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European Archives of Oto-Rhino-Laryngology

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04.08.2020 | Review Article

Review of surgical techniques and guide for decision making in the treatment of benign parotid tumors

verfasst von: Georgios Psychogios, Christopher Bohr, Jannis Constantinidis, Martin Canis, Vincent Vander Poorten, Jan Plzak, Andreas Knopf, Christian Betz, Orlando Guntinas-Lichius, Johannes Zenk

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 1/2021

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Abstract

Purpose

Surgical treatment of benign parotid tumors has developed in the direction of less invasive procedures in recent years and has raised great debate about the best surgical approach. Aim of this article is to analyse anatomical and other factors that are important in selection of the appropriate surgical technique in treatment of benign parotid tumors. Furthermore, to discuss the risk of complications and recurrent disease according to selected operation. Finally, to define patient selection criteria to facilitate decision making in parotid surgery and become a guide for younger surgeons.

Methods

Literature review and authors’ personal opinions based on their surgical experience.

Results

All possible surgical techniques for benign parotid surgery with advantages and disadvantages are being described. An algorithm with anatomical and other criteria influencing decision making in benign parotid surgery is presented.

Conclusion

Surgeons nowadays have many options to choose from for benign parotid surgery. ECD is one of the many surgical techniques available in parotid surgery and can achieve excellent results with proper training and if used for proper indications. PSP is mainly indicated in large tumors of the caudal part of the PG (ESGS level II). SP represents a universal solution in parotid surgery and should be the first technique young surgeons learn. TP has only few but important indications in benign parotid surgery. Surgeons need to carefully consider the patient and his/her preoperative imaging as well as her or his own special expertise to select the most appropriate surgical technique.

McGurk M, Thomas BL, Renehan AG (2003) Extracapsular dissection for clinically benign parotid lumps: reduced morbidity without oncological compromise. Br J Cancer 89(9):1610–1613PubMedPubMedCentral

O’Brien CJ (2003) Current management of benign parotid tumors—the role of limited superficial parotidectomy. Head Neck 25(11):946–952PubMed

Roh JL, Kim HS, Park CI (2007) Randomized clinical trial comparing partial parotidectomy versus superficial or total parotidectomy. Br J Surg 94(9):1081–1087PubMed

Tweedie DJ, Jacob A (2009) Surgery of the parotid gland: evolution of techniques, nomenclature and a revised classification system. Clin Otolaryngol 34(4):303–308PubMed

Iro H, Zenk J (2014) Role of extracapsular dissection in surgical management of benign parotid tumors. JAMA Otolaryngol Head Neck Surg 140(8):768–769PubMed

Dell’Aversana Orabona G, Bonavolonta P, Iaconetta G, Forte R, Califano L (2013) Surgical management of benign tumors of the parotid gland: extracapsular dissection versus superficial parotidectomy—our experience in 232 cases. J Oral Maxillofac Surg 71(2):410–413PubMed

Ruohoalho J, Makitie AA, Aro K et al (2017) Complications after surgery for benign parotid gland neoplasms: a prospective cohort study. Head Neck 39(1):170–176PubMed

Klintworth N, Zenk J, Koch M, Iro H (2010) Postoperative complications after extracapsular dissection of benign parotid lesions with particular reference to facial nerve function. Laryngoscope 120(3):484–490PubMed

Mantsopoulos K, Koch M, Klintworth N, Zenk J, Iro H (2015) Evolution and changing trends in surgery for benign parotid tumors. Laryngoscope 125(1):122–127PubMed

10.

Forner D, Lee DJ, Walsh C, Witterick IJ, Taylor SM, Freeman J (2020) Outpatient versus inpatient parotidectomy: a systematic review and meta-analysis. Otolaryngol Head Neck Surg 162(6):818–825PubMed

11.

Grosheva M, Shabli S, Volk GF et al (2017) Sensation loss after superficial parotidectomy: a prospective controlled multicenter trial. Head Neck 39(3):520–526PubMed

12.

Jin H, Kim BY, Kim H et al (2019) Incidence of postoperative facial weakness in parotid tumor surgery: a tumor subsite analysis of 794 parotidectomies. BMC Surg 19(1):199PubMedPubMedCentral

13.

