A case series of superficial parotidectomy under local anesthesia

Abstract

Superficial parotidectomy is the biopsy procedure of choice for all parotid neoplasm's as well as therapeutic choice for small low-grade malignancies. The key to successful parotid surgery is identification of the facial nerve. It is usually done under general anesthesia (GA).The main focus in this procedure is to remove entire superficial parotid gland along with a disease and at the same time preventing any iatrogenic injury to facial nerve and its peripheral branches which supplies over the face. We present three cases of superficial parotidectomies done under local anesthesia technique. The objectives of these reports are to discuss the clinical presentation, diagnosis and management of these growths surgically under local as an alternative method or when it is desired under some special circumstances and the merits. This technique may avoid the use of facial nerve monitor.

Parotidectomy under sedation and locoregional anesthesia with monitoring of brain activity

“…These authors did not have any cases of conversion to general anesthesia, and 2 patients exhibited postoperative facial nerve paresia but recovered completely. Finally, in 2015, Singh et al reported on 3 patients with high anesthetic risks for whom continuous anesthesia with catheters located at the maxillary and mandibular nerves was administered; these authors achieved good outcomes.…”

Retrograde parotidectomy under local anesthesia for benign, malignant, and inflammatory lesions

“…By and large, this procedure is performed under general anesthesia, which facilitates facial nerve monitoring and allows for more meticulous dissection in the immobile, anesthetized subject. However, the majority of parotid tumors occur during the sixth and seventh decade of life [9], which increases the likelihood that accumulated medical comorbidities may present a very high risk of undergoing general anesthesia. Surgery remains the most effective treatment for salivary malignancies with improved cure rates by the addition of adjuvant radiotherapy for high grade carcinomas.…”

“…In cases of malignancy, surgical excision is key to achieving better locoregional control, disease-free survival, and overall survival compared to nonsurgical treatments such as radiation [1]. Parotidectomy under local anesthesia is a treatment option that has been reported in other countries for a wide variety of indications [2][3][4][5][6][7][8][9]. We report our series of six patients undergoing parotidectomy under local anesthesia, which is the largest series reported in the United States to date.…”

Superficial parotidectomy under local anesthesia, case report

“…Local or regional anesthesia can be used to preserve facial nerve. Under LA, patient complaints of pain and discomfort if dissection involves facial nerve sheath or its peripheral branches thus helping in its identification and prevention of iatrogenic nerve injury [1].…”

“…The surgical management is individualized due to wide variability in the clinical behavior and presentation and influenced by tumor location, histological grade, extent, and spread. The surgical management includes superficial parotidectomy, total conservative parotidectomy, and radical parotidectomy, palliative biopsy only, and neck dissection [1].…”