Alternative surgical restoration of aesthetic defect during superficial parotidectomy – Case report
Nikolaos Kechagias, Elias Tourtounis
St Lukes Hospital, Thessaloniki, Greece
DOI: 10.54936/haoms254349
Abstract:
Tumors in the parotid gland, which is the largest salivary gland, could appear as a swelling in the cheek area or in the area in front of and below the earlobe. The majority are benign tumors. In all cases, removal of the tumor by parotidectomy is the main option. In the majority of these operations, postoperatively a defect remains in the lateral region of the face after the removal of the tumor. Many solutions have been proposed internationally to treatment this aesthetic defect. In this study, a proposal is presented to use part of the remaining parotid tissue, to restore the defect that appears after the removal of the tumor and the preparation of the facial nerve.
KEY WORDS: Benign tumor, parotid tissue, preparation of the facial nerve, facial aesthetic defect
REFERENCES
1. Maria R. Bokhari; Joshua Greene. Pleomorphic Adenoma. NML, Bookshelf ID: NBK430829PMID: 28613579
2. Shalley S, Chand N, Aggarwal A, Garg LN, Yadav V, Yadav A. Diagnostic Accuracy of Fine Needle Aspiration Cytology in Lesions of Oral Cavity and Salivary Glands: A Clinico-Pathological Study. Open Dent J. 2018;12:782-790.
3. Spiro RH. Diagnosis and pitfalls in the treatment of parotid tumors. Semin Surg Oncol; 7:20-41991.
4. Tucker, A.S & Mietich, I.Q. (2010). Salivary Glands, Development, Adaptations and Disease. Karger AG, Basel.
5. Magnano M. et al. Treatment of malignant neoplasms of the parotid gland. Otolaryngol Head Neck Surg Nov; 121 (5):627-32, 1999.
6. Shanwen Chen1 , Mei Zhao2 , Dong Wang1, Yi Zhao1, Jianxin Qiu1, Yehai Liu1* Endoscopic and Robotic Parotidectomy for the Treatment of Parotid Tumors: A Systematic Review and Meta-Analysis. Front. Oncol., 10 November 2021, Sec. Surgical Oncology, Volume 11 – 2021.
7. Infante-Cossio P, Gonzalez-Cardero E, Garcia-Perla-Garcia A, Montes-Latorre E, Gutierrez-Perez JL, Prats-Golczer VE. Complications after superficial parotidectomy for pleomorphic adenoma. Med Oral Patol Oral Cir Bucal. 2018 Jul 01;23(4):e485-e492
8. Germano Guerra a 1, Domenico Testa b 1, Stefania Montagnani c, Domenico Tafuri d, Francesco Antonio Salzano e, Aldo Rocca f, Bruno Amato f, Giovanni Salzano g, Giovanni Dell’Aversana Orabona g, Pasquale Piombino b, Gaetano Mottab. Surgical management of pleomorphic adenoma of parotid gland in elderly patients: Role of morphological features. International Journal of Surgery, Volume 12, Supplement 2, October 2014, Pages S12-S16.
9. Caitlin P. McMullen, MD, Richard V. Smith, MD, Bradley A. Schiff, MD. Minimal Margin Extracapsular Dissection: A Viable Alternative Technique for Benign Parotid Lesions? Annals of Otology, Rhinology & Laryngology. Volume 125, Issue 11.
10. Nikolaos Papadogeorgakis. Partial superficial parotidectomy as the method of choice for treating pleomorphic adenomas of the parotid gland. BrJ Oral Maxillofac Surg. 2011 Sep;49(6): 447-50.doi: 10.1016/j.bjoms.2010.06.012. Epub 2010 Jul 16.
11. José Moreno, Pauline Morgan, Jessica Zeballos, Cristian Matamoros, Christopher Reyes. Extracapsular dissection and minimally invasive procedures of primary benign parotid tumours: Case series. Int. j interdiscip. dent. vol.15 no.3 Santiago dic. 2022
12. Jennifer R. Cracchiolo, MD and Ashok R. Shaha, MD. PAROTIDECTOMY FOR PAROTID CANCER. Otolaryngol Clin North Am. 2016 Apr; 49(2): 415–424. Published online 2016 Feb 17. doi: 10.1016/j.otc.2015.10.007
13. Chen W, Li J, Yang Z, et al. SMAS fold flap and ADM repair of the parotid bed following removal of parotid haemangiomas via pre- and retroauricular incisions to improve cosmetic outcome and prevent Frey’s syndrome. J Plast Reconstr Aesthet Surg. 2008;61:894–899; discussion 899–900
14. 11. Appiani E, Delfino MC. Plastic incisions for facial and neck tumors. Ann Plast Surg. 1984;13:335–352
15. Curry JM, King N, Reiter D, et al. Meta-analysis of surgical techniques for preventing parotidectomy sequelae. Arch Facial Plast Surg. 2009;11:327–331.
