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European Archives of Oto-Rhino-Laryngology

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01-11-2018 | Review Article

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

Authors: Orlando Guntinas-Lichius, Carl E. Silver, Jovanna Thielker, Manuel Bernal-Sprekelsen, Carol R. Bradford, Remco De Bree, Luis P. Kowalski, Kerry D. Olsen, Miquel Quer, Alessandra Rinaldo, Juan R. Rodrigo, Alvaro Sanabria, Ashok R. Shaha, Robert P. Takes, Vincent Vander Poorten, Peter Zbären, Alfio Ferlito

Published in: European Archives of Oto-Rhino-Laryngology | Issue 11/2018

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.

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Spiro JD, Spiro RH (2003) Cancer of the parotid gland: role of 7th nerve preservation. W J Surg 27(7):863–867CrossRef

Guntinas-Lichius O, Klussmann JP, Schroeder U, Quante G, Jungehuelsing M, Stennert E (2004) Primary parotid malignoma surgery in patients with normal preoperative facial nerve function: outcome and long-term postoperative facial nerve function. Laryngoscope 114(5):949–956CrossRef

Lombardi D, McGurk M, Vander Poorten V, Guzzo M, Accorona R, Rampinelli V, Nicolai P (2017) Surgical treatment of salivary malignant tumors. Oral Oncol 65:102–113. https://doi.org/10.1016/j.oraloncology.2016.12.007 CrossRefPubMed

Nishikado A, Kawata R, Haginomori SI, Terada T, Higashino M, Kurisu Y, Hirose Y (2018) A clinicopathological study of parotid carcinoma: 18-year review of 171 patients at a single institution. Int J Clin Oncol. https://doi.org/10.1007/s10147-018-1266-7 (Epub ahead of print) CrossRefPubMedPubMedCentral

Volk GF, Pantel M, Guntinas-Lichius O (2010) Modern concepts in facial nerve reconstruction. Head Face Med 6:25. https://doi.org/10.1186/1746-160X-6-25 CrossRefPubMedPubMedCentral

Buckle T, KleinJan GH, Engelen T, van den Berg NS, DeRuiter MC, van der Heide U, Valdes Olmos RA, Webb A, van Buchem MA, Balm AJ, van Leeuwen FW (2016) Diffusion-weighted-preparation (D-prep) MRI as a future extension of SPECT/CT based surgical planning for sentinel node procedures in the head and neck area? Oral Oncol 60:48–54. https://doi.org/10.1016/j.oraloncology.2016.06.015 CrossRefPubMed

Guntinas-Lichius O (2004) The facial nerve in the presence of a head and neck neoplasm: assessment and outcome after surgical management. Curr Opin Otolaryngol Head Neck Surg 12(2):133–141CrossRef

Hontanilla B, Qiu SS, Marre D (2014) Effect of postoperative brachytherapy and external beam radiotherapy on functional outcomes of immediate facial nerve repair after radical parotidectomy. Head Neck 36:113–119CrossRef

Wen J, Desai NS, Jeffery D, Aygun N, Blitz A (2018) High-resolution isotropic three-dimensional MR imaging of the extraforaminal segments of the cranial nerves. Magn Reson Imaging Clin N Am 26(1):101–119. https://doi.org/10.1016/j.mric.2017.08.007 CrossRefPubMed

10.

Volk GF, Pohlmann M, Sauer M, Finkensieper M, Guntinas-Lichius O (2014) Quantitative ultrasonography of facial muscles in patients with chronic facial palsy. Muscle Nerve 50(3):358–365. https://doi.org/10.1002/mus.24154 CrossRefPubMed

11.

Wegscheider H, Volk GF, Guntinas-Lichius O, Moriggl B (2018) High-resolution ultrasonography of the normal extratemporal facial nerve. Eur Arch Otorhinolaryngol 275(1):293–299. https://doi.org/10.1007/s00405-017-4797-z CrossRefPubMed

12.

Grosheva M, Wittekindt C, Guntinas-Lichius O (2008) Prognostic value of electroneurography and electromyography in facial palsy. Laryngoscope 118(3):394–397. https://doi.org/10.1097/MLG.0b013e31815d8e68 CrossRefPubMed

13.

