[Traumatic neuroma of the great auricular nerve. A clinical case].
A clinical case of neuroma resulting from an amputation which occurred following parotid surgery is reported. The present paper discusses the importance of differential diagnosis relating to this pathology and the surgical techniques that may contribute to setting a limit on its onset. Traumatic neuroma is a possible complication of parotid surgery together with motor deficiencies and Frey's syndrome and the less frequent salivary fistulas. It may also occur following oncological or plastic-reconstructive surgery. During parotidectomy operations, section of the great auricular nerve may be required to facilitate access to the parotid region. This manoeuvre may, however, also be associated with the onset of a neuroma during a time period varying from 2 to 10 years, according to the various authors who have examined the subject. The laterocervical tumefaction associated with neuroma poses a number of diagnostic problems as it has to be differentiated from a likely relapse or possibly from more complex inflammatory or metastatic lymphnodal pathology. A correct clinical and diagnostic multidisciplinary approach is fundamental if the pathology is to be classified in the right way and contributes to alleviating a state of mental unease in the patient that is associated with the sudden appearance of the tumefaction. Sectioning the nervous trunk by means of thermocautery and its subsequent sinking below the main trunk of the sternocleidomastoid muscle, are simple surgical manoeuvres that are useful for preventing the onset of traumatic neuroma.
Colella
G
G
Istituto di Chirurgia Orale e Maxillo-Facciale, Seconda Università degli Studi di Napoli, Naples, Italy.
Borriello
C
C
Lanza
A
A
Rossiello
R
R
Siniscalchi
G
G
D000672:Amputation Stumps / Q000473:pathology*; D002572:Cervical Plexus / Q000293:injuries*; D004564:Electrocoagulation; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D009463:Neuroma / Q000209:etiology* / Q000601:surgery; D010306:Parotid Gland / Q000294:innervation / Q000601:surgery*; D010524:Peripheral Nervous System Neoplasms / Q000209:etiology* / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology*