title: Preauricular infratemporal fossa approach for advanced malignant parotid tumors.
abstract: OBJECTIVE
  The aims of this study were to demonstrate the surgical technique involved in the preauricular infratemporal fossa (ITF) approach, outline the clinical indications for use of this technique, and present the results in using this approach in 159 patients with malignant parotid tumors. At the conclusion of this article, the reader should be able to understand the utility of the preauricular infratemporal fossa approach in the management of patients with advanced malignant parotid tumors.
  
  
  METHODS
  This was a retrospective chart review of 159 patients treated at a tertiary care academic medical center following institutional review board approval.
  
  
  METHODS
  A comprehensive medical records review was performed for all patients with malignant parotid tumors who underwent a preauricular ITF approach between July 1988 and July 2010.
  
  
  RESULTS
  The most common presenting symptoms were pain and trismus, whereas the presence of a parotid mass and facial paralysis were the most common clinical signs. Mucoepidermoid and adenoid cystic carcinoma accounted for 63% of the tumors, and perineural invasion was found in nearly 71% of the patients. Despite negative surgical margins in 92% of the patients, local or regional tumor recurrence was found in 17% of the cases. The mean follow-up time was 12.8 years.
  
  
  CONCLUSIONS
  The preauricular ITF approach should be used in the surgical extirpation of advanced malignant parotid neoplasms. This technique provides proximal facial nerve identification, internal carotid artery protection, and negative tumor margins at the skull base.
authors: Department of Otolaryngology-Head and Neck Surgery, Loyola University Medical Center, Maywood, Illinois, USA. jleonet@lumc.edu
authors: John P
authors: JP
authors: Leonetti
authors: Brent J
authors: BJ
authors: Benscoter
authors: Sam J
authors: SJ
authors: Marzo
authors: Richard W
authors: RW
authors: Borrowdale
authors: George C
authors: GC
authors: Pontikis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D003399:Craniotomy / Q000379:methods*; D054644:Ear Auricle / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D009367:Neoplasm Staging; D010306:Parotid Gland / Q000601:surgery*; D010307:Parotid Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D056888:Patient Positioning; D011300:Preoperative Care / Q000379:methods; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D013701:Temporal Bone / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult