Warthin's tumor surgery

Surgery is the mainstay of treatment for Warthin’s tumor. Recurrence and malignant transformation is very rare. Post surgery complications include facial paralysis, salivary fistula and numbness in the distribution of great auricular nerve.

• Surgery is the mainstay of treatment for Warthin’s tumor. Recurrence is rare, occurring in 6 – 12% of cases. Warthin’s tumor is highly unlikely to become malignant.
• Surgery should be followed by careful observation to watch for changes in the tumor over time.^[1] Frey syndrome has been successfully treated with injections of botulinum toxin A.^[2]

Complications of surgery:

• Frey syndrome:^[3]
  • Frey syndrome is also known as gustatory sweating or auriculotemporal syndrome.
  • Include flushing and sweating over the parotid region during mastication.
  • May occur from 2 weeks to 2 years
  • Result from regeneration of cut parasympathetic fibers between otic ganglion and salivary tissue.
  • Botulinum toxin A by intra cutaneous injections provides successful treatment.

• Bleeding and hematoma
• Numbness in the distribution of great Auricular nerve including ear, face and neck
• Sialocele and salivary fistula occurs in 5% post operative patients.
• Deep lobe and pharyngeal space dissection may result in cramping and spasm in parotid region during swallowing.
• Incidence of facial paralysis is 27-43%

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