Parotid Gland Tumors and the Facial Nerve

Gandolfi, Michele M.; Slattery, William H.

doi:10.1016/j.otc.2015.12.001

Cited by 32 publications

(22 citation statements)

References 16 publications

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“…Parotidectomy in children is a relatively uncommon procedure at most centers . More than 80% of Parotid surgeries are performed for benign inflammatory disease or masses of the parotid gland . At our institution, we perform a high volume of parotidectomy in children.…”

Section: Discussionmentioning

confidence: 99%

“…It then enters the parotid gland as the main trunk of the facial nerve dividing the gland into superficial and deep lobes. In the proximal 20% of the parotid, it divides into superior and lower divisions at the pes anserinus . Topographical analyses have found that several structures can serve as reliable surgical landmarks for identification and preservation of the nerve including the tragal pointer, posterior belly of digastric muscle, and tympanomastoid suture .…”

Section: Discussionmentioning

confidence: 99%

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Displacement of the Facial Nerve by Deep Parotid Lobe Lesions in the Pediatric Population

Maddalozzo

Johnston

Isaac

et al. 2019

Laryngoscope Investig Oto

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Objectives To describe and investigate facial nerve displacement in deep lobe parotid lesions in children and to determine clinical and radiographic predictors of abnormal facial nerve position. Methods Retrospective case review of children who underwent total parotidectomy for deep lobe parotid lesions at a tertiary care center between January 2014 and December 2017. Aberrant facial nerve trajectory was defined as ascension of the nerve at an angle of 45° or greater. Elongation was defined as the main trunk >2 cm in length. Patient demographics, radiographic, pathologic results, postoperative nerve weakness, and intraoperative nerve findings were collected. Wilcoxon rank‐sum test and Fisher's exact test were used to assess the associations between variables of interest and facial nerve position. Results A total of 20 patients were included. The mean age was 7.7 ± 5 years. The most common pathologies were lymphatic malformation, pleomorphic adenoma, and first branchial cleft cyst. Twelve out of twenty (60.0%) patients had abnormal intraoperative facial nerve position. There was no significant difference in distribution of pathologies between those with or without an abnormal intraoperative nerve position (P = .41). Neither radiographic lesion size nor distance between the lesion and proximal portion of the facial nerve (mastoid tip) were associated with abnormal facial nerve position intraoperatively. Conclusion Pediatric deep lobe parotid lesions can displace the facial nerve and distort its anatomy in a posterior lateral direction, in approximately 60% of patients. Statistical analysis of increased numbers of patients to further define predictors of aberrant nerve course is warranted. Level of Evidence 4.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Displacement of the Facial Nerve by Deep Parotid Lobe Lesions in the Pediatric Population

Maddalozzo

Johnston

Isaac

et al. 2019

Laryngoscope Investig Oto

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“…Salivary gland tumours account for 3%-4% of all head and neck neoplasms. Of all the salivary gland neoplasms, tumours originating from the parotid gland are the most prevalent, comprising 70% of all salivary gland tumours [1]. Notably, the incidence of parotid tumour is between one and three cases per 100,000 every year, with a majority presenting in patients between the ages of 18 and 75 years [2].…”

Section: Introductionmentioning

confidence: 99%

Mucoepidermoid Carcinoma of the Parotid Gland Presenting as a Fungating Exophytic Mass: A Surgical Challenge Rooted in Extensive Nerve Encasement

Almas

Hussain

Ehtesham

et al. 2020

Cureus

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Parotid glands, which are predominantly composed of serous acini, are the largest salivary glands in the human body. Mucoepidermoid carcinoma (MEC) of the parotid gland is the most common parotid tumour that routinely presents as a painless, fixed mass below the ears. However, its presentation as a fungating mass remains exceedingly rare. Due to the intimate anatomical relationship between the parotid gland and the facial nerve, parotid malignancies can culminate in facial nerve palsy, posing an onerous surgical challenge. In this paper, we chronicle the case of a male who presented with a fungating/exophytic mass and facial nerve weakness. A superficial parotidectomy was performed, and the eventual histopathological workup divulged an advanced mucoepidermoid parotid carcinoma entirely encasing the marginal mandibular nerve. Consequently, the marginal mandibular nerve was sacrificed, alluding to the remarkable surgical challenge encountered. Clinically, this manifested as an impairment of the motor function in the patient's left lower lip.

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“…[11] The clinical features of parotid gland tumour consist of painless swelling, loss of the function of the cutaneous branches of the facial nerve, numbness or paraesthesia and tenderness in the region of the gland. [11][12][13] This article presents two case reports of patients that developed FBS preoperatively secondary to parotid gland carcinoma.…”

Section: Introductionmentioning

confidence: 99%

Pre-operative Occurrence of First Bite Syndrome in Two Cases of Parotid Gland Tumour

Nasir

Hussain

Jamshed³

2019

J Cancer Allied Spec

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Introduction: First bite syndrome (FBS) is a gustatory-evoked painful condition that is characterized by the onset of severe electric-shock like pain in the periauricular region. In the majority of patients, FBS develops post-operatively. However, in rare instances it may present in a preoperative setting. Case description: Two cases of FBS developing preoperatively secondary to parotid gland tumour are presented. The patients, 54 and 30 years old, presented with complaints of electric-shock like pain localized over the periauricular region. In each case the pain was triggered following first bite of the meal. In both cases, pain lasted for a few seconds and with subsequent bites subsided only to return at the beginning of next meal. Practical implications: Preoperative occurrence of FBS in the absence of a history of trauma or surgery should necessitate a thorough investigation and follow up for an underlying salivary gland tumour.

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Parotid Gland Tumors and the Facial Nerve

Cited by 32 publications

References 16 publications

Displacement of the Facial Nerve by Deep Parotid Lobe Lesions in the Pediatric Population

Displacement of the Facial Nerve by Deep Parotid Lobe Lesions in the Pediatric Population

Mucoepidermoid Carcinoma of the Parotid Gland Presenting as a Fungating Exophytic Mass: A Surgical Challenge Rooted in Extensive Nerve Encasement

Pre-operative Occurrence of First Bite Syndrome in Two Cases of Parotid Gland Tumour

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