Guntinas-Lichius O, Streppel M, Stennert E (2006) Postoperative functional evaluation of different reanimation techniques for facial nerve repair. Am J Surg 191(1):61–67CrossRef

14.

Thakar A, Gupta MP, Srivastava A, Agrawal D, Kumar A (2018) Nonsurgical treatment for posttraumatic complete facial nerve paralysis. JAMA Otolaryngol Head Neck Surg 144(4):315–321. https://doi.org/10.1001/jamaoto.2017.3147 CrossRefPubMed

15.

Fattah A, Gurusinghe A, Gavilan J, Hadlock T, Marcus J, Marres H, Nduka C, Slattery W, Snyder-Warwick A, On behalf of the Sir Charles Bell S (2015) Facial nerve grading scales: systematic review of the literature and suggestion for uniformity. Plast Reconstruct Surg 135(2):569–579. https://doi.org/10.1097/PRS.0000000000001183 CrossRef

16.

Banks CA, Jowett N, Azizzadeh B, Beurskens C, Bhama P, Borschel G, Coombs C, Coulson S, Croxon G, Diels J, Fattah A, Frey M, Gavilan J, Henstrom D, Hohman M, Kim J, Marres H, Redett R, Snyder-Warwick A, Hadlock T (2017) Worldwide testing of the eFACE facial nerve clinician-graded scale. Plast Rconstruct Surg 139(2):491e–498e. https://doi.org/10.1097/PRS.0000000000002954 CrossRef

17.

Hadlock TA, Urban LS (2012) Toward a universal, automated facial measurement tool in facial reanimation. Arch Facial Plast Surg 14(4):277–282. https://doi.org/10.1001/archfacial.2012.111 CrossRefPubMed

18.

Guntinas-Lichius O, Straesser A, Streppel M (2007) Quality of life after facial nerve repair. Laryngoscope 117(3):421–426CrossRef

19.

Kahn JB, Gliklich RE, Boyev KP, Stewart MG, Metson RB, McKenna MJ (2001) Validation of a patient-graded instrument for facial nerve paralysis: the FaCE scale. Laryngoscope 111(3):387–398. https://doi.org/10.1097/00005537-200103000-00005 CrossRefPubMed

20.

Lindsay RW, Bhama P, Hohman M, Hadlock TA (2015) Prospective evaluation of quality-of-life improvement after correction of the alar base in the flaccidly paralyzed face. JAMA Facial Plast Surg 17(2):108–112. https://doi.org/10.1001/jamafacial.2014.1295 CrossRefPubMed

21.

Thielker J, Grosheva M, Ihrler S, Wittig A, Guntinas-Lichius O (2018) Contemporary management of benign and malignant parotid tumors. Front Surg. https://doi.org/10.3389/fsurg.2018.00039 CrossRefPubMedPubMedCentral

22.

Bly RA, Holdefer RN, Slimp J, Kinney GA, Martinez V, Manning SC, Perkins JA (2018) Preoperative facial nerve mapping to plan and guide pediatric facial vascular anomaly resection. JAMA Otolaryngol Head Neck Surg 144(5):418–426. https://doi.org/10.1001/jamaoto.2018.0054 CrossRefPubMed

23.

Sood AJ, Houlton JJ, Nguyen SA, Gillespie MB (2015) Facial nerve monitoring during parotidectomy: a systematic review and meta-analysis. Otolaryngol Head Neck Surg 152(4):631–637. https://doi.org/10.1177/0194599814568779 CrossRefPubMed

24.

Liu H, Wen W, Huang H, Liang Y, Tan X, Liu S, Liu C, Hu M (2014) Recurrent pleomorphic adenoma of the parotid gland: intraoperative facial nerve monitoring during parotidectomy. Otolaryngol Head Neck Surg 151(1):87–91. https://doi.org/10.1177/0194599814528098 CrossRefPubMed

25.

De Seta E, Bertoli G, De Seta D, Covelli E, Filipo R (2010) New development in intraoperative video monitoring of facial nerve: a pilot study. Otol Neurotol 31(9):1498–1502. https://doi.org/10.1097/MAO.0b013e3181f20822 CrossRefPubMed

26.

