Salivary Gland Disorders: Diagnosis, Prognosis, and Treatment

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (28 February 2023) | Viewed by 10767

Special Issue Editors


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Guest Editor
Department of Otolaryngology, E-Da Cancer Hospital, Kaohsiung 824, Taiwan
Interests: intraoperative neuromonitoring (IONM); salivary gland surgery; thyroid surgery

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Co-Guest Editor
Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul 04763, Korea
Interests: thyroid/parathyroid surgery, especially robotic and endoscopic thyroid surgery; head and neck oncology

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Co-Guest Editor
Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Kosin University, Busan 49267, Korea
Interests: thyroid surgery

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Co-Guest Editor
Department of Otolaryngology, National Taiwan University Hospital, Taipei 100, Taiwan
Interests: tumors; cancer; pathology; diagnosis; biopsy; cancer biology; cancer biomarkers

Special Issue Information

Dear Colleagues, 

New advances in the diagnosis, treatment and prognosis of salivary gland disorders have gradually gained attention in recent years. In this special issue, we welcome the up-to-date technologies in the managements of salivary gland disorders, as well as research topics including:

  • Diagnosis of salivary gland disorders: ultrasonography, imaging, and cytological diagnosis.
  • Salivary gland surgery and facial nerve intraoperative neuromonitoring. Electrophysiological change and injury mechanisms of facial nerves in patients after salivary gland surgery.
  • Facial nerve function and facial expression before and after salivary gland surgery. Standardized facial grading system for surgical outcome assessments.
  • Minimal invasive salivary gland treatment: ultrasound-guided procedures, endoscopic or robotic salivary gland surgery.
  • Sialadenitis and sialolithiasis: autoimmune salivary gland disease under sonography, radioactive iodine sialadenitis after thyroid cancer therapy, sialendoscopic interventions etc.
  • Latest advancements in tissue regeneration, artificial intelligence, machine learning, programming electrical stimulation, transcutaneous electrical stimulation

Prof. Dr. Feng-Yu Chiang
Prof. Dr. Kyung Tae
Prof. Dr. Kang Dae Lee
Prof. Dr. Tsung-Lin Yang
Guest Editors

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Keywords

  • salivary gland tumor
  • salivary gland surgery
  • parotidectomy
  • facial nerve and neuromonitoring
  • facial expression
  • salivary gland ultrasonography
  • ultrasound-guided procedures
  • salivary gland robotic surgery
  • salivary gland regeneration
  • sialadenitis and sialolithiasis

Published Papers (5 papers)