Send T, Bertlich M, Eichhorn KW, Bootz F, Jakob M (2019) Management and follow-up results of salivary fistulas treated with botulinum toxin. Laryngoscope 129(2):403–408PubMed

14.

Britt CJ, Stein AP, Gessert T, Pflum Z, Saha S, Hartig GK (2017) Factors influencing sialocele or salivary fistula formation postparotidectomy. Head Neck 39(2):387–391PubMed

15.

Chudek DA, Wilkie MD, Hampton T, Siau R, Panarese A (2020) The effect of fibrin sealant tissue glue in reducing post-operative collections following parotidectomy. Eur Arch Otorhinolaryngol. 277(7):2055–2059PubMed

16.

Zbaren P, Vander Poorten V, Witt RL et al (2013) Pleomorphic adenoma of the parotid: formal parotidectomy or limited surgery? Am J Surg 205(1):109–118PubMed

17.

Johnson JT, Ferlito A, Fagan JJ, Bradley PJ, Rinaldo A (2007) Role of limited parotidectomy in management of pleomorphic adenoma. J Laryngol Otol 121(12):1126–1128PubMed

18.

Park SJ, Han S, Lee HJ, Ahn SH, Jeong WJ (2018) Preservation of salivary function following extracapsular dissection for tumors of the parotid gland. J Oral Maxillofac Surg 76(9):2004–2010PubMed

19.

Mantsopoulos K, Mueller SK, Goncalves M, Schapher M, Koch M, Iro H (2019) Does increasing the incidence of extracapsular dissection for benign tumors of the parotid correlate with an increased need for revision surgery? Oral Oncol 94:111–114PubMed

20.

Kadletz L, Grasl S, Grasl MC, Perisanidis C, Erovic BM (2017) Extracapsular dissection versus superficial parotidectomy in benign parotid gland tumors: the Vienna Medical School experience. Head Neck 39(2):356–360PubMed

21.

Witt RL, Rejto L (2009) Pleomorphic adenoma: extracapsular dissection versus partial superficial parotidectomy with facial nerve dissection. Del Med J 81(3):119–125PubMed

22.

Xie S, Wang K, Xu H et al (2015) PRISMA-extracapsular dissection versus superficial parotidectomy in treatment of benign parotid tumors: evidence From 3194 Patients. Medicine (Baltimore) 94(34):e1237

23.

Bar B, Mantsopoulos K, Iro H (2019) Paradigm shift in surgery for benign parotid tumors: 19 years of experience with almost 3000 cases. Laryngoscope 130(8):1941–1946PubMed

24.

Barca I, Cristofaro MG (2020) Surgical approach to parotid pleomorphic adenoma: a 15-year retrospective cohort study. Br J Oral Maxillofac Surg 58(6):659–662PubMed

25.

Martin H, Jayasinghe J, Lowe T (2020) Superficial parotidectomy versus extracapsular dissection: literature review and search for a gold standard technique. Int J Oral Maxillofac Surg 49(2):192–199PubMed

26.

Quer M, Vander Poorten V, Takes RP et al (2017) Surgical options in benign parotid tumors: a proposal for classification. Eur Arch Otorhinolaryngol 274(11):3825–3836PubMed

27.

Quer M, Guntinas-Lichius O, Marchal F et al (2016) Classification of parotidectomies: a proposal of the European Salivary Gland Society. Eur Arch Otorhinolaryngol 273(10):3307–3312PubMed

28.

Dostalova L, Kalfert D, Jechova A et al (2020) The role of fine-needle aspiration biopsy (FNAB) in the diagnostic management of parotid gland masses with emphasis on potential pitfalls. Eur Arch Otorhinolaryngol 277(6):1763–1769PubMed

29.

Omura S, Kawata R, Higashino M et al (2020) Challenges with preoperative diagnosis of low/intermediate-grade carcinoma of the parotid gland: single-center study of 112 patients. Eur Arch Otorhinolaryngol 277(7):2031–2039PubMed

30.

Borsetto D, Fussey JM, Cazzador D et al (2020) The diagnostic value of cytology in parotid Warthin’s tumors: international multicenter series. Head Neck 42(3):522–529PubMed

31.

