Management of the facial nerve in parotid cancer: preservation or resection and reconstruction
Por:
Guntinas-Lichius, O, Silver, CE, Thielker, J, Bernal-Sprekelsen, M, Bradford, CR, De Bree, R, Kowalski, LP, Olsen, KD, Quer, M, Rinaldo, A, Rodrigo, JR, Sanabria, A, Shaha, AR, Takes, RP, Poorten, VV, Zbaren, P, Ferlito, A
Publicada:
1 nov 2018
Resumen:
PurposeManagement of the facial nerve is instrumental in the surgical treatment of parotid cancer.MethodsA 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.ResultsIn 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.ConclusionsThe 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.
Filiaciones:
Guntinas-Lichius, O:
Jena Univ Hosp, Inst Phoniatry Pedaudiol, Dept Otorhinolaryngol, Klinikum 1, D-07747 Jena, Germany
Jena Univ Hosp, Facial Nerve Ctr, Jena, Germany
European Salivary Gland Soc, Geneva, Switzerland
Silver, CE:
Univ Arizona, Coll Med, Dept Surg, Phoenix, AZ USA
Thielker, J:
Jena Univ Hosp, Inst Phoniatry Pedaudiol, Dept Otorhinolaryngol, Klinikum 1, D-07747 Jena, Germany
Jena Univ Hosp, Facial Nerve Ctr, Jena, Germany
Bernal-Sprekelsen, M:
Univ Barcelona, Hosp Clin, Serv ORL, Barcelona, Spain
Bradford, CR:
Univ Michigan, Dept Otolaryngol, Ann Arbor, MI 48109 USA
De Bree, R:
Univ Med Ctr Utrecht, Dept Head & Neck Surg Oncol, UMC Utrecht Canc Ctr, Utrecht, Netherlands
Kowalski, LP:
AC Camargo Canc Ctr, Dept Head & Neck Surg & Otorhinolaryngol, Sao Paulo, Brazil
Olsen, KD:
Mayo Clin, Dept Otorhinolaryngol, Rochester, MN USA
Quer, M:
European Salivary Gland Soc, Geneva, Switzerland
Hosp Santa Creu & Sant Pau, Dept Otolaryngol, Barcelona, Spain
Rinaldo, A:
Univ Udine, Sch Med, Udine, Italy
Rodrigo, JR:
Hosp Univ Cent Asturias, Dept Otolaryngol, Oviedo, Spain
Inst Univ Oncol Principado Asturias, CIBERONC, Oviedo, Spain
Sanabria, A:
Univ Antioquia, Sch Med, Dept Surg, Clin Vida, Medellin, Colombia
Shaha, AR:
Mem Sloan Kettering Canc Ctr, Head & Neck Serv, 1275 York Ave, New York, NY 10021 USA
Takes, RP:
Radboud Univ Nijmegen, Dept Otolaryngol Head & Neck Surg, Med Ctr, Nijmegen, Netherlands
Poorten, VV:
European Salivary Gland Soc, Geneva, Switzerland
Katholieke Univ Leuven, Univ Hosp Leuven, Otorhinolaryngol Head & Neck Surg, Leuven, Belgium
Katholieke Univ Leuven, Univ Hosp Leuven, Dept Oncol, Sect Head & Neck Oncol, Leuven, Belgium
Zbaren, P:
Univ Hosp, Dept Otorhinolaryngol Head & Neck Surg, Bern, Switzerland
Ferlito, A:
Int Head & Neck Sci Grp, Padua, Italy
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