IDENTIFICATION OF THE FACIAL NERVE TRUNK DURING SUPERFICIAL PAROTIDECTOMY BY TRIDENT LANDMARK

2019 ◽  
Vol 2 (1) ◽  
pp. 17-26
Author(s):  
Yasser Hatata ◽  
Mohamed Ibrahim ◽  
Reda Fawzy ◽  
Hazem Elgohary
Keyword(s):  
Facial Nerve ◽  
Nerve Trunk ◽  
Superficial Parotidectomy

scholarly journals Do Benign Mass Lesions in the Superficial Lobe of Parotid Gland Influence Landmark-Based Search for Facial Nerve Trunk at Surgery?

2021 ◽  
Author(s):  
Subhadip Sardar ◽  
Mainak Dutta ◽  
Sirshak Dutta ◽  
Saumik Das ◽  
Ramanuj Sinha
Keyword(s):  
Observational Study ◽  
Facial Nerve ◽  
Correlation Coefficients ◽  
Nerve Trunk ◽  
Digastric Muscle ◽  
Superficial Parotidectomy ◽  
Anatomic Landmarks ◽  
Superficial Lobe ◽  
Mass Lesions ◽  
Benign Mass

Objective: To assess the influence of benign mass lesions in the superficial lobe of parotid on the known anatomic landmarks for identifying the facial nerve trunk. Method: Patients with unilateral biopsy-proven benign mass lesions in the superficial parotid were selected for this observational study. During superficial/partial superficial parotidectomy, distance of the facial nerve trunk from each landmark was assessed using spring calliper and correlated with the lesion’s volume (measured from the pre-operative imaging). At least two identifiers among tragal pointer (TP), posterior belly of digastric muscle (PBDM) and tympanomastoid suture (TMS) were considered. Results: The study involved 32 patients. The lesions mostly involved the parotid tail (50%) and pretragal region (34.3%), and constituted of pleomorphic adenoma (~66%) and Warthin’s tumor (~9%), the rest being various cysts and hamartomas. TP was universally uncovered, while PBDM and TMS were exposed in 26 and 25 patients, respectively. Average distances between the facial nerve trunk and TP, PBDM and TMS were 12.79 mm (SD=2.33), 9.78 mm (SD=1.21) and 7.58 mm (SD=1.33), respectively. Correlation coefficients between the lesion’s volume and the distance of facial nerve from a given landmark were -0.11, 0.04 and -0.16 for TP, PBDM and TMS, respectively. Conclusions: TP was the most easily available landmark on surgical dissection, while PBDM was the most consistent and the least variable when volumetric data of the benign mass lesions in the superficial lobe of parotid were considered as a factor influencing the distance from the facial nerve trunk.

scholarly journals POSTERIOR AURICULAR NERVE – A NOVEL LANDMARK FOR IDENTIFICATION OF THE FACIAL NERVE IN SUPERFICIAL PAROTIDECTOMY

2021 ◽  
Vol Volume 9 (upjohns/volume9/Issue2) ◽  
pp. 10-14
Author(s):  
Arulalan Mathialagan
Keyword(s):  
Facial Nerve ◽  
Pleomorphic Adenoma ◽  
Nerve Trunk ◽  
Target Area ◽  
Superficial Parotidectomy ◽  
Tertiary Referral Center ◽  
Individual Variations ◽  
Parotid Surgery ◽  
Auricular Branch ◽  
Nerve Identification

ABSTRACT Background-Facial nerve identification and preservation is the most critical step in parotid surgery. Though there are described landmarks to locate the facial nerve trunk, they have individual variations. The posterior auricular nerve (PAN) is a branch of the facial nerve and is always present, it can be followed to reach the facial nerve trunk. MATERIALS AND METHODS A retrospective cohort study in which analysis of parotidectomy performed from January 2017 to November 2018 at our tertiary referral center was done. RESULTS A total of 23 parotidectomies were performed, of which 18 cases were pleomorphic adenoma. In four cases of pleomorphic adenoma we could clearly identify and preserve the PAN. Using PAN as the landmark the facial nerve trunk was located, all its peripheral branches were dissected and preserved. PAN identification narrows down the target area of dissection to identify the facial nerve trunk. CONCLUSION The posterior auricular branch of the facial nerve can be used as a standard landmark in parotid surgeries, that almost always leads to the facial nerve trunk. CLINICAL SIGNIFICANCE Though identification of PAN may be difficult in all cases, effort must be made to identify it under magnification. If done meticulously PAN can be an ideal landmark to identify facial nerve in parotid surgery. KEYWORDS Parotid surgery, Superficial Parotidectomy, Posterior auricular nerve, Facial nerve.

scholarly journals Superficial Parotidectomy by Retrograde Facial Nerve Dissection

2017 ◽  
Vol 10 (1) ◽  
pp. 25-27
Author(s):  
Narendra Vikram Gurung ◽  
D Shrestha ◽  
A Acharya ◽  
A Gurung ◽  
S Shrestha ◽  
...  
Keyword(s):  
Salivary Gland ◽  
Parotid Gland ◽  
Facial Nerve ◽  
Head And Neck Neoplasms ◽  
Complication Rate ◽  
Gland Tumor ◽  
Superficial Parotidectomy ◽  
Salivary Fistula ◽  
Parotid Tumors ◽  
Parotid Gland Tumor

