Interdisciplinary management of advanced temporal and parotid malignancies

Introduction Surgical therapy of advanced malignancies of the temporal and parotid regions presents a special challenge. Due to the different ENT and maxillofacial surgical focus, the individual disciplines are limited in resection and restoration of functionality.

Materials and Methods This case series retrospectively analyzes the therapeutic concepts for advanced malignancies of the temporal and parotid regions, which were treated interdisciplinarily by the departments of ENT and maxillofacial surgery at the University Medical Center Freiburg in the period of 2018-2021.

Results 6 patients (4 male, 2 female) with advanced, partially recurred skin (3 squamous cell carcinomas, 1 basal cell carcinoma; stages: pT3, n=3/pT4, n=1) and parotid carcinomas (1 liposarcoma, 1 adenoid cystic carcinoma; stages: pT2, n=1/pT3, n=1). Tumor resection was used for local sanitation, in some cases including partial mandibular resection and radical parotidectomy (n=4) and partial petrosectomy (auditory canal, mastoid, middle ear; n=4). For reconstruction CAD-guided resection templates and implants were used in some cases, over which scapular or fibular grafts were fixed (n=3). All patients underwent R0 resection (n=6), in one case recurrence occurred during the course. No graft losses occurred.

Discussion Interdisciplinary therapy concepts allow reliable resection of even advanced carcinomas temporally and parotidally. Therefore more complex reconstruction procedures are necessary, nonetheless they are associated with few postoperative complications. In the future, in addition to resection and reconstruction, an additional focus must be placed on post-therapeutic rehabilitation and quality of life.

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Artikel online veröffentlicht:
24. Mai 2022