title: Tumor recurrence and complications of parotidectomy using the marginal mandibular branch as a landmark during the retrograde technique.
abstract: OBJECTIVE
  To investigate the recurrence of tumors and morbidity rates of postoperative complications associated with primary parotid pleomorphic adenomas treated with a parotidectomy using the marginal mandibular branch of the facial nerve as a landmark during the retrograde approach.
  
  
  METHODS
  Our study retrospectively analyzed the clinical data from 71 patients with a primary parotid pleomorphic adenoma who underwent a parotidectomy using the marginal mandibular branch of the facial nerve as a guide during the retrograde approach between November 2003 and August 2012. Three surgical modalities were involved in the study: a partial superficial parotidectomy was performed in 8 cases, a superficial parotidectomy was performed in 54 cases, and a total parotidectomy was performed in 9 cases. The recurrence of tumors and the morbidity rates of postoperative complications, such as transient facial nerve paralysis, permanent facial nerve paralysis, sensory deficiency, Frey syndrome, salivary fistulas, and xerostomia, were investigated.
  
  
  RESULTS
  Tumor recurrence occurred in only 1 case. Overall, the morbidity rates for transient facial nerve paralysis, permanent facial nerve paralysis, sensory deficiency, Frey syndrome, and xerostomia were 22.5%, 1.4%, 39.4%, 59.2%, and 8.5%, respectively. No cases developed a salivary fistula.
  
  
  CONCLUSIONS
  The use of the marginal mandibular branch of the facial nerve as a guide during the retrograde approach is a reliable and safe method for dissecting the facial nerve.
authors.affiliation: From the Department of Otolaryngology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China.
authors.forename: Yu-ting
authors.initials: YT
authors.lastname: Lai
authors.forename: Qin
authors.initials: Q
authors.lastname: Liang
authors.forename: Xian-hao
authors.initials: XH
authors.lastname: Jia
authors.forename: Xiao-tong
authors.initials: XT
authors.lastname: Zhang
mesh_terms: D008949:Adenoma, Pleomorphic / Q000601:surgery*; D000328:Adult; D000368:Aged; D059925:Anatomic Landmarks; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery*; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D009364:Neoplasm Recurrence, Local; D013517:Otorhinolaryngologic Surgical Procedures / Q000009:adverse effects*; D010307:Parotid Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000601:surgery; D012189:Retrospective Studies; D012468:Salivary Gland Neoplasms / Q000601:surgery*