Removal of Parotid, Submandibular, and Sublingual Glands
ABSTRACT Surgical removal of the major salivary glands is a common task for the oral and maxillofacial surgeon. The major salivary glands have complex anatomic relationships with the surrounding neurovascular structures, and a thorough understanding of the surgical anatomy is essential for any surgeon involved in the management of salivary gland disease. This article reviews the indications, surgical anatomy, diagnostic evaluation, and surgical techniques for removal of the major salivary glands.
SourceAvailable from: Ryan N Heffelfinger[Show abstract] [Hide abstract]
ABSTRACT: Management of facial nerve injuries requires knowledge and skills that should be in every facial plastic surgeon's armamentarium. This article will briefly review the anatomy of the facial nerve, discuss the assessment of facial nerve injury, and describe the management of facial nerve injury after soft tissue trauma.Facial Plastic Surgery 12/2010; 26(6):511-8. DOI:10.1055/s-0030-1267726 · 0.92 Impact Factor
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ABSTRACT: (1) The temporal branch of the facial nerve emerges within the parotid gland to cross the zygomatic arch at the deep surface of the temporoparietal fascia. The nerve is separated from the deep temporal fascia immediately above the zygomatic arch by a loose areolar plane; this plane may be obliterated when previous surgical procedures have been performed in this region. (2) The temporal branch can be found within a trajectory that has been described relating the lower portion of the auricle to the lateral aspect of the eyebrow. However, one must be aware that these surface landmarks may vary with respect to the underlying skeleton and from one individual to the next. (3) Recent studies indicate that the temporal branch consists of not one, but multiple rami that cross the zygomatic arch. Because there are multiple rami to the temporal branch of the facial nerve, any single trajectory can describe only a portion and not the entirety of the temporal branch. (4) The zygomatic, buccal, and marginal mandibular branches of the facial nerve innervate the mimetic muscles of the face from either their superficial or deep surfaces. Several mimetic muscles are innervated by two or more branches of the facial nerve. (5) Interconnections between the zygomatic and buccal branches are noted in over 70% of cases, whereas interconnections between the temporal or marginal mandibular branches to other facial nerve branches occur in less than 15% of cases. (6) The zygomatic, buccal, and marginal mandibular branches lie in intimate relationship with the retaining ligaments of the face. Surgical dissection for release of the zygomatic ligament, the masseteric cutaneous ligament, or the mandibular ligament should be performed meticulously and with extreme caution.Clinics in Plastic Surgery 05/1995; 22(2):241-51. DOI:10.1016/S0278-2391(96)90659-X · 1.35 Impact Factor
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ABSTRACT: To present our initial experience with sialendoscopy of the parotid duct. Diagnostic and interventional sialendoscopy procedures were performed in 79 and 55 cases, respectively. Diagnostic sialendoscopy was used to classify ductal lesions into sialolithiasis, stenosis, sialodochitis, and polyps. Interventional sialendoscopy was used to treat these disorders. The type of endoscope used, the type of sialolithiasis fragmentation and/or extraction device used, the total number of procedures, the type of anesthesia, and the number and size of the sialoliths removed were the dependent variables. The outcome variable was the endoscopic clearing of the ductal tree and resolution of symptoms. Diagnostic sialendoscopy was possible in all cases, with an average duration of 26+/-14 minutes and no complications. Interventional sialendoscopy was successful in 85% of cases, with an average duration of 73+/-43 minutes (+/- standard deviation). Multiple procedures were performed in 45% of cases, general anesthesia was used in 24%, and parotidectomy in 2%. Multiple sialoliths were found in 58% of ducts and associated with more procedures under general anesthesia and longer operations. The average size of sialoliths was 3.2+/-1.3 mm; larger stones were associated with more procedures under general anesthesia, longer and multiple procedures, use of fragmentation, and sialendoscopy failures. Sialolithiasis fragmentation was required in 10% of cases, with a success rate of 70%. Semirigid sialendoscopes performed better than flexible ones. Complications were mostly minor but were encountered in 12% of cases. Diagnostic sialendoscopy is a new technique for evaluating salivary duct disease, a technique which is associated with low morbidity. Interventional sialendoscopy allows the extraction of sialoliths in most patients, preventing open gland excision.The Laryngoscope 03/2001; 111(2):264-71. DOI:10.1097/00005537-200102000-00015 · 2.03 Impact Factor