16. Loyo M, Gourin CG. Free abdominal fat transfer for partial and total parotidectomy defect reconstruction. Laryngoscope (United States). 2016;126:p2694–2698
17. Kiya Movassaghi, MD, DMD,† Matthew Lewis, MD, MS,* Farooq Shahzad, MBBS, FACS,* and James W. May, Jr., MD. Optimizing the Aesthetic Result of Parotidectomy with a Facelift Incision and Temporoparietal Fascia Flap. Plast Reconstr Surg Glob Open. 2019 Feb; 7(2): e2067.
18. Pierre G. Vico,1Axel Delange,1and Axel De Vooght1 Autologous Fat Transfer: An Aesthetic and Functional Refinement for Parotidectomy. Surgery Research and Practice. Volume 2014 | Article ID 873453
19. A. D. Kornblut, P. Westphal, and A. Miehlke, “The effectiveness of a sternomastoid muscle flap in preventing post parotidectomy occurrence of the Frey syndrome,” Acta Oto-Laryngologica, vol. 77, no. 5, pp. 368–373, 1974.
20. J. D. Casler and J. Conley, “Sternocleidomastoid muscle transfer and superficial musculoaponeurotic system plication in the prevention of Frey’s syndrome,” Laryngoscope, vol. 101, no. 1, pp. 95–100, 1991.
21. L. Cesteleyn, J. Helman, S. King, and G. Van De Vyvere, “Temporoparietal fascia flaps and superficial musculoaponeurotic system plication in parotid surgery reduces Frey’s syndrome,” Journal of Oral and Maxillofacial Surgery, vol. 60, no. 11, pp. 1284–1297, 2002.
St Lukes Hospital, Thessaloniki, Greece
DOI: 10.54936/haoms254349
Abstract:
Tumors in the parotid gland, which is the largest salivary gland, could appear as a swelling in the cheek area or in the area in front of and below the earlobe. The majority are benign tumors. In all cases, removal of the tumor by parotidectomy is the main option. In the majority of these operations, postoperatively a defect remains in the lateral region of the face after the removal of the tumor. Many solutions have been proposed internationally to treatment this aesthetic defect. In this study, a proposal is presented to use part of the remaining parotid tissue, to restore the defect that appears after the removal of the tumor and the preparation of the facial nerve.
KEY WORDS: Benign tumor, parotid tissue, preparation of the facial nerve, facial aesthetic defect
REFERENCES
1. Maria R. Bokhari; Joshua Greene. Pleomorphic Adenoma. NML, Bookshelf ID: NBK430829PMID: 28613579
2. Shalley S, Chand N, Aggarwal A, Garg LN, Yadav V, Yadav A. Diagnostic Accuracy of Fine Needle Aspiration Cytology in Lesions of Oral Cavity and Salivary Glands: A Clinico-Pathological Study. Open Dent J. 2018;12:782-790.
3. Spiro RH. Diagnosis and pitfalls in the treatment of parotid tumors. Semin Surg Oncol; 7:20-41991.
4. Tucker, A.S & Mietich, I.Q. (2010). Salivary Glands, Development, Adaptations and Disease. Karger AG, Basel.
5. Magnano M. et al. Treatment of malignant neoplasms of the parotid gland. Otolaryngol Head Neck Surg Nov; 121 (5):627-32, 1999.
6. Shanwen Chen1 , Mei Zhao2 , Dong Wang1, Yi Zhao1, Jianxin Qiu1, Yehai Liu1* Endoscopic and Robotic Parotidectomy for the Treatment of Parotid Tumors: A Systematic Review and Meta-Analysis. Front. Oncol., 10 November 2021, Sec. Surgical Oncology, Volume 11 – 2021.
