Uncommon extension of the main trunk of the facial nerve in a patient with a
giant parotid pleomorphic adenoma. Case report
Evangelos KALFARENTZOS, Vassilis PETSINIS, Ioannis PAPADIOHOS, Nickolaos PAPADOGEORGAKIS
Department of Oral & Maxillofacial Surgery, at “Evangelismos” Hospital, Dental School, University of Athens, Greece (Head: Professor C. Alexandridis, Director: Professor N. Papadogeorgakis)
Hellenic Archives of Oral & Maxillofacial Surgery (2013) 3, 153-158
SUMMARY: Pleomorphic adenomas account for 60–70% of all neoplasms in the parotid gland thus making it the most commonly encountered neoplasm of the salivary glands. It is a slow-growing benign salivary tumour, usually presenting as a palpable painless mass with no other associated symptoms. However, in many cases usually because of late diagnosis or lack of treatment they can reach enormous sizes. Large parotid gland tumours can result in infiltration, elongation or displacement of the facial nerve. An abnormally elongated or displaced facial nerve is of special interest because of the resulting anatomical abnormality regarding facial nerve position. Even more elongated facial nerves are more delicate and follow more tortuous courses. As a result identification and dissection of the facial nerve with either antegrade or retrograde dissection techniques may easily cause injury, because the usual surgical landmarks become unreliable. The aim of this paper is to present an unusual case of elongation (68mm) of the facial nerve’s main trunk, in a 79 year old Caucasian female with a giant multilobular pleomorphic adenoma of the deep lobe of the parotid gland; the tumor had been growing for 45 years. The intraoperative considerations related to facial nerve excessive elongation of the main trunk of the facial nerve are discussed.
KEY WORDS: pleomorphic adenoma, large parotid tumor, facial nerve main trunk elongation
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