Sternocleidomastoid Flap in Parotid Surgery: A Case Series

AbstractSuperficial and deep parotidectomies are known treatments for benign and malignant neoplasms of parotid glands. Due to the gland ’s proximity to facial nerve and other vital structures, this surgery carries the highest risk of facial nerve palsy. Another frequently overlooked complication, which can be detrimental to patient’s life style is Frey’s syndrome, or gustatory sweating. Other complications include flap necrosi s and various contour deformities. We conducted this study on a group of 40 patients of parotid swellings to assess usage of sternocleidomastoid flap in prevention of Frey’s syndrome, contour deformities, flap necrosis, salivary fistula and drain related injuries. We divided the patients in two gr oups based on the usage of sternomastoid flap. In Group A, the patients underwent superficial or total parotidectomies with a partial thickness, superiorly based sternomastoid flap. In Group B, no sternomastoid flap was placed. The incidence of Frey’s syndrome was seen to be 3 times in Group B, wh ile a visible contour deformity was seen in a third of patients in Group B, with Group A reporting no incidence. Also Group A, did not see any cases of flap necrosis or salivary fistula, while Group B saw 3 and 2 cases respectively. Also, among the two revision cases done in Group A, the one with pr eviously placed sternomastoid flap (done by us 3 years back) had an excellent plane preserved, while another revision case without ste...
Source: Indian Journal of Otolaryngology and Head and Neck Surgery - Category: ENT & OMF Source Type: research

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Cross-facial nerve graft is considered the treatment of choice for facial reanimation in patients with unilateral facial palsy caused by central facial nerve damage. In most cases, a traditional parotidectomy ...
Source: Maxillofacial Plastic and Reconstructive Surgery - Category: ENT & OMF Authors: Tags: Methodology Source Type: research
ConclusionsPartial parotidectomy adopting a retrograde nerve dissection under LA is feasible and minimally invasive in treating benign parotid tumors. It can avoid the adverse effects of general anesthesia and promote day surgery or minimize hospital stay.
Source: American Journal of Otolaryngology - Category: Endocrinology Source Type: research
Conclusions Partial parotidectomy adopting a retrograde nerve dissection under LA is feasible and minimally invasive in treating benign parotid tumors. It can avoid the adverse effects of general anesthesia and promote day surgery or minimize hospital stay.
Source: American Journal of Otolaryngology - Category: Endocrinology Source Type: research
Authors: Carta F, Chuchueva N, Gerosa C, Sionis S, Caria RA, Puxeddu R Abstract Temporary and permanent facial nerve dysfunctions can be observed after parotidectomy for benign and malignant lesions. Intraoperative nerve monitoring is a recognised tool for the preservation of the nerve, while the efficacy of the operative microscope has been rarely stated. The authors report their experience on 198 consecutive parotidectomies performed on 196 patients with the aid of the operative microscope and intraoperative nerve monitoring. 145 parotidectomies were performed for benign lesions and 53 for malignancies. Thirteen ...
Source: Acta Otorhinolaryngologica Italica - Category: ENT & OMF Tags: Acta Otorhinolaryngol Ital Source Type: research
ConclusionAlthough outcomes using the vastus lateralis free flap for midface reanimation need to be objectively determined, the flap adds the potential of dynamic midface movement in patients undergoing radical parotidectomy who would otherwise not be afforded this opportunity. © 2017 Wiley Periodicals, Inc. Head Neck, 2017
Source: Head and Neck - Category: ENT & OMF Authors: Tags: Operative Techniques Source Type: research
Abstract BackgroundThe purpose of this study was to evaluate the clinical outcome in patients with benign parotid gland tumors after extracapsular dissection or superficial parotidectomy (SP). MethodsEight hundred ninety‐four patients with primary pleomorphic adenoma or Warthin's tumor were included from this study. Type and length of surgery, tumor size, resection margins, and complication rates were assessed. ResultsThree hundred ninety‐five (44.2%) extracapsular dissections and 499 SPs (55.8%) were performed. The rate of positive margins was significantly higher in the extracapsular dissection compared to the SP gro...
Source: Head and Neck - Category: ENT & OMF Authors: Tags: Original Article Source Type: research
Abstract We conducted a retrospective review to assess the clinical presentation of patients with tumor-related nonacute complete peripheral facial weakness or an incomplete partial facial paresis and to provide an algorithm for the evaluation and management of these patients. Our study population was made up of 221 patients-131 females and 90 males, aged 14 to 79 years (mean: 49.7)-who had been referred to the Facial Nerve Disorders Clinic at our tertiary care academic medical center over a 23-year period with a documented neoplastic cause of facial paralysis. In addition to demographic data, we compiled informat...
Source: Ear, Nose and Throat Journal - Category: ENT & OMF Authors: Tags: Ear Nose Throat J Source Type: research
ConclusionDepending on the operation type, up to half of the patients experience facial palsy after benign parotid surgery. Higher age and longer duration of operation increase the risk. The role of operative instrumentation requires further studies. © 2016 Wiley Periodicals, Inc. Head Neck, 2016
Source: Head and Neck - Category: ENT & OMF Authors: Tags: Clinical Review Source Type: research
Conclusion PG surgery provides sufficient radicality with a minimum of functional loss. Patient's outcome is associated with the reliable estimation of the lesional entity/dignity. Diagnostic approaches are required to determine morphological aspects, avoid unnecessary surgery, and to reliable identify primary carcinomas/occult metastases. Objectives The pre-operative assessment of parotid gland (PG) lesions is of major clinical impact, whilst surgery remains the diagnostic/therapeutic mainstay. There are still controversies about the distribution of entities, clinical course, functional outcome, and survival. Methods In t...
Source: Acta Oto-Laryngologica - Category: ENT & OMF Authors: Tags: Acta Otolaryngol Source Type: research
Conclusion Tumors with 3.0cm or more in length and/or 2.0cm or more in depth have a significant higher risk of facial nerve injury. Secondary surgery to recurrent tumors also has a much higher risk of evolving with facial palsy after superficial parotidectomy.
Source: Brazilian Journal of Otorhinolaryngology - Category: ENT & OMF Source Type: research
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