Management of the facial nerve in parotid gland surgery

1972 ◽  
Vol 124 (4) ◽  
pp. 473-476 ◽  
Author(s):  
Oliver H. Beahrs ◽  
Guan C. Chong
Keyword(s):  
Parotid Gland ◽  
Facial Nerve

scholarly journals Metastatic Parotid Myoepithelial Carcinoma in a 7-Year-Old Boy

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Issam Saliba ◽  
Nazir El Khatib ◽  
Antoine Nehme ◽  
Selim Nasser ◽  
Nabil Moukarzel
Keyword(s):  
Parotid Gland ◽  
Facial Nerve ◽  
Smooth Muscle Actin ◽  
Postoperative Radiotherapy ◽  
Lumbar Vertebra ◽  
Myoepithelial Carcinoma ◽  
Cervical Lymph Nodes ◽  
Immunohistochemical Markers ◽  
First Case ◽  
Rare Malignancy

Myoepithelial carcinoma is a rare malignancy of the parotid gland that is usually seen in adults. We report the first case in children of myoepithelial carcinoma of the parotid gland with massive invasion of the facial nerve and metastasis to cervical lymph nodes. Due to its rarity, the treatment and the clinical course of this tumor are not well defined yet. We performed a total parotidectomy, a modified neck dissection, and a postoperative radiotherapy in 7-year-old boy. Sparing of the facial nerve was impossible; it was sacrificed and grafted with a sural nerve. Histopathology confirmed the diagnosis of a parotid gland carcinoma and immunohistochemical markers showed that the tumor cells express cytokeratin, epithelial membrane antigen, cytokeratin 7, smooth muscle actin, P63, CEA, and S100. This pattern of immunostaining is consistent with the diagnosis of myoepithelial carcinoma. On the postoperative tenth month he presented with a pulmonary and lumbar vertebra metastasis.

scholarly journals Oncocytic carcinoma of the parotid gland with facial nerve invasion

2011 ◽  
Vol 2011 (jul28 1) ◽  
pp. bcr0220113818-bcr0220113818 ◽  
Author(s):  
T. Leahy ◽  
C. Sader
Keyword(s):  
Parotid Gland ◽  
Facial Nerve ◽  
Oncocytic Carcinoma ◽  
Nerve Invasion

Surgical treatment of benign parotid gland tumors in the years 2014–2018 at the ENT department of Hospital České Budějovice, a.s.

2021 ◽  
Vol 70 (2) ◽  
pp. 82-88
Author(s):  
Hana Zapletalová ◽  
Martin Kuchař ◽  
Lubor Mrzena
Keyword(s):  
Surgical Treatment ◽  
Parotid Gland ◽  
Facial Nerve ◽  
Pleomorphic Adenoma ◽  
Benign Tumors ◽  
Histological Structure ◽  
Warthin’S Tumor ◽  
Parotid Gland Tumors ◽  
Warthin's Tumor ◽  
Keywords Parotid Gland

ntroduction: Salivary tumors represent a heterogeneous group of tumors of diverse location, histological structure and bio logical behavior. The purpose of this study was a retrospective evaluation of surgical treatment of a group of patients with newly dia gnosed benign tumors of the parotid salivary gland operated in the years 2014–2018 at the ENT department of Hospital České Budějovice, a.s. Material and methods: A type of surgery, defi nitive histology, postoperative complications and a number of recurrences were monitored. The data were evaluated by descriptive statistical methods. Results: A total of 190 surgeries with benign histological fi ndings in 182 patients were performed. The most common benign result was Warthin‘s tumor (90 cases, 47.4%), followed by pleomorphic adenoma (66 cases, 34.7%). Uncommon histological types of tumors were dia gnosed in 14 patients (7.4%). Non-tumorous fi ndings were found in 20 cases (10.5%). The most frequently performed procedure in 84 cases (44.2%) was extracapsular extirpation. Transient lesion in the area of innervation of the temporofacial and / or cervicofacial branch of the facial nerve was present in 34 (17.9%) patients. Permanent paresis of some of the branches of the facial nerve was reported in 2 (1.1%) patients. In 12 patients, the postoperative course was complicated by the development of salivary fi stula (6.3%). Pleomorphic adenoma relapsed after extracapsular extirpation in 5 cases (20.0%). After partial parotidectomy, one recurrence of pleomorphic adenoma (3.6%) was recorded. Warthin‘s tumor relapsed after simple extirpation in 4 cases (20.0%). Conclusion: Our evaluation results of the surgical treatment of benign parotid gland tumors lead us to make further eff orts improve the care of our patients. We see reserves mainly in the routine use of ultrasonographic examination with performance FNAC and thus planning a safe and suffi ciently radical operational solution. Keywords: parotid gland – pleomorphic adenoma – Warthin‘s tumor – parotidectomy – recurrence – facial nerve paresis – FNAC

