Abstract
Up to 32% of parotid neoplasms are malignant, and treatment for resectable parotid
carcinomas remains primarily surgical. Resection is centred round the identification
and preservation (where possible) of the main trunk of the facial nerve. Limited dissection
of the temporal bone and identification of the facial nerve proximally in the mastoid
portion can facilitate resection for all parotid carcinomas that occur in the preauricular
portion of the gland. Dissection in the narrow space between the ear or base of the
skull and the tumour reduces the risk of tumour spillage, and the margin for resection
is optimised. Intramastoid localisation of the facial nerve allows a posterior approach,
and access to the dissection plane lies medial to the nerve. We describe the technique
in a series of eight patients undergoing resection for parotid malignancies. In our
experience the technique promotes adequate resection margins, reduces the risk of
tumour spillage, and allows better access for nerve grafting if the facial nerve has
to be sacrificed.
Keywords
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Article info
Publication history
Published online: January 04, 2012
Accepted:
December 5,
2011
Identification
Copyright
© 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
