrasound-guided tattooing as a technique to facilitate identification and excision of parotid pleomorphic adenomas.
  
  
  METHODS
  We reviewed 23 consecutive patients with pleomorphic adenoma of the parotid gland. All patients underwent ultrasound-guided tattooing of the lesions with a charcoal suspension. Baseline tumor and patients' characteristics, major and minor complications, and subjective tolerance to the procedure were recorded. We assessed the number of intralesionally marked masses and the percentage of intraoperatively detected marked lesions.
  
  
  RESULTS
  The injection was well tolerated. No major complications were recorded. In 2 cases (9%), a transient increase in lesion size was observed. No other minor complications were encountered. Charcoal was found inside the tumor in 19 cases (83%). In 4 cases (17%), it was found in the tissues above the lesion. Twenty-three lesions were intraoperatively detected (100%) and dissected.
  
  
  CONCLUSIONS
  Charcoal suspension tattooing is safe and well tolerated for the detection of small pleomorphic adenomas during parotid surgery.
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, University of Trieste, Trieste, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Tirelli
authors.affiliation: Department of Radiology, University of Trieste, Trieste, Italy.
authors.forename: Maria Assunta
authors.initials: MA
authors.lastname: Cova
authors.affiliation: Department of Neurosciences, University of Padova, Treviso, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Boscolo-Rizzo
authors.affiliation: Department of Neurosciences, University of Padova, Treviso, Italy.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Da Mosto
authors.affiliation: Department of Radiology, University of Trieste, Trieste, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Makuc
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, University of Trieste, Trieste, Italy nicolettagardenal@gmail.com.
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Gardenal
mesh_terms: D008949:Adenoma, Pleomorphic / Q000000981:diagnostic imaging / Q000601:surgery*; D000368:Aged; D002606:Charcoal; D015331:Cohort Studies; D004396:Coloring Agents; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010307:Parotid Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted; D013535:Suspensions; D013653:Tattooing / Q000379:methods*; D014463:Ultrasonography
chemical_list: D004396:Coloring Agents; D013535:Suspensions; D002606:Charcoal
keywords: adenoma; charcoal; parotid gland; pleomorphic; salivary gland neoplasms