Parotid Tumours with Skin Extension

Abstract

Tumours affecting the parotid gland and the external skin can evolve from the gland itself or infiltrate secondarily the parotid gland originating from the external skin or metastases. Due to the anatomy of the gland and its close relation to the facial and auriculotemporal nerve, these structures can be affected, either by the tumour itself or the resection.

 The complete resection of these extended tumours requires the reconstruction of the skin, the nerve and sometimes even the mandibular bone as well. There are multiple ways to reconstruct the defects after resection by local flaps, myocutaneous flaps or free, microvascular flaps. This chapter focuses on the reconstruction by local flaps, such as skin rotation and transposition techniques of the neighbouring tissue, including large skin transpositions, e.g. the cervicofacial flap. Pedicled flaps like the submental island flap or the supraclavicular artery flap are alternative possibilities. A parotid resection could cause severe complications. The auriculotemporal syndrome accompanied with gustatory sweating can be prevented by an interpolation of a temporal muscle flap. A salivary fistula after surgery of the parotid gland can be addressed by a pressure bandage or infiltration of botulinum toxin A.