Jechova A, Kuchar M, Novak S et al (2019) The role of fine-needle aspiration biopsy (FNAB) in Warthin tumour diagnosis and management. Eur Arch Otorhinolaryngol 276(10):2941–2946PubMed

32.

Howlett DC, Skelton E, Moody AB (2015) Establishing an accurate diagnosis of a parotid lump: evaluation of the current biopsy methods—fine needle aspiration cytology, ultrasound-guided core biopsy, and intraoperative frozen section. Br J Oral Maxillofac Surg 53(7):580–583PubMed

33.

McEvedy MV, Ross WM (1976) The treatment of mixed parotid tumours by enucleation and radiotherapy. Br J Surg 63(5):341–342PubMed

34.

Witt RL (2002) The significance of the margin in parotid surgery for pleomorphic adenoma. Laryngoscope 112(12):2141–2154PubMed

35.

Donovan DT, Conley JJ (1984) Capsular significance in parotid tumor surgery: reality and myths of lateral lobectomy. Laryngoscope 94(3):324–329PubMed

36.

Savvas E, Hillmann S, Weiss D, Koopmann M, Rudack C, Alberty J (2016) Association between facial nerve monitoring with postoperative facial paralysis in parotidectomy. JAMA Otolaryngol Head Neck Surg 142(9):828–833PubMed

37.

Stankovic P, Wittlinger J, Georgiew R et al (2020) Safety of the “Saxophone((R))” electrode in parotid surgery for continuous intraoperative neuromonitoring of the facial nerve: results of a pro- and retrospective cohort study. Eur Arch Otorhinolaryngol 277(5):1449–1456PubMedPubMedCentral

38.

Sood AJ, Houlton JJ, Nguyen SA, Gillespie MB (2015) Facial nerve monitoring during parotidectomy: a systematic review and meta-analysis. Otolaryngol Head Neck Surg 152(4):631–637PubMed

39.

Guntinas-Lichius O, Eisele DW (2016) Facial nerve monitoring. Adv Otorhinolaryngol 78:46–52PubMed

40.

Knopf A, Heiser C, Karasoy O, Hofauer B, Bier H, Mansour N (2017) Bipolar dissection technique in parotid gland surgery. Acta Otolaryngol 137(11):1210–1214PubMed

41.

Guntinas-Lichius O, Klussmann JP, Wittekindt C, Stennert E (2006) Parotidectomy for benign parotid disease at a university teaching hospital: outcome of 963 operations. Laryngoscope 116(4):534–540PubMed

42.

Zheng CY, Cao R, Gao MH, Huang ZQ, Sheng MC, Hu YJ (2019) Comparison of surgical techniques for benign parotid tumours: a multicentre retrospective study. Int J Oral Maxillofac Surg 48(2):187–192PubMed

43.

Albergotti WG, Nguyen SA, Zenk J, Gillespie MB (2012) Extracapsular dissection for benign parotid tumors: a meta-analysis. Laryngoscope 122(9):1954–1960PubMed

44.

Brennan PA, Ammar M, Matharu J (2017) Contemporary management of benign parotid tumours—the increasing evidence for extracapsular dissection. Oral Dis 23(1):18–21PubMed

45.

Schapher M, Koch M, Goncalves M, Mantsopoulos K, Iro H (2020) Extracapsular dissection in pleomorphic adenomas of the parotid gland: results after 13 years of follow-up. Laryngoscope. https://doi.org/10.1002/lary.28696CrossRefPubMed

46.

Ozturk K, Ozturk A, Turhal G, Kaya I, Akyildiz S, Uluoz U (2019) Comparative outcomes of extracapsular dissection and superficial parotidectomy. Acta Otolaryngol 139(12):1128–1132PubMed

47.

Kato MG, Erkul E, Nguyen SA et al (2017) Extracapsular dissection vs superficial parotidectomy of benign parotid lesions: surgical outcomes and cost-effectiveness analysis. JAMA Otolaryngol Head Neck Surg 143(11):1092–1097PubMedPubMedCentral

48.

