Parotidectomy combined with identification and preservation procedures of the great auricular nerve.
CONCLUSIONS
We found that the great auricular nerve (GAN) passes at the median (m) point between the tips of the mandibular angle and mastoid process. We also established the GAN definitive line using this point for rapid identification of the trunk of the GAN and systematic parotidectomy combined with procedures for identification of the GAN, elevation of the skin flap, and exposure of the parotid capsule, which showed a high rate of preservation of the nerve and the lobular branch.


OBJECTIVE
The aim of this study was to improve parotidectomy and the rate of preservation of the GAN.


METHODS
This study comprised 74 consecutive patients who were scheduled to have parotidectomy for benign tumors at our department between November 2011 and April 2014. We examined whether our GAN definitive line including the m point was useful to identify the trunk of the GAN and whether anterograde dissection of the nerve could be performed simultaneously with skin flap elevation and exposure of the parotid capsule and contributed to preservation of the trunk to the lobular branch.


RESULTS
The trunk was identified under the GAN definitive line drawn preoperatively in 97.3% of cases (72/74). Combined surgery was successfully performed with a 95.9% (71/74) preservation rate of the GAN including the lobular branch.
Department of Otolaryngology, Takii Hospital, Kansai Medical University , Osaka.
Hiroshi
H
Iwai
Masaya
M
Konishi
D000236:Adenoma / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D020209:Cranial Nerve Injuries / Q000517:prevention & control*; D004210:Dissection / Q000379:methods*; D004431:Ear, External / Q000294:innervation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000294:innervation; D018193:Neoplasms, Complex and Mixed / Q000473:pathology / Q000601:surgery*; D010307:Parotid Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
Frey’s syndrome; Lobular branch; S-shaped incision; external jugular vein; mandibular angle; mastoid process; parotid fascia; preservation rate