Conservative parotidectomy: a new surgical concept

Area of Science:

• Surgical Anatomy
• Head and Neck Surgery
• Facial Nerve Anatomy

Background:

• The posterior approach to conservative parotidectomy, introduced by Janes (1940), has seen numerous elaborations.
• Existing methods for localizing the facial nerve trunk during parotidectomy are often difficult or time-consuming.

Purpose of the Study:

• To present an operative concept for safe, quick, and simple localization of the facial nerve trunk.
• To identify reliable and easily identifiable landmarks for facial nerve dissection in parotidectomy.

Main Methods:

• Utilizes a novel operative concept focusing on easily identifiable landmarks.
• Employs an imaginary line joining the angle of the mouth to the mastoid process for nerve localization in the retromandibular fossa.
• Complete dissection of the parotid plexus, including the cervical branch, and retention of the platysma muscle.

Main Results:

• The presented method allows for safe, quick, and relatively simple localization of the facial nerve trunk.
• The position of the nerve trunk is remarkably constant, minimizing issues related to tumor enlargement.
• Preservation of the cervical branch and platysma muscle contributes to the function of mimetic muscles in the lower face.

Conclusions:

• This operative concept offers a reliable and efficient method for facial nerve localization in conservative parotidectomy.
• The technique enhances surgical safety and speed by using consistent anatomical landmarks.
• Preservation of key neural and muscular structures ensures better functional outcomes for patients undergoing parotid surgery.