Cristofaro MG, Allegra E, Giudice A et al (2014) Pleomorphic adenoma of the parotid: extracapsular dissection compared with superficial parotidectomy—a 10-year retrospective cohort study. Sci World J 2014:564053

49.

Kilavuz AE, Songu M, Pinar E, Ozkul Y, Ozturkcan S, Aladag I (2018) Superficial parotidectomy versus partial superficial parotidectomy: a comparison of complication rates, operative time, and hospital stay. J Oral Maxillofac Surg 76(9):2027–2032PubMed

50.

Lin YQ, Wang Y, Ou YM, Dong SY, Wang YD (2019) Extracapsular dissection versus partial superficial parotidectomy for the treatment of benign parotid tumours. Int J Oral Maxillofac Surg 48(7):895–901PubMed

51.

Stathopoulos P, Igoumenakis D, Smith WP (2018) Partial superficial, superficial, and total parotidectomy in the management of benign parotid gland tumors: a 10-year prospective study of 205 patients. J Oral Maxillofac Surg 76(2):455–459PubMed

52.

Koch M, Zenk J, Iro H (2010) Long-term results of morbidity after parotid gland surgery in benign disease. Laryngoscope 120(4):724–730PubMed

53.

Huang G, Yan G, Wei X, He X (2015) Superficial parotidectomy versus partial superficial parotidectomy in treating benign parotid tumors. Oncol Lett 9(2):887–890PubMed

54.

Grosheva M, Pick C, Granitzka T et al (2019) Impact of extent of parotidectomy on early and long-term complications: a prospective multicenter cohort trial. Head Neck 41(6):1943–1951PubMed

55.

Wong WK, Shetty S (2018) The extent of surgery for benign parotid pathology and its influence on complications: a prospective cohort analysis. Am J Otolaryngol 39(2):162–166PubMed

56.

Li C, Matthies L, Hou X, Knipfer C, Gosau M, Friedrich RE (2020) A meta-analysis of the pros and cons of partial superficial parotidectomy versus superficial parotidectomy for the treatment of benign parotid neoplasms. J Craniomaxillofac Surg 48(6):590–598PubMed

57.

Hussein O, Abdel Wahab K, Hamdy O et al (2018) Parotid quadrantectomy is a safe management for localized pleomorphic adenoma. Front Surg 5:3PubMedPubMedCentral

58.

Guntinas-Lichius O, Kick C, Klussmann JP, Jungehuelsing M, Stennert E (2004) Pleomorphic adenoma of the parotid gland: a 13-year experience of consequent management by lateral or total parotidectomy. Eur Arch Otorhinolaryngol 261(3):143–146PubMed

59.

Haring CT, Ellsperman SE, Edwards BM et al (2019) Assessment of intraoperative nerve monitoring parameters associated with facial nerve outcome in parotidectomy for benign disease. JAMA Otolaryngol Head Neck Surg 145(12):1137–1143PubMedCentral

60.

Mashrah MA, Al-Dhohrah TA, Al-Zubeiry FA et al (2018) Antegrade versus retrograde facial nerve dissection in benign parotid surgery: is there a difference in postoperative outcomes? A meta-analysis. PLoS One 13(10):e0206028PubMedPubMedCentral

61.

O’Regan B, Bharadwaj G (2011) Comparison of facial nerve injury and recovery rates after antegrade and retrograde nerve dissection in parotid surgery for benign disease: prospective study over 4 years. Br J Oral Maxillofac Surg 49(4):286–291PubMed

62.

Psychogios G, Rueger H, Jering M, Tsoures E, Kunzel J, Zenk J (2019) Ultrasound can help to indirectly predict contact of parotid tumors to the facial nerve, correct intraglandular localization, and appropriate surgical technique. Head Neck 41(9):3211–3218PubMed

63.

Poletti AM, Imparato S, Signorelli GC, Cugini G, Colombo G (2018) The multiplanar analysis of the retromandibular vein in surgical planning for parotid gland tumors. Eur Arch Otorhinolaryngol 275(6):1587–1593PubMed

64.

Rüger H, Psychogios G, Jering M, Zenk J (2020) Multimodal ultrasound including virtual touch imaging quantification for differentiating cervical lymph nodes. Ultrasound Med Biol 12:13. https://doi.org/10.1016/j.ultrasmedbio.2020.06.005CrossRef

65.

