title: Facial nerve reconstruction following radical parotidectomy and subtotal petrosectomy for advanced malignant parotid neoplasms.
abstract: BACKGROUND
  To describe the oncological management and functional outcome of patients with advanced parotid malignant tumors undergoing facial nerve reconstruction after radical parotidectomy and subtotal petrosectomy.
  
  
  METHODS
  A combined approach was used to treat advanced stage parotid malignancies with intrapetrous involvement of the facial nerve main trunk or abutment on the stylomastoid foramen. Patients underwent facial nerve rehabilitation with cable graft reconstruction or with static techniques.
  
  
  RESULTS
  Six patients were included. All patients had Stage IV disease and underwent surgical treatment using a combined approach. Three patients underwent facial-nerve cable graft technique and three patients underwent static techniques to rehabilitate facial nerve function. Five patients received adjuvant treatment with radiotherapy and/or chemotherapy. The mean follow-up was 27.5 months, with a minimum of 7 months and a maximum of 8 years. Four patients remain disease-free, with an overall survival rate of 66%. Among the patients undergoing dynamic reconstruction, first signs of recovery were established at 6 months of follow-up. All patients achieved a House-Brackmann score of III-IV within the first two postoperative years.
  
  
  CONCLUSIONS
  When possible, facial nerve grafting is the preferred method of facial nerve rehabilitation in an advanced stage parotid tumors. A multidisciplinary approach allows better functional and oncological outcomes.
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Hospital of the Canary Islands, Tenerife, Spain.
authors.forename: Rocío
authors.initials: R
authors.lastname: Sánchez-Burgos
authors.affiliation: Department of Oral and Maxillofacial Surgery, La Paz University Hospital, Madrid, Spain.
authors.forename: Teresa Gonzalez
authors.initials: TG
authors.lastname: Otero
authors.affiliation: Department of Otorhinolaryngology, La Paz University Hospital, Madrid, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Lassaletta
authors.affiliation: Department of Oral and Maxillofacial Surgery, La Moraleja Hospital, Madrid, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Arias Gallo
authors.affiliation: Department of Oral and Maxillofacial Surgery, General Hospital of Toledo, Toledo, Spain.
authors.forename: Ignacio Navarro
authors.initials: IN
authors.lastname: Cuellar
authors.affiliation: Department of Oral and Maxillofacial Surgery, La Paz University Hospital, Madrid, Spain.
authors.forename: Miguel Burgueño
authors.initials: MB
authors.lastname: García
keywords: Facial nerve graft; facial nerve reconstruction; malignant parotid tumor; radical parotidectomy; subtotal petrosectomy