The pattern of salivary gland tumours among patients attending orl and maxillofacial services at Muhimbili National Hospital

Abstract

Introduction: Salivary gland neoplasm constitutes about 10% of all head & neck neoplasm which represent 3% of all neoplasm of the body. The diseases contribute to significant morbidity worldwide while its epidemiology in Tanzania remains sparse. There was paucity of information regarding salivary gland tumours in our setting; therefore it was important to conduct this study to describe our experience on salivary gland tumours, associated co-morbidities and treatment outcome in patients attending Muhimbili national hospital. This study was carried out to find the prevalence and the frequency of malignancy among salivary gland neoplasms, their histological types, age and sex distribution of the patient. Objective: The study aimed at determining the pattern of salivary gland tumours among patients attending Otorhinolaryngology and Maxillofacial services at Muhimbili National Hospital. Method: This was a hospital based cross-sectional study that was conducted in the departments of the Otorhinolaryngology and Maxillofacial at Muhimbili national hospital involving all patients with a clinical diagnosis of Salivary gland tumours. Study was carried out on a total number of 276 patients of salivary neoplasms of different age groups. Data was collected by history taking, physical examination and the necessary investigations using a pre-tested coded questionnaire and analyzed using SPSS statistical computer software version 20.0. The study took a period of six months from July to December 2016 with an estimated cost of 1,500,000 TShs. Results Among 276 study participants 156 (56.5%) were males and 120 (43.5%) were females. Their age ranged from 0 to 90 years with mean age of 49.47 years, SD ±15.7. Most of them 69 (28.6 %), were in the age group of above 60 years. Most of them 31 (26.1 %), were in the age group of40-49 and 60+ years. The prevalence obtained was higher among males, 64 (55.1%) salivary gland tumours occurred in men and 52 (44.8%) occurred in women, P=0.76 which is not statistically significant. The parotid gland was the most commonly affected site (75%) and the submandibular and sublingual were the least affected sites (7.5%). Among 116 patients with SGT, 76 (66%) had malignant type and 40 (34%) benign type. Both benign and malignant SGT tumours had male preponderance. The most common benign histology was pleomorphic adenoma which was high in males (28.1%) compared to females(25.0%), and the common malignant histology was mucoepidermoid carcinoma,(23.4%) in males and (28.9%) in females. The tumours affected men more commonly, particularly the 40-49 age group, but these differences were not statistically significant (p= 0.07). Conclusion. Majority of salivary gland tumours in our setting were malignant type and mucoepidermoid carcinoma being the most occuring histological type while Pleomorphic adenoma was the mostly frequent encountered benign type and both had male preponderance mostly seen at the age of 40 years and above. Majority of patients with malignant tumours presented late to the hospital therefore there is a need for advocacy for early health seeking behaviour to the community and early detection of the disease by health personnels in the primary health centers hence prompty referal to otorhinolaryngology specialists for definitive management.