Colella G, Biondi P, Itro A, Compilato D, Campisi G (2010) Warthin’s tumor distribution within the parotid gland. A feasible etiologic source from lymph nodal tissue. Minerva Stomatol 59(5):245–249 (250–252)PubMed

66.

Lee DH, Yoon TM, Lee JK, Lim SC (2017) Extracapsular dissection for Warthin tumor in the tail of parotid gland. Acta Otolaryngol 137(9):1007–1009PubMed

67.

Bonavolonta P, Dell’Aversana Orabona G, Maglitto F et al (2019) Postoperative complications after removal of pleomorphic adenoma from the parotid gland: A long-term follow up of 297 patients from 2002 to 2016 and a review of publications. Br J Oral Maxillofac Surg 57(10):998–1002PubMed

68.

Lee YC, Park GC, Lee JW, Eun YG, Kim SW (2016) Prevalence and risk factors of sialocele formation after partial superficial parotidectomy: a multi-institutional analysis of 357 consecutive patients. Head Neck 38(Suppl 1):E941–E944PubMed

69.

Lopez F, Suarez C, Vander Poorten V et al (2019) Contemporary management of primary parapharyngeal space tumors. Head Neck 41(2):522–535PubMed

70.

Wang KY, Yang Z, Wang WL, Xu H, Liu FY (2019) Autologous free fat graft for repair of concave deformity after total parotidectomy. J Craniofac Surg 30(3):834–837PubMed

71.

Bianchi B, Ferri A, Ferrari S, Copelli C, Sesenna E (2011) Improving esthetic results in benign parotid surgery: statistical evaluation of facelift approach, sternocleidomastoid flap, and superficial musculoaponeurotic system flap application. J Oral Maxillofac Surg 69(4):1235–1241PubMed

72.

Li C, Yang X, Pan J, Shi Z, Li L (2013) Graft for prevention of Frey syndrome after parotidectomy: a systematic review and meta-analysis of randomized controlled trials. J Oral Maxillofac Surg 71(2):419–427PubMed

73.

Psychogios G, Vlastos I, Tholken R, Zenk J (2020) Warthin’s tumour seems to be the most common benign neoplasm of the parotid gland in Germany. Eur Arch Otorhinolaryngol

74.

Franzen AM, Kaup Franzen C, Guenzel T, Lieder A (2018) Increased incidence of Warthin tumours of the parotid gland: a 42-year evaluation. Eur Arch Otorhinolaryngol 275(10):2593–2598PubMed

75.

Mantsopoulos K, Goncalves M, Koch M, Iro H (2018) Extracapsular dissection for warthin tumors despite the risk of ipsilateral metachronous occurrence. Laryngoscope 128(11):2521–2524PubMed

76.

Heine D, Zenk J, Psychogios G (2018) Two case reports of synchronous unilateral pleomorphic adenoma and cystadenolymphoma of the parotid gland with literature review. J Ultrason 18(75):369–373PubMedPubMedCentral

77.

Mantsopoulos K, Psychogios G, Agaimy A et al (2015) Inflamed benign tumors of the parotid gland: diagnostic pitfalls from a potentially misleading entity. Head Neck 37(1):23–29PubMed

78.

Witt RL, Iacocca M, Gerges F (2015) Contemporary diagnosis and management of Warthin’s tumor. Del Med J 87(1):13–16PubMed

79.

Dulguerov P, Todic J, Pusztaszeri M, Alotaibi NH (2017) Why do parotid pleomorphic adenomas recur? A systematic review of pathological and surgical variables. Front Surg 4:26PubMedPubMedCentral

80.

Schapher M, Koch M, Agaimy A, Goncalves M, Mantsopoulos K, Iro H (2019) Parotid pleomorphic adenomas: factors influencing surgical techniques, morbidity, and long-term outcome relative to the new ESGS classification in a retrospective study. J Craniomaxillofac Surg 47(9):1356–1362PubMed

81.

