Benign tumours affecting the deep lobe of the parotid gland: how to select the optimal surgical approach.

Benign tumours affecting the deep lobe of the parotid gland: how to select the optimal surgical approach. Acta Otorhinolaryngol Ital. 2015 Apr;35(2):80-7 Authors: Casani AP, Cerchiai N, Dallan I, Seccia V, Sellari Franceschini S Abstract Many types of approaches allow extra-capsular dissection in the deep parotid parenchyma in the treatment of benign tumours. A transcervical approach (TCA), transparotid approach (TPA) and a combined transcervical-transparotid approach (TPTCA) are the three main procedures performed to expose the deep parenchyma. We conducted a retrospective chart review enrolling 24 consecutive patients treated for benign tumours affecting the deep lobe of the parotid. Review of the surgical data was accompanied by careful follow-up to establish surgical morbidity, functional (Frey's Syndrome and first-bite syndrome) and aesthetical outcomes. A TPA was performed in the majority of cases; in 26% superficial parotidectomy was not required (selective deep parotidectomy). Minor's test showed a low rate of Frey's syndrome (3 cases of 23, 13%). No long-lasting first-bite syndrome was reported. Some additional procedures were easily performed in order to improve aesthetical results (rotational flap of sternocleidomastoid muscle, free abdominal fat transfer); these had the same results as selective deep parotidectomy. TCA (or TPTCA) ensures the best control of the facial nerve, providing good exposure and good functional and...
Source: Acta Otorhinolaryngologica Italica - Category: ENT & OMF Tags: Acta Otorhinolaryngol Ital Source Type: research