Abstract-
Diagnosis and Management of Parotid Tumor
under Nerve Monitoring System
Elliot Shih-Jung Cheng
Salivary gland tumors are rare, representing only 6 to 8 percent of head and neck tumors. However, parotid tumor accounts for 80% of the salivary gland tumor. In general, tentative diagnosis is derived from clinical presentation and imaging study, but conformed by ultrasound or CT-guided core needle biopsy or even after tumor excision with comprehensive pathological verification. Of course, surgery is the first consideration for parotid tumor especially for malignancy and adjuvant therapy by irradiation alone or combined with chemotherapy depending on oncological aggressiveness and cell type entity.
Facial nerve protection is commonly depicted by facial surgery, including parotidectomy, rhytidectomy or other cosmetic surgery. Nevertheless, facial re-animation is the uppermost for post-surgical patients with facial nerve integrity. In fact, minor and temporary facial nerve dysfunction is usually detected after surgery even for an experienced surgeon. Based on reduction of incidentally iatrogenic facial nerve injury, nerve monitoring system is highly recommended with delicate dissection and sensitive alertness. In addition to facial nerve preservation and protection, the monitoring system can provide some advantages with decreased over-excision of normal parotid tissue, improved dissection skill with retrograde and antegrade approaches and shorten surgical time.
