Treatment of locally advanced parotid malignancies with parotidectomy and temporal bone resection

Martin, James R.; Filip, P.; Thorpe, Eric; Leonetti, John

doi:10.1016/j.amjoto.2017.03.005

Cited by 11 publications

(8 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…10 Many patients who overcome their disease are demanding smile restoration after longstanding paralysis, as well as facial and neck contour improvements. 11 Several techniques to restore the motion of a paralyzed face have been described, [12][13][14][15][16] and it is currently accepted that the optimal smile reconstruction should focus on early surgery 17,18 and in the recovery of the damaged facial nerve whenever possible. Unfortunately, primary neurorrhaphy or interposition grafting is not always feasible, and it is only useful when the proximal and distal portions of the facial nerve are available.…”

Section: Discussionmentioning

confidence: 99%

Salvage Procedures for Facial Reanimation With Neurovascular Flaps When Previous Surgeries Failed

Ibarra

Lasso

2022

Ann Plast Surg

View full text Add to dashboard Cite

Background: Facial paralysis reconstruction can be difficult in extensive defects after complex facial or cranial base tumor resection and radiotherapy or when primary smile reanimation attempt has failed. The surgical challenge is more complicated when defects are associated with recipient vessels or nerves depletion. This scenario has not been well described in the literature, and the present article will address the alternatives that plastic surgeons may use in these circumstances. Methods: Seventy-five patients operated in the Hospital Gregorio Marañon between 2008 and 2020, for dynamic reconstruction of facial paralysis, were retrospectively evaluated, collecting data about previous facial nerve surgeries, radiotherapy, chemotherapy, recipient nerve for motor restoration and vessels used for free flaps, type of neurovascular free flap (NVFF), and functional score before and after the facial reanimation surgery. Patients presenting recipient vessel and/or nerve depletion after several facial surgeries requiring a variation from the common NVFF surgical protocol were included in this study. Results: Six cases (8%) with facial paralysis and absent recipient homolateral vessels or nerves after severe cranial base surgery, parotid malignancies, or schwannoma surgery were included. Two patients had an immediate functional reconstruction during the oncologic resection surgery, and 4 patients had a delayed reconstruction. Three patients had previous reconstruction with free flaps, and the vascular pedicles of previous flaps were used for the new NVFF. In the other 3 cases, interposition vein grafts to the contralateral recipient vessels were required to perform NVFF. Masseteric nerve in 4 cases, hypoglossal nerve and posterior branch of the deep temporal nerve in 1 case each, were used as recipient nerves. House-Brackmann score improved in all patients after surgery. Conclusions: Neurovascular free flap can be successfully performed to restore facial motion after depletion of homolateral recipient vessels or nerves after previous facial or cranial base surgeries. In these cases, interposition vascular grafts or the pedicle of previous flaps are essential to provide vascularization as well as an optimal orientation of flaps, to reach recipient nerves in a 1-step procedure.

show abstract

Section: Discussionmentioning

confidence: 99%

Salvage Procedures for Facial Reanimation With Neurovascular Flaps When Previous Surgeries Failed

Ibarra

Lasso

2022

Ann Plast Surg

View full text Add to dashboard Cite

show abstract

“…Management of the facial nerve for parotid surgery has been discussed extensively [8,[16][17][18]. A multidisciplinary approach is the gold standard which is in place at our center.…”

Section: Discussionmentioning

confidence: 99%

Facial Nerve Involvement During Temporal Bone Resection: Overall Survival And Locoregional Recurrence Outcomes.

Gendre¹,

Jones²,

McHugh³

et al. 2022

Preprint

View full text Add to dashboard Cite

Purpose: Facial nerve resection is often required in lateral temporal bone resection for tumors extending to the lateral skull base. Limited data exists to guide facial nerve reanimation strategies. Methods: This is a retrospective cohort study. Patients undergoing lateral temporal bone resection in a national referral center were included and divided into two groups: facial nerve preservation or resection. Survival and locoregional recurrence outcomes were analyzed by Kaplan-Meier survival analysis. Prognostic factors were identified using univariate and multivariate analysis. Facial nerve reconstructive methods were collected.Results: 39 patients were included with 20 having facial nerve resection at surgery. Squamous cell carcinoma (SCC) was the most common pathology. 48% of patients died during follow-up. Mean overall survival (OS) was 27 months and mean time to locoregional recurrence (LRR) 23 months in the facial nerve preservation group. Mean OS was 16 months and mean time to LRR was 13 months in the facial nerve resection groups (logrank OS p=0.330 and LRR p=0.445). 75% of patients in the facial nerve resection group had static facial nerve reanimation using tarsorrhaphy, gold-weight eyelid implant and fascia lata sling. Middle ear cavity extension was a negative predictor of OS and LRR.Conclusion: Facial nerve resection during lateral temporal bone surgery is associated with poor overall survival and locoregional control outcomes. Multidisciplinary surgical management and static facial reanimation should be offered to maintain function and quality of life in this group of patients.

show abstract

“…This compares to Martin et al's finding of positive margins in 6 out of 15, or 40%, patients who had parotidectomy with TBR. 25 The advanced nature of parotid malignancies requiring TBR may explain the greater likelihood of positive surgical margins and therefore the need for postoperative chemotherapy or radiotherapy. In fact, NCCN guidelines for treatment of salivary gland tumors (version 3.2019) recommend postoperative radiotherapy for all advanced malignancies with close or positive margins after resection or other adverse features such as high grade or stage.…”

Section: Discussionmentioning

confidence: 99%

Factors and Outcomes Associated With Temporal Bone Resection for Primary Parotid Malignancy

et al. 2021

View full text Add to dashboard Cite

Although parotid cancer invading into the temporal bone makes up only a small fraction of all parotid cancers, it is more common and relatively understudied compared with primary cancer of the external auditory canal. The objective of this study was to determine what factors are associated with receiving parotidectomy with temporal bone resection (TBR) and the immediate postoperative outcomes.Methods: We reviewed the National Cancer Database (2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015) for patients with primary parotid malignancy who received parotidectomy with or without TBR. Patient demographic, clinical, and perioperative variables were collected and then compared. Multivariate logistic regression was performed to determine factors associated with receiving TBR.Results: We identified 134 patients who received parotidectomy with TBR and 16,595 who received parotidectomy only. Reported in terms of odds ratios (95% confidence interval), our multivariate model showed having surgery at an academic facility (1.91 [1.34-2.71],

show abstract

Treatment of locally advanced parotid malignancies with parotidectomy and temporal bone resection

Cited by 11 publications

References 9 publications

Salvage Procedures for Facial Reanimation With Neurovascular Flaps When Previous Surgeries Failed

Salvage Procedures for Facial Reanimation With Neurovascular Flaps When Previous Surgeries Failed

Facial Nerve Involvement During Temporal Bone Resection: Overall Survival And Locoregional Recurrence Outcomes.

Factors and Outcomes Associated With Temporal Bone Resection for Primary Parotid Malignancy

Contact Info

Product

Resources

About