Succinct points
- En-bloc clearance of malignant deep lobe parotid tumours involving the
stylomandibular tunnel and parapharyngeal space is challenging in view
of the limited surgical access and the critical structures that are
located in close proximity
- The technique that we describe is a combined
transmandibular-transmastoid approach that allows complete en-bloc
resection of the deep parotid lobe and stylomandibular tunnel with a
lateral temporal bone resection and a marginal mandibulectomy
- This approach provides good exposure of the critical structures and
allows for a safe en-bloc resection and good oncological margins
- This clinical scenario is common in Australia, due to the high
incidence of cutaneous squamous cell carcinoma involving the parotid
gland, either through direct invasion or lymphatic spread
- In this article we explain step-by-step how to perform these
resections to allow potential cure in patients with very locally
advanced disease