RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

BANGALORE, KARNATAKA

ANNEXURE - II

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

1. / NAME OF THE CANDIDATE AND ADDRESS / Dr. PRAVEEN KAMATAGI
POST GRADUATE STUDENT
DEPARTMENT OF GENERAL SURGERY
KIMS, HUBLI.
2. / NAME OF THE INSTITUTION / KARNATAKA INSTITUTE OF MEDICAL SCIENCES
HUBLI. 580022.
3. / COURSE OF THE STUDY AND SUBJECT / GENERAL SURGERY MS
4. / DATE OF ADMISSION TO THE
COURSE / 01 AUGUST 2013
5. / TITLE OF THE TOPIC / “THE CLINICOPATHOLOGICAL STUDY OF SALIVARY GLAND TUMOURS AND ITS MANAGEMENT”
6. / BRIEF RESUME OF INTENDED STUDY.
6.1 NEED FOR STUDY:
The major salivary glands include the parotid glands, the submandibular glands, and the sublingual glands. There are also approximately 750 minor salivary glands scattered throughout the submucosa of the oral cavity, oropharynx, hypopharynx, larynx, parapharyngeal space, and nasopharynx. Salivary gland neoplasms are rare and constitute 3% to 4% of head and neck neoplasms. The majority of neoplasms arise in the parotid gland (70%), whereas tumours of t ; Minor salivary glands: 25% benign and 75% malignant.(1)
The present study aims to determine the distribution, management and prognosis of various types of Salivary Gland Tumours.
6.2 REVIEW OF LITERATURE:
1. Salivary gland tumours; a study done by Dr. Dhananjay sharma concluded that salivary gland tumours though less common, are encountered in our country. Problems in their management are largely related to the facial nerve. A proper consent should thus be taken from the patient before embarking on surgery for these tomours and should be managed preferably at centers where expertise to handle complications resulting from surgery can be tackled in a proper and judicious way.
2.  Salivary gland tumours – our experience; a study done by Nitin M, Sandeep Bansal concluded that in the present series of 36 patients, twenty four patients had parotid lesions while 12 had involvement of other salivary glands. There was no sex preponderance(19 males and 17 females) and no specific age group affliction, though 14/36 patients were in their third and fourth decades. At the time of the diagnosis, the age range was from 3 year to 95 year with a mean age of 49.5 years
3.  Role of fine needle aspiration cytology in salivary gland pathology and its histopathological correlation; A two year prospective study in western india. A study done by Amit h Agarwal, gauravi A dhruva concluded that fnac offers valuable information which is not obtained by any other means. Fnac of the salivary gland tumours is advantageous for both the patients and clinicians because of its immediate results, accuracy, economy, lack of complications.
4.  In this study, we analysed the full histological spectrum of oral salivary gland carcinomas in a consecutive data base retrieved from 3 institutions. The study confirmed MEC,ACC,and PLGA as the most common types of oral salivary gland tumours. Kaplan Meier analyses revealed comparable prognosis for these 3 major entities with no significant difference in outcome.
5.  Parotid gland tumours; study done by Khalid ahsan malik.results;a total of 27 patients 15 males and 12 females,with ages ranging from 15 to 65 were included in study. Most of the patients were in the 31-50 years of age group. Pleomorphic adenoma was the commonest benign tumour with an incidence of 66.6%, while mucoepidermoid carcinoma with an incidence of 11.11% was the most common malignant tumour. They concluded that parotid gland is the principal site of salivary gland tomours.
6.  A review of parotid tumours and their management;a study done by s shashinder. They concluded that the current study is small and covering ten year duration. It shows a higher proportion of malignant cases as compared to other studies. Fnac and ct scan were performed prior to the surgery were useful guidance in planning the definite operation but clinical judgment was considered more important. The incidence of complications and tumour recurrence are comparable to other international studies but the data may well be affected by the limitations of patient follow-up. Prior knowledge of anatomy and careful planning is needed to decrease the incidence of facial nerve palsy.