Introduction: Tumors of the salivary gland are relatively uncommon and represent less than two percentage of all head and neck neoplasms. Parotid gland tumor comprises 85% of the salivary gland tumors of which 80% are being benign. Superficial parotidectomy is the commonest procedure done for parotid tumors which can be performed by either anteretrograde or retrograde facial nerve dissection technique.Methods: Outcome of 60 patients after superficial parotidectomy with retrograde facial nerve dissection has been studied.Results: Total of 60 patients had been studied. Complications like facial nerve weakness, Freys syndrome, salivary fistula, and wound infection were taken into account. Among them, 13.33% patients developed temporary facial nerve weakness, followed by temporary salivary fistula, 1.6%. None of the patients developed any severe complication.Conclusion: Superficial parotidectomy by retrograde facial nerve dissection is an easy technique to carry out with low complication rate and without compromising surgical outcome.Journal of Gandaki Medical CollegeVol. 10, No. 1, 2017, page: 25-27

Antegrade versus Retrograde Facial Nerve Dissection during Superficial Parotidectomy

2014 ◽  
Vol 1 (1) ◽  
pp. 33-40
Author(s):  
El-Sayed Mahmoud Abd-Elwahab ◽  
Sayed Kadh ◽  
Olfat A. Khaled
Keyword(s):  
Facial Nerve ◽  
Superficial Parotidectomy

Pleomorphic adenomas of the parotid gland: superficial parotidectomy or limited excision?

1988 ◽  
Vol 102 (7) ◽  
pp. 603-605 ◽  
Author(s):  
C. Wennmo ◽  
O. Spandow ◽  
P. Emgård ◽  
B. Krouthén
Keyword(s):  
Retrospective Study ◽  
Side Effects ◽  
Parotid Gland ◽  
Facial Nerve ◽  
Superficial Parotidectomy ◽  
Operative Results ◽  
Gustatory Sweating ◽  
Pleomorphic Adenomas ◽  
Parotid Tumours

AbstractIn this retrospective study of parotid tumours. 57 patients with pleomorphic adenomas were treated with superficial parotidectomy and 33 patients with limited excision. The follow-up period has been 4–14 years. When the operation was superficial parotidectomy, recurrences occurred in 8.7 per cent compared to 6 per cent in cases of limited excision. Side-effects such as permanent weakness of the facial nerve or postoperative gustatory sweating were also more common when superficial parotidectomy was performed. The post-operative results observed suggest that limited excision under magnification is more favourable than superficial parotidectomy in the treatment of pleomorphic adenomas.

Bifid Facial Nerve Trunk

2016 ◽  
Vol 27 (6) ◽  
pp. e541-e543
Author(s):  
María Fe García Reija ◽  
Julia C. Blasco Palacio
Keyword(s):  
Facial Nerve ◽  
Nerve Trunk

scholarly journals Factors associated with facial nerve palsy in patients undergoing superficial parotidectomy for pleiomorphic adenoma: our experience of eight and half years

2019 ◽  
Vol 6 (1) ◽  
pp. 60
Author(s):  
Dheer S. Kalwaniya ◽  
Goutam Kothathi Chowdegowda ◽  
Monish Raj ◽  
Jaspreet S. Bajwa ◽  
Satya V. Arya ◽  
...  
Keyword(s):  
Parotid Gland ◽  
Facial Nerve ◽  
Pleomorphic Adenoma ◽  
Surgical Approaches ◽  
Depth Of Invasion ◽  
Tumor Depth ◽  
Facial Paresis ◽  
Superficial Parotidectomy ◽  
Parotid Surgery ◽  
Nerve Paresis

<p class="abstract"><strong>Background:</strong> The pleomorphic adenoma comprises 45-60% of all salivary gland tumors most often in parotid gland up to 80%. The association between the facial nerve and the gland is responsible for most of the technical difficulties and complications of the surgical approaches.</p><p class="abstract"><strong>Methods:</strong> This is a retrospective observational study performed in a unit of General Surgery, Safdarjung Hospital, New Delhi from May 2011 to October 2019 of all patients who underwent superficial parotidectomy for pleomorphic adenoma of parotid gland. The data was tabulated and results made using SPSS 21.0 system.  </p><p class="abstract"><strong>Results:</strong> Male:female ratios are 29:33. Average age was 47.1 years (31-61). Average duration of disease was 2.2 years (0.3-5). 4 were operated for recurrence. Facial paresis occurred in 7 out of 62 patients (11.3%), 4 females and 3 males. 11 patients have tumor greater than 4 cm, out of these 11 patients 2 patients had pre-op facial paresis. Out of 51 patients (size &lt;4 cm), 2 suffered facial paresis and out of 11 patients (size &gt;4 cm), 5 suffered same. Out of 59 patients with depth of tumor &lt;2 cm, 4 patients had post-op facial paresis. All the three patients having tumor depth &gt;2 cm suffered post op facial paresis. Patients with pre-op facial nerve paresis had mean duration of tumor 3.35 year (±0.92) while with post-op facial nerve paresis had mean duration of tumor 2.99 year (±1.35).</p><p class="abstract"><strong>Conclusions:</strong> Meticulous separation of facial nerve from parotid tissue is key to preservation of the facial nerve. But factors like size of tumor, depth of invasion, previous surgery do affect the outcome in parotid surgery.</p>

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