Case Study 1
Case Study 1
Fig.1 Painless lump in parotid region with normal facial function. Coronal MRI shows tumour (green arrow) within the parotid gland. Thickened facial nerve (yellow arrow) seen at the level of stylomastoid foramen and fallopian canal.
Fig.2 Sagittal MRI shows tumour (green arrow) within the parotid gland. Thickened facial nerve (yellow arrow) seen at the level of stylomastoid foramen and fallopian canal.
Fig.3 Superficial parotidectomy is done in retrograde fashion exposing the peripheral branches of facial nerve (yellow arrowheads) and the tumour (yellow arrow). Green arrow points at the dissected superficial lobe.
Fig.4 Incision was extended behind the pinna and the mastoid is exposed. Picture shows mastoid tip, posterior belly of digastric muscle, tumour and the peripheral branches of facial nerve (yellow arrowheads).
Fig.5 Mastoid is drilled to decompress the vertical mastoid segment of facial nerve. Picture shows the thickened facial nerve (green arrows) at the level of stylomastoid foramen.
Fig.6 Facial nerve is divided at the fallopian canal proximal to the tumour. Picture shows the thickened facial nerve proximal to the tumour (green arrow), tumour and the peripheral brances distal to the tumour.
Fig.7 After complete excision of tumour. Green arrow points at the site of transection of mastoid segment of facial nerve.
Fig.8 Sural nerve was used as cable graft (yellow arrowheads) and anastamosed to facial nerve trunk (green arrow) and peripheral branches.
Fig.9 Ten days after surgery. Complete facial paralysis on left side.
Fig.10 Eleven months after surgery. Patient has regained facial movement with minimal weakness in forehead and eye.
The Heart Of Clinic
Dr. C. Rayappa MBBS, DLO, FRCS(Edin)
SENIOR CONSULTANT
+91 44 3315 1105
Dr. C. Rayappa graduated from Madras Medical College, Chennai, India in 1982. He completed his post graduation in Otolaryngology (ENT)
The Heart Of Clinic
Dr. C. Rayappa MBBS, DLO, FRCS(Edin)
SENIOR CONSULTANT
+91 44 3315 1105
Dr. C. Rayappa graduated from Madras Medical College, Chennai, India in 1982. He completed his post graduation in Otolaryngology (ENT)