Intraparotid Aneurysm of the Posterior Communicating Vein

Coscarón Blanco, Enrique; Suárez Ortega, María Soledad; Martín Garrido, Eva Purificación

doi:10.1016/j.otoeng.2012.03.001

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It changed size according to head position, had an elastic consistency, was painless and without infiltration or fistulisation to a cutaneous plane. Its evolution was unknown (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). It presented symptoms of sialolithiasis. Facial examination was normal. The MRI study reported a “well-defined nodular lesion, consistent with pleomorphic adenoma or Warthin's tumour”, with intralesional calcifications (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). The ultrasound and Doppler studies noted a “homogeneous, central, cystic image 37×17mm in size, although not entirely anechoic. Moderate pulse transmitted from normal vessels”. The hypoechoic image was attributed to sialolithiasis although cystic tumour was not ruled out. We performed extrafacial parotidectomy with a Harmonic Ultracision scalpel, observing a venous vascular tumour dependent on the posterior facial vein or temporomaxillary vein, medial and deep to the mandibular and middle branches of the facial nerve. It elongated and displaced them, but was not adhered to them and did not infiltrate them (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). The tumoural nerve was dissected and removed as a single block, together with the deep sialolithiasis lobe. Previously, the ends of the vein of origin were ligated and the aneurysm was emptied, in order to prevent haemorrhage or facial nerve lesion during haemostasis.<elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia>In light of the cystic tumour diagnosis, and especially in the absence of a solid component, we reconsidered the radiological diagnosis of Warthin's tumour and suspected arterial aneurysm (pulsating or not) or venous aneurysm. Vessel dissection was an option, but given the fragility of its walls, we opted for resection as a single block with the adjacent, glandular, sialolithiasis tissue, in order to prevent sialoceles or lithiasis, and also to avoid haemorrhage or lesions to the facial nerve." "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Coscarón Blanco E, et al. Aneurisma intraparotídeo de vena comunicante posterior. 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ISSN: 2173-5735

Acta Otorrinolaringológica Española, the official publication of the Spanish Society of Otolaryngology and Head and Neck Surgery and the Ibero-American Society of Otorhinolaryngology, is the most important journal in Spanish dedicated to Otorhinolaryngology, which reflects the continuous scientific and technical progress of the specialty. It has become an important tool to be kept up to date. The Journal publishes Original Articles (articles on basic research and clinical investigation), reviews, brief communications, case studies and images, which are subjected to a rigorous peer review process.

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Vol. 63. Issue 2.