7. Infante-Cossio P, Gonzalez-Cardero E, Garcia-Perla-Garcia A, Montes-Latorre E, Gutierrez-Perez JL, Prats-Golczer VE. Complications after superficial parotidectomy for pleomorphic adenoma. Med Oral Patol Oral Cir Bucal. 2018 Jul 01;23(4):e485-e492
8. Germano Guerra a 1, Domenico Testa b 1, Stefania Montagnani c, Domenico Tafuri d, Francesco Antonio Salzano e, Aldo Rocca f, Bruno Amato f, Giovanni Salzano g, Giovanni Dell’Aversana Orabona g, Pasquale Piombino b, Gaetano Mottab. Surgical management of pleomorphic adenoma of parotid gland in elderly patients: Role of morphological features. International Journal of Surgery, Volume 12, Supplement 2, October 2014, Pages S12-S16.
9. Caitlin P. McMullen, MD, Richard V. Smith, MD, Bradley A. Schiff, MD. Minimal Margin Extracapsular Dissection: A Viable Alternative Technique for Benign Parotid Lesions? Annals of Otology, Rhinology & Laryngology. Volume 125, Issue 11.
10. Nikolaos Papadogeorgakis. Partial superficial parotidectomy as the method of choice for treating pleomorphic adenomas of the parotid gland. BrJ Oral Maxillofac Surg. 2011 Sep;49(6): 447-50.doi: 10.1016/j.bjoms.2010.06.012. Epub 2010 Jul 16.
11. José Moreno, Pauline Morgan, Jessica Zeballos, Cristian Matamoros, Christopher Reyes. Extracapsular dissection and minimally invasive procedures of primary benign parotid tumours: Case series. Int. j interdiscip. dent. vol.15 no.3 Santiago dic. 2022
12. Jennifer R. Cracchiolo, MD and Ashok R. Shaha, MD. PAROTIDECTOMY FOR PAROTID CANCER. Otolaryngol Clin North Am. 2016 Apr; 49(2): 415–424. Published online 2016 Feb 17. doi: 10.1016/j.otc.2015.10.007
13. Chen W, Li J, Yang Z, et al. SMAS fold flap and ADM repair of the parotid bed following removal of parotid haemangiomas via pre- and retroauricular incisions to improve cosmetic outcome and prevent Frey’s syndrome. J Plast Reconstr Aesthet Surg. 2008;61:894–899; discussion 899–900
14. 11. Appiani E, Delfino MC. Plastic incisions for facial and neck tumors. Ann Plast Surg. 1984;13:335–352
15. Curry JM, King N, Reiter D, et al. Meta-analysis of surgical techniques for preventing parotidectomy sequelae. Arch Facial Plast Surg. 2009;11:327–331.
16. Loyo M, Gourin CG. Free abdominal fat transfer for partial and total parotidectomy defect reconstruction. Laryngoscope (United States). 2016;126:p2694–2698
17. Kiya Movassaghi, MD, DMD,† Matthew Lewis, MD, MS,* Farooq Shahzad, MBBS, FACS,* and James W. May, Jr., MD. Optimizing the Aesthetic Result of Parotidectomy with a Facelift Incision and Temporoparietal Fascia Flap. Plast Reconstr Surg Glob Open. 2019 Feb; 7(2): e2067.
18. Pierre G. Vico,1Axel Delange,1and Axel De Vooght1 Autologous Fat Transfer: An Aesthetic and Functional Refinement for Parotidectomy. Surgery Research and Practice. Volume 2014 | Article ID 873453
19. A. D. Kornblut, P. Westphal, and A. Miehlke, “The effectiveness of a sternomastoid muscle flap in preventing post parotidectomy occurrence of the Frey syndrome,” Acta Oto-Laryngologica, vol. 77, no. 5, pp. 368–373, 1974.
20. J. D. Casler and J. Conley, “Sternocleidomastoid muscle transfer and superficial musculoaponeurotic system plication in the prevention of Frey’s syndrome,” Laryngoscope, vol. 101, no. 1, pp. 95–100, 1991.
21. L. Cesteleyn, J. Helman, S. King, and G. Van De Vyvere, “Temporoparietal fascia flaps and superficial musculoaponeurotic system plication in parotid surgery reduces Frey’s syndrome,” Journal of Oral and Maxillofacial Surgery, vol. 60, no. 11, pp. 1284–1297, 2002.
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