Amano M, Kohno M, Nagata O, Taniguchi M, Sora S, Sato H (2011) Intraoperative continuous monitoring of evoked facial nerve electromyograms in acoustic neuroma surgery. Acta Neurochir 153(5):1059–1067. https://doi.org/10.1007/s00701-010-0937-6 (discussion 1067) CrossRefPubMed

27.

Stankovic P, Wittlinger J, Timmesfeld N, Stephan SH, Georgiew R, Gunzel T, Teymoortash A, Wilhelm T (2018) Antero- vs. retrograde nerve dissection in parotidectomy: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol 275(6):1623–1630. https://doi.org/10.1007/s00405-018-4982-8 CrossRefPubMed

28.

Yawn RJ, Wright HV, Francis DO, Stephan S, Bennett ML (2016) Facial nerve repair after operative injury: impact of timing on hypoglossal-facial nerve graft outcomes. Am J Otolaryngol 37(6):493–496. https://doi.org/10.1016/j.amjoto.2016.05.001 CrossRefPubMed

29.

Munir N, Tandon S, Brown JS, Lesser TH (2012) Trans-mastoid facial nerve localisation for malignant neoplasms confined to the parotid gland. Br J Oral Maxillofac Surg 50(8):736–738. https://doi.org/10.1016/j.bjoms.2011.12.002 CrossRefPubMed

30.

Olsen KD, Moore EJ, Lewis JE (2013) Frozen section pathology for decision making in parotid surgery. JAMA Otolaryngol Head Neck Surg 139(12):1275–1278. https://doi.org/10.1001/jamaoto.2013.5217 CrossRefPubMed

31.

Coca-Pelaz A, Rodrigo JP, Bradley PJ, Vander Poorten V, Triantafyllou A, Hunt JL, Strojan P, Rinaldo A, Haigentz M Jr, Takes RP, Mondin V, Teymoortash A, Thompson LD, Ferlito A (2015) Adenoid cystic carcinoma of the head and neck—an update. Oral Oncol 51(7):652–661. https://doi.org/10.1016/j.oraloncology.2015.04.005 CrossRefPubMed

32.

Hohman MH, Hadlock TA (2014) Etiology, diagnosis, and management of facial palsy: 2000 patients at a facial nerve center. Laryngoscope 124(7):E283–E293. https://doi.org/10.1002/lary.24542 CrossRefPubMed

33.

Bhama PK, Hadlock TA (2014) Contemporary facial reanimation. Facial Plast Surg 30(2):145–151. https://doi.org/10.1055/s-0034-1371900 CrossRefPubMed

34.

van Veen MM, Dijkstra PU, Werker PMN (2017) A higher quality of life with cross-face-nerve-grafting as an adjunct to a hypoglossal-facial nerve jump graft in facial palsy treatment. J Plast Reconstr Aesth Surg 70(11):1666–1674. https://doi.org/10.1016/j.bjps.2017.06.002 CrossRef

35.

Henstrom DK (2014) Masseteric nerve use in facial reanimation. Cur Opin Otolaryngol Head Neck Surg 22(4):284–290. https://doi.org/10.1097/MOO.0000000000000070 CrossRef

36.

Rofagha S, Seiff SR (2010) Long-term results for the use of gold eyelid load weights in the management of facial paralysis. Plast Reconstruct Surg 125(1):142–149. https://doi.org/10.1097/PRS.0b013e3181c2a4f2 CrossRef

37.

Sohrab M, Abugo U, Grant M, Merbs S (2015) Management of the eye in facial paralysis. Facial Plast Surg 31(2):140–144. https://doi.org/10.1055/s-0035-1549292 CrossRefPubMed

38.

Loyo M, Jones D, Lee LN, Collar RM, Molendijk J, Boahene KD, Ishii LE, Byrne PJ (2014) Treatment of the periocular complex in paralytic lagophthalmos. Ann Otol Rhinol Laryngol 124(4):273–279. https://doi.org/10.1177/0003489414560584 CrossRefPubMed

39.

Boahene KD, Ishii LE, Byrne PJ (2014) In vivo excursion of the temporalis muscle-tendon unit using electrical stimulation: application in the design of smile restoration surgery following facial paralysis. JAMA Facial Plast Surg 16(1):15–19. https://doi.org/10.1001/jamafacial.2013.1236 CrossRefPubMed

40.