Surgical Anatomy of the Parotid Gland

2021 ◽  
pp. 13-23
Keyword(s):  
Parotid Gland ◽  
Facial Nerve ◽  
External Auditory Meatus ◽  
Styloid Process ◽  
Terminal Segment ◽  
External Carotid Artery ◽  
Surgical Anatomy ◽  
Mastoid Process ◽  
External Carotid ◽  
Superficial Lobe

The parotid gland consists of two lobes: superficial and deep with regard to its relation with the facial nerve. It is wrapped around the mandibular ramus and secretes saliva through the parotid (Stensen's) duct. It is a paired organ, weighing 15-30g each. Its superficial lobe overlies the lateral surface of the masseter muscle and is bounded superiorly by the zygomatic arch, while its deep lobe is located in the pre-styloid compartment of the parapharyngeal space between the mastoid process posteriorly, ramus of mandible anteriorly, and external auditory meatus superiorly. Medially, the gland reaches to the styloid process. Inferiorly, the parotid tail extends down to the anteromedial margin of sternocleido-mastoid muscle. Several structures run through the parotid gland, namely, terminal segment of external carotid artery, retro-mandibular vein, parotid lymph nodes, and facial nerve, which soon gives two divisions (temporo-facial and cervico-facial) that give off five branches inside the gland radiating forwards. This chapter explores the surgical anatomy of the parotid gland.

scholarly journals Warthin's tumor with necrotizing tuberculous granulomatous inflammation causing severe facial nerve adhesion in parotid gland

Medicine ◽  
2020 ◽  
Vol 99 (7) ◽  
pp. e18763
Author(s):  
Shih-Lung Chen ◽  
Cheng-Cheng Hwang ◽  
Yu-Chih Liu ◽  
Wei-Ting Chen ◽  
Shih-Wei Yang
Keyword(s):  
Parotid Gland ◽  
Facial Nerve ◽  
Granulomatous Inflammation ◽  
Warthin’S Tumor ◽  
Warthin's Tumor

scholarly journals Nodular fasciitis of the parotid gland engulfing the facial nerve: a conservative approach

2019 ◽  
Vol 12 (10) ◽  
pp. e231203
Author(s):  
Stephen Bennett ◽  
Kristian Hutson ◽  
Olakunle Ajayi ◽  
Andreas Hilger
Keyword(s):  
Parotid Gland ◽  
Facial Nerve ◽  
Benign Lesion ◽  
Surgical Excision ◽  
Needle Aspiration ◽  
Nodular Fasciitis ◽  
Conservative Approach ◽  
Complete Excision ◽  
Diagnostic Uncertainty ◽  
Accepted Practice

Nodular fasciitis (NF) is a rapidly growing benign lesion rarely reported in the parotid gland. It shares cytological features with other benign and malignant parotid neoplasms and may be difficult to diagnose based on fine needle aspiration cytology alone. Given this diagnostic conundrum, surgical excision for histology is recommended to facilitate definitive diagnosis. A case with significant involvement of the facial nerve is described, which has not previously been reported in the literature. Despite features of potential malignancy, the decision was taken to biopsy the lesion and not proceed to complete excision in an attempt to reduce the risk of facial nerve injury. Expert opinion later diagnosed NF. Contrary to accepted practice, where diagnostic uncertainty remains around the malignant potential of a lesion, risks and benefits of complete excision versus a conservative approach should be carefully weighed especially when the facial nerve is involved and NF is a possible diagnosis.

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