Adult ; Facial Neoplasms ; Facial Nerve ; Humans ; Male ; Neurilemmoma

Surgical extirpation of parotid cancer frequently results in sacrifice of the facial nerve. In each case when sacrifice of nerve is necessary, immediate nerve repair with cable graft is preferred. However, controversy continues over the effects of postoperative radiotherapy on facial nerve graft function. Six patients with parotid cancer who had extensive resection with sacrifice of the seventh nerve and primary autogenous cable graft repair were reviewed. Five of six patients had good to excellent dynamic function. Three of four patient who were treated with postoperative radiotherapy had good to excellent function. Immediate nerve grafting should be used even when postoperative radiotherapy is planned.
Facial Nerve* ; Humans ; Parotid Neoplasms ; Radiotherapy ; Transplants*

Idiopathic facial palsy of the peripheral type is the most common facial palsy. However, the rate of incident is much lower in children under 10 years. In children, many other conditions can cause peripheral facial nerve palsy. We present the cases of 2 children with whom the initial manifestation of their leukemia and brain stem tumor were shown through the peripheral type of facial nerve palsy. These cases should alert physicians to consider other serious causes in younger children with facial palsy.
Brain Stem Neoplasms* ; Brain Stem* ; Brain* ; Child ; Facial Nerve* ; Facial Paralysis ; Humans ; Leukemia* ; Paralysis*

The clinical appearance of metastatic lesions without an obvious primary source for the tumor is not uncommon event although modern diagnostic technology has improved. Metastatic neoplasms of unknown primary origin account for up to 2.1-11% of metastatic lesions in temporal bones. We recently experienced a case with metastatic adenocarcinoma of unknown primary origin involving the temporal bone. A 66-year-old woman was admitted to our hospital because of facial palsy and facial pain. She was diagnosed with metastatic adenocarcinoma in the temporal bone based on the pathologic findings but the primary origin was not found despite extensive diagnostic work-up for all suspicious sites. So we report this case with a review of related literatures.
Adenocarcinoma ; Aged ; Facial Pain ; Facial Paralysis ; Female ; Humans ; Neoplasm Metastasis ; Neoplasms, Unknown Primary ; Temporal Bone

BACKGROUND AND OBJECTIVES: Most of parotid glands tumors, including pleomorphic adenoma and Warthin's tumor, are benign tumors. The method of surgical treatment for benign tumors of the parotid glands has not yet been rationalized. Even in the case of the most frequently occuring tumor, pleomorphic adenoma, the surgical treatments have been varied over the years, with superficial parotidectomy now being the most widely accepted form of the treatment. Conservative partial parotidectomy has been shown to be a reliable option with a successful outcom and a lower complication rate compared with the classic superficial parotidectomy. The aim of this study is to evaluate the advantages of partial parotidectomy in benign parotid tumors by comparing it with the superficial and total parotidectomy. MATERIALS AND METHOD: Of the 84 parotiectomies performed from 1993 to 2001 at Hanyang University hospital, 31 were classic superficial parotidectomies, 14 were total parotidectomies, and 39 were partial parotidectomies. All of the tumors in this study were benign tumor, most of them being pleomorphic adenoma and Warthin's tumor. A retrospective review was performed based on the patient records and their continued documentation by the practice. RESULTS: Partial parotidectomy took less time to perform (60 to 270 minutes) and caused less risk of facial nerve injuries although it was not significant. The procedure also has its cosmetic advantages. No recurrence occurred after partial and superficial parotidectomy in benign tumors. CONCLUSION: Partial parotidectomy might be the reliable option for benign parotid tumors as it has the advantages of reduced risk of facial injuries, less operating time, and apparently no increased recurrence of benign tumors.
Adenoma, Pleomorphic ; Facial Injuries ; Facial Nerve Injuries ; Humans ; Parotid Gland ; Parotid Neoplasms ; Recurrence ; Retrospective Studies

