Total Parotidectomy with Preservation of Facial Nerve

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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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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Incidence and Management of Siaolocele Post-Parotidectomy

Otolaryngology ◽

10.1016/j.otohns.2008.05.127 ◽

2008 ◽

Vol 139 (2_suppl) ◽

pp. P38-P39 ◽

Cited By ~ 2

Author(s):

Robert L Witt

Keyword(s):

Facial Nerve ◽

Needle Aspiration ◽

Single Institution ◽

Superficial Parotidectomy ◽

Chi Square ◽

Chi Square Analysis ◽

Total Parotidectomy

Objective (1)To determine if a post-parotidectomy sialocele occurs at a higher incidence with a partial superficial parotidectomy compared to a near complete parotidectomy; both with facial nerve dissection. (2)To determine if needle aspiration vs. observation yields more persistant sialoceles beyond 4 weeks. Methods Retrospective, single surgeon, single institution study comparing 100 consecutive partial superficial parotidectomy procedures and 20 consecutive near-total parotidectomy procedures for formation of post-operative sialocele. Study period 2004–2007. The first 18 sialoceles were treated with one or more needle aspirations. The last 21 sialoceles were treated with observation and no needle aspiration. Antibiotics were not used beyond the first week of surgery in either group. Chi Square analysis was performed. Results There were 39 sialoceles in the partial superficial parotidecotomy group (39/100–39%) and none in the near-total parotidectomy group (0/20–0%). (p<0.05). All sialoceles resolved by the end of the fourth post-operative week whether aspirated or not aspirated. Conclusions Sialoceles are common post-partial superficial parotidectomy and did not occur after near-total parotidectomy. Patients should be advised in the pre-operative counseling period of this possible event after partial superficial parotidectomy. Sialoceles after parotidectomy can generally be treated by observation. Needle aspiration and antibiotics are optional.

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Total parotidectomy—a routine treatment for parotid gland swellings?

The Journal of Laryngology & Otology ◽

10.1017/s0022215100108394 ◽

1989 ◽

Vol 103 (2) ◽

pp. 181-186 ◽

Cited By ~ 20

Author(s):

E. Alajmo ◽

G. Polli ◽

W. De Meester

Keyword(s):

Facial Nerve ◽

Adenoid Cystic Carcinoma ◽

Malignant Tumours ◽

Nerve Preservation ◽

Adenoid Cystic ◽

Benign Tumours ◽

University Of Florence ◽

Monomorphic Adenoma ◽

The University ◽

Total Parotidectomy

AbstractThe results of 25 years of quasi-routine total parotidectomy performance are shown. At the Department of Otolaryngology of the University of Florence, 582 patients were treated as follows: on 527 occasions by total parotidectomy with facial never preservation; 24 occasions by lateral lobectomy; 27 occasions by total parotidectomy with removal of the whole facial nerve; four times by enucleo-resection of the disease. Benign tumours were 378; primary and metastatic malignant tumours—100; non tumoral lesions—104.The benign tumours follow-up showed three recurrences only (two pleomorphic adenomas—one of them proved to be an adenoid-cystic carcinoma, and one monomorphic adenoma, which also proved to be an adenoid-cystic carcinoma), respectively 6, 6 and 8 years later. The malignant tumours were also treated by total parotidectomy with adequate management both of the facial nerve and the neck lymph nodes. The results thoroughly justify the nerve preservation, when preserved.

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