0521779407-10 CUNY1086/Karliner 0 521 77940 7 June 6, 2007 17:44
Jaw Swelling and Masses 881Neoplastic Masses
■All parotid masses should be excised, the exception being known
Warthin’s tumors and known lymphoepithelial cysts (which can be
sclerosed).
Submandibular tumors should be removed.
Lymphomas are treated non-surgically, usually with chemothera-
peutic regimens when appropriate.
■Squamous cell carcinomas are treated primarily with surgery and/or
radiation therapy with chemotherapy sometimes included, espe-
cially in neoadjuvant combination with radiation therapy.
■Nasopharyngeal carcinoma is treated with neoadjuvant chemother-
apy and radiation therapy, with surgery being reserved when salvage
is necessary or when residual disease remains after chemo/radiation
intervention.
Infectious Masses
■Stones are treated with antibiotics, sialogogues, hydration, and occa-
sionally with surgical removal of the stone itself or of the gland itself.
Bacterial adenitis is treated with broad-spectrum antibiotics,
which cover anaerobes and aerobes; penicillin derivatives are often
preferred. However, abscesses from adenitis are treated with surgical
incision and drainage.
Cat-Scratch can be treated with ciprofloxacin.
Actinomycosis can be treated with 6 weeks of IV penicillin.
Atypical Mycobacterial infection can be treated with macrolides,
quinolones, or surgical excision or surgical debridement.
TB is treated with various triple antibiotic regimens.
Dental infections are treated with antibiotics, often in combination
with dental surgery, such as root canal procedures or tooth extraction.follow-up
n/acomplications and prognosis
Complications
■Surgical excision can result in cranial nerve injury and subsequent
deficit.
Medical therapy with antibiotics can result in a myriad of problems
related to the specific drug selected for treatment.
■Complications of FNA are minimal, especially with regard to seeding
tumor in the needle tract.