Abstract
Posttherapeutic courses of 18 fresh cases of parotid cancer were analyzed. 5 year cumulative and crude survival rate were 56.7% and 63.6%, respectively and 10 year cumulative survival rate was 45.4%. The most frequent causes of death were distant metastasis and local recurrence. Prognosis of the cases with facial nerve paralysis and/or cerviacl lymph node metastasis was remarkably poor. Depending upon histopathological type and extension of the tumor, postoperative radiotherapy combined with chemotherapy was assumed mandatory.
Cosmetic and functional results were evaluated in 8 cases in which postoperative defects after extended total parotidectomy were reconstructed with cervical flap, DP flap, pectoralis major mc flap (PMMC), free rectus abdominis mc flap (RAMC) and free rectus abdominis muscle flap (RAM). Merits and demerits of each flap were as follows. DP flap is superior in color match but is inadequate to fill up the large and deep wound. PMMC is useful in filling up the deep defect and its color match is fair. The demerit is the secondary atrophy of the muscle, the degree of which is unpredictable. RAMC is superior in filling up the deep defect. However it is poor in color match. RAM is the first choice in female subjects who had extended total parotidectomy leaving the facial skin intact. Muscle flap can fill up the large defect adequately and regeneration of the grafted nerve may possibly be facilitated by covering the nerve with richly vascularized muscle.