Abstract Tumor of the accessory parotid gland is frequently mistaken as a cheek subcutaneous tumor because of its location and rarity. Preoperative tissue diagnosis is imperative for proper treatment of this rare tumor. In technical point of view, the parotidectomy approach with wide facial nerve dissection and careful elevation of cheek flap is the key to safe resection of the tumor without complication of facial nerve injury. We report one case each of primary and metastatic cancer of accessory parotid gland with a brief review of literature.
Cheek ; Diagnosis ; Facial Nerve ; Facial Nerve Injuries ; Parotid Gland* ; Parotid Neoplasms

BACKGROUND: Because there are numerous methods for reconstruction of the lower lip, it is not easy to choose the optimal method. In choosing the surgical method for lower lip reconstruction, we obtained acceptable outcomes based on our treatment strategy, which included either a barrel-shaped excision or the Webster modification of the Bernard operation. We report on the surgical outcomes based on our treatment strategy. METHODS: This study included 26 patients who underwent lower lip reconstructive surgery from September 1996 to September 2010. The operation was done using either a barrel-shaped excision or the Webster modification, considering the location of the defect, the size of the defect, and the amount of residual tissue on the lateral side of the vermilion after excision. RESULTS: In our series, 3 patients underwent a single barrel-shaped excision, and nine patients underwent a double barrel-shaped excision. In addition, the unilateral Webster modification was performed on in 6 patients, and there were eight cases of bilateral Webster modification. All of the patients except one were satisfied with the postoperative shape of the lip. In one case both recurrence and dehiscence occurred. One patient had a good postoperative lip shape, but had difficulty wearing a denture, and also underwent commissuroplasty. Furthermore, there were two patients who complained of drooling, and 4 with paresthesia. CONCLUSIONS: A soft tissue defect resulting from wide excision of a lower lip malignancy can be successfully reconstructed using only one of two surgical methods: the barrel-shaped excision or the Webster modification of the Bernard operation.
Dentures ; Facial Neoplasms ; Humans ; Lip ; Reconstructive Surgical Procedures ; Recurrence ; Sialorrhea

OBJECTIVETo summarize the therapeutic experience in removing huge craniofacial hemangioma in 135 cases and reveal the rules of repairing the damaged tissues or organs caused by the extirpation.

METHODSThe procedure was to remove the focal lesion correctly, control hemorrhage, keep the stable blood volume, repair and rebuild the damaged tissues or organs reasonably.

RESULTSThe focal lesion was removed rather completely without accidental injuries or deaths. The damaged tissues or organs were repaired and rebuilt quite satisfactorily.

CONCLUSIONHuge craniofacial hemangioma of any type should be operated on as early as possible with sufficient preoperative preparations.

Retention cyst of the maxillary sinus is a benign lesion produced from obstruction of a seromucous gland or duct. It is mostly asymptomatic but sometimes is accompanied by facial pain, headache, nasal obstruction, and other symptoms. However, there are some debates on whether the symptoms are directly related with retention cyst. These cysts typically do not require treatment. However, when accompanied by symptoms, treatment can be administered for diagnostic and therapeutic purposes. We report a case in which facial pain is caused by a maxillary retention cyst suspended from an infraorbital nerve.
Facial Pain ; Headache ; Maxillary Sinus ; Nasal Obstruction ; Paranasal Sinus Neoplasms

OBJECTIVE: To investigate the clinical efficacy of a modified paramedian lower lip-submandibular approach for maxillary (subtotal) total resection. METHODS: Eleven patients of maxillary tumors underwent maxillary (subtotal) total resection through the modified paramedian lower lip-submandibular approach. Clinical follow-up visits were conducted to evaluate appearance restoration, facial nerve functional status, parotid gland functional status, and orbital region complication. RESULTS: During the follow-up period of 6-36 months, the appearance of all 11 patients recovered well. All cases presented hidden scars. No facial nerve and parotid duct injury, lower eyelid edema, lower eyelid ectropion, or epiphora in all cases was observed. CONCLUSIONS Applying modified paramedian lower lip-submandibular approach to maxillary (subtotal) total resection effectively reduces incidence of orbital region complications including lower eyelid edema, lower eyelid ectropion, and epiphora, which often occur to traditional approach. The modified approach produces more subtle scars than other methods and should be applied to treatment of maxillary (subtotal) total resection.
Facial Nerve ; Humans ; Lip ; Maxilla ; Maxillary Neoplasms ; Surgical Flaps