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Research

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13 pages, 3921 KiB  
Article
Assessment of Parotid Gland Tumors by Means of Quantitative Multiparametric Ultrasound (mpUS)
by Katharina Margherita Wakonig, Markus Herbert Lerchbaumer, Steffen Dommerich, Heidi Olze, Bernd Hamm, Thomas Fischer and Philipp Arens
Diagnostics 2023, 13(1), 12; https://doi.org/10.3390/diagnostics13010012 - 21 Dec 2022
Cited by 2 | Viewed by 2768
Abstract
Objective: The preoperative diagnostical differentiation of parotid gland tumor (PGT) is not always simple due to several different entities. B-mode-ultrasound (US) remains the imaging modality of choice, while histopathology serves as the gold standard for finalizing the diagnosis. We aimed to evaluate the [...] Read more.
Objective: The preoperative diagnostical differentiation of parotid gland tumor (PGT) is not always simple due to several different entities. B-mode-ultrasound (US) remains the imaging modality of choice, while histopathology serves as the gold standard for finalizing the diagnosis. We aimed to evaluate the use of multiparametric US (mpUS) in the assessment of PGT. Methods: We included 97 PGTs from 96 patients. A standardized mpUS protocol using B-mode-US, shear-wave elastography (SWE), and standardized contrast-enhanced ultrasound (CEUS) was performed prior to surgical intervention. SWE was assessed by real-time measurement conducting a minimum of five measurements, while quantitative CEUS parameters were assessed with a post-processing perfusion software. Results: SWE allowed differentiation between benign PGT (Warthin’s Tumor (WT) paired with lymph nodes (LN) and pleomorphic adenoma (PA)), and WT and LN were softer compared to PA. WT showed lower velocities than squamous cell carcinoma (SCC): the most common malignant PGT. CEUS parameters showed significant group differences between WT and PA, WT and malignant lesions, WT and SCC, WT paired with LN versus PA, and WT paired with LN versus SCC. Conclusion: MpUS seems to be beneficial in the assessment of PGT characterization, with benign PGT appearing to be softer in SWE than tumors with malignant tendencies. The quantitative CEUS parameter shows higher perfusion in WT than in PA, and malignant PGTs are less vascularized than WTs. Full article
(This article belongs to the Special Issue Salivary Gland Disorders: Diagnosis, Prognosis, and Treatment)
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12 pages, 1285 KiB  
Article
Comparisons among the Ultrasonography Prediction Model, Real-Time and Shear Wave Elastography in the Evaluation of Major Salivary Gland Tumors
by Ping-Chia Cheng, Wu-Chia Lo, Chih-Ming Chang, Ming-Hsun Wen, Po-Wen Cheng and Li-Jen Liao
Diagnostics 2022, 12(10), 2488; https://doi.org/10.3390/diagnostics12102488 - 14 Oct 2022
Cited by 1 | Viewed by 1376
Abstract
We aimed to validate the diagnostic accuracy of a novel sonographic scoring model and compare it with other methods in the evaluation of malignant major salivary gland tumors. We enrolled 138 patients who received neck ultrasound (US) with fine needle aspiration (FNA) and [...] Read more.
We aimed to validate the diagnostic accuracy of a novel sonographic scoring model and compare it with other methods in the evaluation of malignant major salivary gland tumors. We enrolled 138 patients who received neck ultrasound (US) with fine needle aspiration (FNA) and further operations or core needle biopsies for major salivary gland tumors from June 2015 to October 2021. The sonographic scoring model was presented as 2.08 × (vague boundary) + 1.75 × (regional lymphadenopathy) + 1.18 × (irregular or speculated shape) + 1.45 × (absence of posterior acoustic enhancement) + 2.4 × (calcification). We compared the diagnostic accuracy of the sonographic scoring model with shear wave elastography (SWE), real-time elastography (RTE), and US-FNA cytology for differentiating between benign and malignant lesions. The sensitivity, specificity, and accuracy were 58%, 89%, and 85% for the sonographic scoring model, 74%, 62%, and 64% for the SD of SWE with optimal cutoff value of 31.5 kPa, 69%, 70%, and 70% for the 4-point scoring system of RTE, and 74%, 93%, and 91% for US-FNA cytology, respectively. The sonographic scoring model is feasible as assistance in the evaluation of major salivary gland tumors. US-FNA cytology remains the tool of choice in diagnosing malignant salivary gland tumors. Full article
(This article belongs to the Special Issue Salivary Gland Disorders: Diagnosis, Prognosis, and Treatment)
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15 pages, 1484 KiB  
Article
Salivary Gland Toxicity of PSMA-Targeted Radioligand Therapy with 177Lu-PSMA and Combined 225Ac- and 177Lu-Labeled PSMA Ligands (TANDEM-PRLT) in Advanced Prostate Cancer: A Single-Center Systematic Investigation
by Thomas Langbein, Harshad R. Kulkarni, Christiane Schuchardt, Dirk Mueller, Gerd Fabian Volk and Richard P. Baum
Diagnostics 2022, 12(8), 1926; https://doi.org/10.3390/diagnostics12081926 - 10 Aug 2022
Cited by 16 | Viewed by 2326
Abstract
Purpose: PSMA-targeted radioligand therapy (PRLT) is a promising treatment option for patients with metastatic castration-resistant prostate cancer (mCRPC). However, a high uptake of the radiopharmaceutical in the salivary glands (SG) can lead to xerostomia and becomes dose-limiting for 225Ac-PSMA-617. This study investigated [...] Read more.
Purpose: PSMA-targeted radioligand therapy (PRLT) is a promising treatment option for patients with metastatic castration-resistant prostate cancer (mCRPC). However, a high uptake of the radiopharmaceutical in the salivary glands (SG) can lead to xerostomia and becomes dose-limiting for 225Ac-PSMA-617. This study investigated the sialotoxicity of 177Lu-PSMA-I&T/-617 monotherapy and co-administered 225Ac-PSMA-617 and 177Lu-PSMA-617 (Tandem-PPRLT). Methods: Three patient cohorts, that had undergone 177Lu-PSMA-I&T/-617 monotherapy or Tandem-PRLT, were retrospectively analyzed. In a short-term cohort (91 patients), a xerostomia assessment (CTCAE v.5.0), a standardized questionnaire (sXI), salivary gland scintigraphy (SGS), and SG SUVmax and the metabolic volume (MV) on 68Ga-PSMA-11-PET/CT were obtained before and after two cycles of 177Lu-PSMA-I&T/-617. In a long-term cohort, 40 patients were similarly examined. In a Tandem cohort, the same protocol was applied to 18 patients after one cycle of Tandem-PRLT. Results: Grade 1 xerostomia in the short-term follow-up was observed in 22 (24.2%) patients with a worsening of sXI from 7 to 8 at (p < 0.05). In the long-term cohort, xerostomia grades 1 to 2 occurred in 16 (40%) patients. SGS showed no significant changes, but there was a decline of the MV of all SGs. After Tandem-PRLT, 12/18 (66.7%) patients reported xerostomia grades 1 to 2, and the sXI significantly worsened from 9.5 to 14.0 (p = 0.005), with a significant reduction in the excretion fraction (EF) and MV of all SGs. Conclusion: 177Lu-PSMA-I&T/-617 causes only minor SG toxicity, while one cycle of Tandem-PRLT results in a significant SG impairment. This standardized protocol may help to objectify and quantify SG dysfunction. Full article
(This article belongs to the Special Issue Salivary Gland Disorders: Diagnosis, Prognosis, and Treatment)
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Review

