Parotidectomy with Retrograde Preparation Technique of Facial Nerve

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  • 逆行性顔面神経剥離術による耳下腺腫瘍摘出術

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Abstract

In this paper, a surgical procedure of parotidectomy preserving the facial nerve with retrograde preparation technique was described. The skin incision is given the shape of “S” around the auricle. The temporal branch of the facial nerve was searched out on the zygomatic arch at first. Then the nerve was preparated in a centripetal direction to the trunk of facial nerve. Having reach the trunk of facial nerve the other branches were preparated in a centrifugal direction between the upper and lower lobe of parotid gland. The advantages of this method are as follows:<BR>1. As the most of parotid tumor locates at the lower part of the parotid gland, it is possible to reach the trunk of facial nerve without a manipulation of tumor.<BR>2. As the temporal branch locates on the zygomatic arch superficially, it is very easy to find out the branch.<BR>3. Communicating branch of auriculotemporal nerve to facial nerve is cut simultaneously preventing the salivary fistula and Frey's syndrome.<BR>4. As the temporal branch supplies no important facial muscles, the methcd reported is safer than the other method which starts from buccal or mandibular branch.

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