7.  Tumors of the salivary gland are relatively uncommon and represent less than 2% of all head and neck tumors. 85% of salivary gland tumors arise within the parotid gland. The majority of these tumors are benign,with the most common histology being pleomorphic adenoma. In contrast,approximately 50% of tumors arising in the submandibular and sublingual glands are malignant. Tumors arising from minor salivary gland tissue carry an even higher risk for malignancy 75%.
8.  Salivary gland tumors are rare and constitute 3% to 4% ofhead and neck tumors,most tumors arise in the parotid gland 70%,where as tumors of submandibular gland 22%,sublingual and minor salivary glands 8% are less common.
9.  The histology has prognostic implications and provides information for treatment optimization.acinic cell carcinoma and grade 1&2 mucoepidermoid tumors are considered to be low grade malignancies while grade 3 mucoepidermoid tumor and other tumors are considered to be high grade malignancies.
10.  Prognostic factors in malignancy of the minor salivary glands. Study done by Kwok sengloh.They concluded that the 5 and 10 year overall and DSS of minor salivary gland malignancies are good.recorrences are usually local and distant. Our data shows that surgery is the main treatment modality either alone or in combination.high grade tomors are associated with worse DSS.
6.3 Objectives of Study
1.  To Study the Distribution of Salivary Gland tumour in Male and Female Population.
2.  To Study the distribution of Benign and Malignant Salivary Gland tumours.
3.  To Study the different Treatment Modalities/ Management in Salivary Gland Tumours.
4.  To Study the Prognosis of patients after the Surgery.
7. / MATERIALS AND METHODS:
7.1 Source of Data:It includes all the patients admitted to KIMS in the Dept. of General Surgery diagnosed with Salivary Gland Tumours.
7.2 Method of Collection of Data:
Sample Size: Patients with salivary gland tumours admitted during study period
Duration of Study: 1 1/2 Years (December2013-may2015)
Sampling Design: Observational Study
Significance Test: Chi Square Test
INCLUSION CRITERIA:
AllPatients Diagnosed with Salivary Gland Tumours.
EXCLUSION CRITERIA:
Late Stage and inoperable Salivary Gland Tumours.
Follow up of Patients & How Long: 3 months after the Surgery.
7.3 Does the study require any investigations or interventions to be conducted on patients or other humans or animals? If so, please describe briefly.
Before Surgery: CBC, Urine Routine and Microscopy, FNAC, Ultrasound, CT Scan(If needed), MRI Scan (If Needed).
After Surgery:Histopathology
7.4 Has ethical clearance been obtained from your institution in case of 7.3.
Yes.
8. / LIST OF REFERENCES
1.  Dr. S. Dhanajay ; Salivary Gland Tumours; Smt. Radha Devi Memorial Oration delived on 29th December, 99 at Madurai during ASICON
2.  M Nitin,Nagarkar, B Sandeep, D Arjun; Salivary Gland Tumours – Our Experience; Indian Journal of Otolaryngology and Head and Neck Surgery Vol, 56 No.1,
3.  Agravat AH, Dhruva GA, Pujar KM, Sanghvi HK. Role of Fine Needle Aspiration Cytology in Salivary Gland Pathology and its Histopathological Correlation; A Two Year Prospective Study in Western India
4.  S Stephan, M Maximilan, E Tobias, S Philip. Morphological heterogeneity of oral salivary gland carcinomas; A clinicopathologic study of 41 cases with long term follow-up emphasizing the overlapping spectrum of adenoid cystic carcinoma and polymorphous low grade adenocarcinoma. Int J Clin Exp Pathol 2011;4(4);336-348
5.  M A Khalid; Parotid Gland Tumors a six year experience. Pakistan journal of surgery, volume 23, Issue 2, 2007.
6.  S. Shashindhar, I P Tang, P Velayutham: A review of parotid tumors and their management; a 10 year experience. Med J Malaysia Vol 64 No 1 March 2009
7.  Sabiston, 19th edition volume 1, parotid gland tumors, page 811.
8.  Schwartz 9th edition, parotid gland tumors page 507.
9.  Kirby, bland,markus w, buchler,principles and international practice of surgery, second edition, parotid gland tumors page 395.
10.  S Kwok,B Emma, B Guillem,prognostic factors in malignancy of the minor salivary glands. HEAD & NECK – DOI 10. 1002/hed
9 / SIGNATURE OF THE CANDIDATE
10 / REMARKS OF THE GUIDE / The study is done to know the Different types of tumours arising from different Salivary Glands & Different types of Treatment.
11 / NAME & DESIGNATION.
11.1 GUIDE / DR. VIJAY. V. KAMATH MS.
ASSOCIATE PROFESSOR
DEPT. OF GENERAL SURGERY
KIMS, HUBLI.
11.2 SIGNATURE
11.3 HEAD OFTHE
DEPARTMENT / DR. B. S. MADAKATTI MS.
PROF. & HEAD,
DEPT. OF GENERAL SURGERY
KARNATAKA INSTITUTE OF MEDICAL SCIENCES, HUBLI- 580022.
11.4  SIGNATURE
12 / 12.1 REMARKS OF CHAIRMAN
AND PRINCIPAL
12.2 SIGNATURE