The Chimeric Scapulodorsal-Vascularized Latissimus Dorsi Nerve Flap for Immediate Total Parotidectomy With Facial Nerve Sacrifice Reconstruction: About 24 Cases

Abstract BackgroundPrimary squamous cell carcinoma rarely occurs in parotid gland. Partial, superficial or total parotidectomy as well as radical resection is performed based on patients’ conditions. For patients with symptoms of facial nerve weakness or dysfunction, facial nerve preservation is considered justifiably, whereas groundlessly if the malignancy is asymptomatic. We hereby reported a case of symptomatic primary parotid squamous cell carcinoma performed with total parotidectomy and facial nerve preservation.Case summaryWith the complaint of an asymptomatic mass in right parotid gland for five years and it grew aggressively and pricked recent months, a 46-year-old man visited the local hospital two week ago. A biopsy was performed and squamous cell carcinoma in right parotid gland was diagnosed. He was subsequently referred to Tongji hospital in Wuhan, China. Physical exam revealed a scar in the right parotid gland and impaired function of right facial nerves. An immoveable mass was touched in lower and posterior pole of right parotid gland. The mass was about 2.1*3.1 cm without clear boundary, and moderate pain was observed. No obvious enlarged lymph node was touched in right submandibular region and neck. Magnetic resonance imaging revealed a 1.6*2.4 cm nodular located in a diffuse suspicious mass in right parotid gland. Radical resection of the malignancy was rejected due to the inevitable facioplegia. Considering the short history of tumor aggressive behaviors, unique anatomical structure of parotid gland and absent sign of lymph node metastasis, total parotidectomy with facial nerve preservation and elective right neck dissection were performed. Finial pathological examination confirmed squamous cell carcinoma of right parotid gland. Post-operation radiotherapy was scheduled in the following month. Restoration of facial nerve function was observed in two months later, absent local recurrence and distant metastasis was observed in the three years’ follow-up.Conclusion Primary parotid squamous cell carcinoma is rarely observed in clinical and facial nerve sacrifice requires great attention in treatment. Based on carefully evaluation of patients’ conditions before treatment, individualized treatment is crucial for improvement of patients’ quality of life while completely dissection of the malignancy.

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Periauricular Reconstruction After Total Parotidectomy with Facial Nerve Reconstruction and Free Flaps

Clinical Scenarios in Reconstructive Microsurgery ◽

10.1007/978-3-319-94191-2_19-1 ◽

2020 ◽

pp. 1-10

Author(s):

Lara Cristóbal ◽

Andrés Rodríguez-Lorenzo

Keyword(s):

Facial Nerve ◽

Free Flaps ◽

Nerve Reconstruction ◽

Facial Nerve Reconstruction ◽

Total Parotidectomy

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Evaluation of the Methylene Blue Staining of the Salivary Parenchyma in Surgery of the Parotid Gland

Tumori Journal ◽

10.1177/030089166405000404 ◽

1964 ◽

Vol 50 (4) ◽

pp. 309-316 ◽

Cited By ~ 4

Author(s):

Vinicio C. Catania ◽

Leandro Gennari

Keyword(s):

Aqueous Solution ◽

Methylene Blue ◽

Parotid Gland ◽

Facial Nerve ◽

Blue Staining ◽

Metastatic Tumors ◽

Total Parotidectomy

Injection of methylene blue in the salivary parenchyma was performed in 33 cases of total parotidectomy for primary or metastatic tumors of the parotid gland. The technique of Robinson et al. was employed, with injection of 5–8 ml of a 1 percent aqueous solution of methylene blue in the Stenone's duct. The method showed its usefulness facilitating the search and isolation of the facial nerve and its branches. An improved radicality of the operation was also allowed.

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Dual innervation method using one-stage reconstruction with free latissimus dorsi muscle transfer for re-animation of established facial paralysis: simultaneous reinnervation of the ipsilateral masseter motor nerve and the contralateral facial nerve to improve the quality of smile and emotional facial expressions

Journal of Plastic Reconstructive & Aesthetic Surgery ◽

10.1016/j.bjps.2008.07.025 ◽

2009 ◽

Vol 62 (12) ◽

pp. 1589-1597 ◽

Cited By ~ 39

Author(s):

Yorikatsu Watanabe ◽

Tanetaka Akizuki ◽

Tsuyoshi Ozawa ◽

Kei Yoshimura ◽

Kaori Agawa ◽

...

Keyword(s):

Facial Nerve ◽

Facial Expressions ◽

Latissimus Dorsi ◽

Motor Nerve ◽

Latissimus Dorsi Muscle ◽

Emotional Facial Expressions ◽

Muscle Transfer ◽

Dorsi Muscle ◽

One Stage Reconstruction

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Recurrent Pleomorphic Adenoma of the Parotid Gland

Otolaryngology ◽

10.1016/j.otohns.2005.04.008 ◽

2005 ◽

Vol 133 (3) ◽

pp. 319-322 ◽

Cited By ~ 34

Author(s):

John P. Leonetti ◽

Sam J. Marzo ◽

Guy J. Petruzzelli ◽

Brian Herr

Keyword(s):

Parotid Gland ◽

Facial Nerve ◽

Pleomorphic Adenoma ◽

Surgical Procedures ◽

Recurrent Disease ◽

Long Term Results ◽

Subtotal Petrosectomy ◽

Total Parotidectomy ◽

Recurrent Pleomorphic Adenoma

OBJECTIVES: To assess the long-term results in the management of 42 patients with recurrent pleomorphic adenoma of the parotid gland. STUDY DESIGN: A retrospective analysis of 42 patients who underwent parotidectomy for recurrent pleomorphic adenoma was performed to study presenting clinicoradiographic features, surgical technique, facial nerve management, and the long-term risk of recurrence. RESULTS: All 42 patients had multi-focal, nontender recurrent nodules following one to four prior surgical procedures and 6 patients underwent prior radiotherapy. Surgical procedures included subtotal parotidectomy in 12 patients, total parotidectomy in 18 patients, parotidectomy with facial nerve resection in 7 cases, and subtotal petrosectomy with facial nerve resection in 5 individuals. The 2 patients with malignant transformation died of disseminated lung and bone metastasis. Twenty-nine of the remaining 40 patients had no recurrent disease. Seven patients developed local parotid bed or cutaneous recurrent disease, 2 patients died of unrelated causes, and 2 patients were lost to follow-up. CONCLUSIONS: All 7 patients with recurrent disease underwent subtotal parotidectomy with “negative” surgical margins. Total parotidectomy or subtotal petrosectomy with facial nerve resection in selected cases may reduce the risk of multiple episodes of pleomorphic adenoma recurrence. Two of 42 patients were found to have carcinoma ex-pleomorphic adenoma, both of these patients underwent prior radiotherapy, and both died of metastatic disease.

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