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Eur Arch Otorhinolaryngol. 2018 Nov;275(11):2615-2626. doi: 10.1007/s00405-018-5154-6. Epub 2018 Sep 28.

Management of the facial nerve in parotid cancer: preservation or resection and reconstruction.

Author information

1
Department of Otorhinolaryngology, Institute of Phoniatry/Pedaudiology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany. orlando.guntinas@med.uni-jena.de.
2
Facial Nerve Center, Jena University Hospital, Jena, Germany. orlando.guntinas@med.uni-jena.de.
3
European Salivary Gland Society, Geneva, Switzerland. orlando.guntinas@med.uni-jena.de.
4
Department of Surgery, University of Arizona College of Medicine, Phoenix, USA.
5
Department of Otorhinolaryngology, Institute of Phoniatry/Pedaudiology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.
6
Facial Nerve Center, Jena University Hospital, Jena, Germany.
7
Hospital Clinic, Servicio de ORL, University of Barcelona, Barcelona, Spain.
8
Department of Otolaryngology, University of Michigan, Ann Arbor, USA.
9
Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands.
10
Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, São Paulo, Brazil.
11
Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN, USA.
12
European Salivary Gland Society, Geneva, Switzerland.
13
Department of Otolaryngology, Hospital Santa Creu i Sant Pau, Barcelona, Spain.
14
University of Udine School of Medicine, Udine, Italy.
15
Department of Otolaryngology, Hospital Universitario Central de Asturias and Instituto Universitario de Oncología del Principado de Asturias, CIBERONC, Oviedo, Spain.
16
Department of Surgery, School of Medicine, Clinica Vida, Universidad de Antioquia, Medellín, Colombia.
17
Head and Neck Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
18
Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
19
Otorhinolaryngology-Head and Neck Surgery and Department of Oncology, section Head and Neck Oncology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
20
Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital, Berne, Switzerland.
21
Coordinator of the International Head and Neck Scientific Group, Padua, Italy.

Abstract

PURPOSE:

Management of the facial nerve is instrumental in the surgical treatment of parotid cancer.

METHODS:

A literature search was conducted using PubMed and ScienceDirect database. A total of 195 articles were finally included into the analysis, based on relevance, scientific evidence and actuality.

RESULTS:

In the majority of cases the facial nerve is not involved by tumor. In these cases, identification and preservation of the nerve, in addition to complete tumor removal, are essential for successful surgery. When the nerve is infiltrated by tumor, the affected portion of the nerve must be resected as part of radical parotidectomy. Primary nerve reconstruction or other reanimation techniques give the best long-term functional and cosmetic results. A comprehensive diagnostic evaluation with current imaging and electrophysiological studies will provide the surgeon with the best knowledge of the relationship of the facial nerve to the tumor. Several standardized methods are helpful in finding, dissecting and preserving the nerve during parotid cancer surgery. When radical parotidectomy is indicated, the initial diagnostic work-up can assist in defining the need for adjuvant postoperative therapy and facial reanimation. The aim of rehabilitation is to restore tone, symmetry, and movement to the paralyzed face.

CONCLUSIONS:

The surgical management of facial paralysis has undergone many improvements in recent years. This review gives an overview of recent advances in the diagnostic work-up, surgical techniques and any necessary rehabilitation of the facial nerve in parotid cancer surgery.

KEYWORDS:

Facial nerve; Facial nerve preservation; Facial nerve reconstruction; Facial nerve sacrifice; Parotid cancer; Parotid tumor; Parotidectomy

PMID:
30267218
DOI:
10.1007/s00405-018-5154-6
[Indexed for MEDLINE]

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