Leckenby JI, Harrison DH, Grobbelaar AO (2014) Static support in the facial palsy patient: a case series of 51 patients using tensor fascia lata slings as the sole treatment for correcting the position of the mouth. J Plast Reconstruct Aesth Surg 67(3):350–357. https://doi.org/10.1016/j.bjps.2013.12.021 CrossRef

41.

Faris C, Heiser A, Hadlock T, Jowett N (2018) Free gracilis muscle transfer for smile reanimation after treatment for advanced parotid malignancy. Head Neck 40(3):561–568. https://doi.org/10.1002/hed.25022 CrossRefPubMed

42.

Lindsay RW, Robinson M, Hadlock TA (2010) Comprehensive facial rehabilitation improves function in people with facial paralysis: a 5-year experience at the Massachusetts Eye and Ear Infirmary. Phys Ther 90(3):391–397CrossRef

43.

Fargher KA, Coulson SE (2017) Effectiveness of electrical stimulation for rehabilitation of facial nerve paralysis. Phys Ther News 22(3–4):169–176. https://doi.org/10.1080/10833196.2017.1368967 CrossRef

44.

Cecini M, Pavese C, Comelli M, Carlisi E, Sala V, Bejor M, Dalla Toffola E (2013) Quantitative measurement of evolution of postparetic ocular synkinesis treated with botulinum toxin type A. Plast Reconstruct Surg 132(5):1255–1264. https://doi.org/10.1097/PRS.0b013e3182a48d16 CrossRef

45.

Guarin DL, Dusseldorp J, Hadlock TA, Jowett N (2018) A machine learning approach for automated facial measurements in facial palsy. JAMA Facial Plast Surg. https://doi.org/10.1001/jamafacial.2018.0030 (Epub ahead of print) CrossRefPubMed

46.

Hussain T, Nguyen LT, Whitney M, Hasselmann J, Nguyen QT (2016) Improved facial nerve identification during parotidectomy with fluorescently labeled peptide. Laryngoscope 126(12):2711–2717. https://doi.org/10.1002/lary.26057 CrossRefPubMedPubMedCentral

47.

Chen SC, Wang MC, Wang WH, Lee CC, Yang TF, Lin CF, Wang JT, Liao CH, Chang CC, Chen MH, Shih YH, Hsu SP (2015) Fluorescence-assisted visualization of facial nerve during mastoidectomy: a novel technique for preventing iatrogenic facial paralysis. Auris Nasus Larynx 42(2):113–118. https://doi.org/10.1016/j.anl.2014.08.008 CrossRefPubMed

48.

Haubner F, Gassner HG, Brawanski A, Schebesch KM (2017) Fluorescein sodium-guided surgery of parotid gland tumors as a technical advance. BMC Ear Nose Throat Dis 17:6. https://doi.org/10.1186/s12901-017-0039-7 CrossRef

49.

Gaudin R, Knipfer C, Henningsen A, Smeets R, Heiland M, Hadlock T (2016) Approaches to peripheral nerve repair: generations of biomaterial conduits yielding to replacing autologous nerve grafts in craniomaxillofacial surgery. BioMed Res Int. https://doi.org/10.1155/2016/3856262 CrossRefPubMedPubMedCentral

50.

Grosheva M, Shabli S, Volk GF, Sommer B, Ludwig L, Finkensieper M, Wittekindt C, Klussmann JP, Guntinas-Lichius O, Beutner D (2017) Sensation loss after superficial parotidectomy: a prospective controlled multicenter trial. Head Neck 39(3):520–526. https://doi.org/10.1002/hed.24647 CrossRefPubMed

Title: Management of the facial nerve in parotid cancer: preservation or resection and reconstruction
Authors: Orlando Guntinas-Lichius
Carl E. Silver
Jovanna Thielker
Manuel Bernal-Sprekelsen
Carol R. Bradford
Remco De Bree
Luis P. Kowalski
Kerry D. Olsen
Miquel Quer
Alessandra Rinaldo
Juan R. Rodrigo
Alvaro Sanabria
Ashok R. Shaha
Robert P. Takes
Vincent Vander Poorten
Peter Zbären
Alfio Ferlito
Publication date: 01-11-2018
Publisher: Springer Berlin Heidelberg
Published in: European Archives of Oto-Rhino-Laryngology / Issue 11/2018
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-018-5154-6

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

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

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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