Mansour N, Bas M, Stock KF, Strassen U, Hofauer B, Knopf A (2017) Multimodal ultrasonographic pathway of parotid gland lesions. Ultraschall Med 38(2):166–173PubMed

82.

Klintworth N, Mantsopoulos K, Zenk J, Psychogios G, Iro H, Bozzato A (2012) Sonoelastography of parotid gland tumours: initial experience and identification of characteristic patterns. Eur Radiol 22(5):947–956PubMed

83.

Mantsopoulos K, Mueller S, Goncalves M, Koch M, Iro H (2019) Completion surgery after extracapsular dissection of low-grade parotid gland malignant tumors. Head Neck 41(9):3383–3388PubMed

84.

Grasl S, Kadletz L, Janik S et al (2019) Fine-needle aspiration cytology and intraoperative frozen section in parotid gland tumour surgery: a retrospective multicenter analysis of 417 cases. Clin Otolaryngol 44(3):461–465PubMed

85.

Olsen KD, Moore EJ, Lewis JE (2013) Frozen section pathology for decision making in parotid surgery. JAMA Otolaryngol Head Neck Surg 139(12):1275–1278PubMed

86.

Suzuki M, Nakaegawa Y, Kobayashi T, Kawase T, Matsuzuka T, Murono S (2019) The role of frozen section biopsy for parotid gland tumour with benign fine-needle aspiration cytology. J Laryngol Otol 133(3):227–229PubMed

87.

Mantsopoulos K, Muller S, Agaimy A et al (2017) Extracapsular dissection in the parapharyngeal space: benefits and potential pitfalls. Br J Oral Maxillofac Surg 55(7):709–713PubMed

88.

Olsen KD, Quer M, de Bree R, Vander Poorten V, Rinaldo A, Ferlito A (2017) Deep lobe parotidectomy-why, when, and how? Eur Arch Otorhinolaryngol 274(12):4073–4078PubMed

89.

Betka J, Chovanec M, Klozar J et al (2010) Transoral and combined transoral-transcervical approach in the surgery of parapharyngeal tumors. Eur Arch Otorhinolaryngol 267(5):765–772PubMed

90.

Kanatas A, Ho MWS, Mucke T (2018) Current thinking about the management of recurrent pleomorphic adenoma of the parotid: a structured review. Br J Oral Maxillofac Surg 56(4):243–248PubMed

91.

de Zinis LOR, Piccioni M, Antonelli AR, Nicolai P (2008) Management and prognostic factors of recurrent pleomorphic adenoma of the parotid gland: personal experience and review of the literature. Eur Arch Otorhinolaryngol 265(4):447–452

92.

Witt RL, Eisele DW, Morton RP, Nicolai P, Poorten VV, Zbaren P (2015) Etiology and management of recurrent parotid pleomorphic adenoma. Laryngoscope 125(4):888–893PubMed

93.

Mantsopoulos K, Goncalves M, Koch M, Iro H (2019) Watchful waiting in carefully selected metachronous cystadenolymphomas of the parotid gland: a reliable option? Br J Oral Maxillofac Surg 57(5):425–429PubMed

94.

Mc Loughlin L, Gillanders SL, Smith S, Young O (2019) The role of adjuvant radiotherapy in management of recurrent pleomorphic adenoma of the parotid gland: a systematic review. Eur Arch Otorhinolaryngol 276(2):283–295PubMed

95.

Knopf A, Szyper M, Mansour N, Sonnenberg J, Hofauer B, Niedermeyer H (2016) A critical review of 20 years of parotid gland surgery. Acta Otolaryngol 136(7):711–716PubMed

Titel: Review of surgical techniques and guide for decision making in the treatment of benign parotid tumors
verfasst von: Georgios Psychogios
Christopher Bohr
Jannis Constantinidis
Martin Canis
Vincent Vander Poorten
Jan Plzak
Andreas Knopf
Christian Betz
Orlando Guntinas-Lichius
Johannes Zenk
Publikationsdatum: 04.08.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: European Archives of Oto-Rhino-Laryngology / Ausgabe 1/2021
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-020-06250-x

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Review of surgical techniques and guide for decision making in the treatment of benign parotid tumors

Abstract

Purpose

Methods

Results

Conclusion

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Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

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