Abstract
Total parotidectomy is a treatment option for radical surgery for patients with advanced parotid cancer. We have selected and used extended total parotidectomy with mastoidectomy followed by proximal resection of the facial nerve to obtain a sufficient safety margin for advanced cases. Here, we report the clinical features of 12 cases who have undergone this surgical procedure so far. There were 9 males and 3 females. Their tumors appeared at the right parotid in 6 cases and at the left parotid in 6 cases. The tumor originated from the parotid gland in all but one case, who had skin cancer in the parotid region. There were 3 salivary duct carcinomas, 2 mucoepidermoid carcinomas, 2 myoepithelial carcinomas, 2 carcinosarcomas, 1 acinic cell carcinoma, 1 adenoid cystic carcinoma and 1 squamous cell carcinoma. Five patients showed facial nerve palsy preoperatively. Two patients underwent lateral temporal resection with resection of the condylar process. Four patients underwent free flap reconstruction because of the defect of the skin. Seven patients underwent facial nerve reconstruction by nerve grafting and also 3 patients underwent static reconstruction of the facial nerve. One patient with carcinosarcoma died of disease due to lung and brain metastases, and another patient died due to lung metastasis. They showed no local recurrence and ten patients remain alive now. We think this surgical procedure is an effective radical treatment for advanced parotid cancers.