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10 pages, 4869 KiB  
Review
Proposals for Standardization of Intraoperative Facial Nerve Monitoring during Parotid Surgery
by Feng-Yu Chiang, Ching-Feng Lien, Chih-Chun Wang, Chien-Chung Wang, Tzer-Zen Hwang, Yu-Chen Shih, Hsin-Yi Tseng, Che-Wei Wu, Yaw-Chang Huang and Tzu-Yen Huang
Diagnostics 2022, 12(10), 2387; https://doi.org/10.3390/diagnostics12102387 - 30 Sep 2022
Cited by 3 | Viewed by 2152
Abstract
Intraoperative facial nerve monitoring (FNM) has been widely accepted as an adjunct during parotid surgery to facilitate identification of the facial nerve (FN) main trunk, dissection of FN branches, confirmation of FN function integrity, detection of FN injury and prognostication of facial expression [...] Read more.
Intraoperative facial nerve monitoring (FNM) has been widely accepted as an adjunct during parotid surgery to facilitate identification of the facial nerve (FN) main trunk, dissection of FN branches, confirmation of FN function integrity, detection of FN injury and prognostication of facial expression after tumor resection. Although the use of FNM in parotidectomy is increasing, little uniformity exists in its application from the literature. Thus, not only are the results of many studies difficult to compare but the value of FNM technology is also limited. The article reviews the current literature and proposes our standardized FNM procedures during parotid surgery, such as standards in FNM setup, standards in general anesthesia, standards in FNM procedures and application of stimulus currents, interpretation of electrophysiologic signals and prediction of the facial expression outcome and pre-/post-operative assessment of facial expressions. We hope that the FNM standardized procedures will provide greater uniformity, improve the quality of applications and contribute to future research. Full article
(This article belongs to the Special Issue Salivary Gland Disorders: Diagnosis, Prognosis, and Treatment)
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Other

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10 pages, 2628 KiB  
Case Report
Solitary Extrapleural Fibrous Tumor in Salivary Glands: Our Experience—Case Series and Literature Review
by Ciro Emiliano Boschetti, Rita Vitagliano, Gianmaria Imola, Nicola Cornacchini, Maria Luisa Colella, Gianpaolo Tartaro and Giuseppe Colella
Diagnostics 2022, 12(11), 2688; https://doi.org/10.3390/diagnostics12112688 - 04 Nov 2022
Cited by 2 | Viewed by 1313
Abstract
(1) Background: Extrapleural solitary fibrous tumors (ESFTs) are rare oncological entities occurring in the head and neck, and even more so in the salivary glands. The clinical presentation and histologic features are usually unspecific, resulting in frequent misclassification. As an unusual tumor, ESTFs [...] Read more.
(1) Background: Extrapleural solitary fibrous tumors (ESFTs) are rare oncological entities occurring in the head and neck, and even more so in the salivary glands. The clinical presentation and histologic features are usually unspecific, resulting in frequent misclassification. As an unusual tumor, ESTFs have an unpredictable clinical behavior. (2) Methods: We present two clinical cases referred to our Maxillofacial Surgery Unit for the onset of a symptomless mass involving, in one case, the parotid gland, and in the other case, the sublingual gland. (3) Results: Solitary fibrous tumors could be considered as neoplasms with intermediate biological behavior that are not entirely predictable on the basis of morphological features, as these are mostly still unknown. However, a few histologic, immunohistochemical, and imaging features, such as a hypodense signal at the T1 sequence in an MRI, or positivity for CD34, bcl2, and CD99, and the NAB2-STATS6 fusion gene, could be useful for an early differential diagnosis of ESTFs. (4) Conclusions: All patients were alive at follow-up with no evidence of disease. Surgical management should always be considered as the first choice for oncological radicality, and clinical behavior should always be defined with the help of the study of radiological and anatomopathological features. Full article
(This article belongs to the Special Issue Salivary Gland Disorders: Diagnosis, Prognosis, and Treatment)
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