TY - JOUR ID - 5446 TI - Promising Technique for Facial Nerve Reconstruction in Extended Parotidectomy JO - Iranian Journal of Otorhinolaryngology JA - IJORL LA - en SN - 2251-7251 AU - Villarreal, Ithzel Maria AU - Rodriguez- Valiente, Antonio AU - Castello, Jose Ramon AU - Gorriz, Carmen AU - Alvarez- Montero, Oscar AU - Garcia -Berrocal, Jose Ramon AD - Department of Otorhinolaryngology, “Puerta de Hierro-Majadahonda” University Hospital, Madrid, Spain. AD - Department of Plastic Surgery, “Puerta de Hierro-Majadahonda” University Hospital, Madrid, Spain. Y1 - 2015 PY - 2015 VL - 27 IS - 6 SP - 485 EP - 489 KW - Anterior Lateral Thigh flap KW - Facial Nerve KW - Parotidectomy KW - Vascularized flap DO - 10.22038/ijorl.2015.5446 N2 - Introduction: Malignant tumors of the parotid gland account scarcely for 5% of all head and neck tumors. Most of these neoplasms have a high tendency for recurrence, local infiltration, perineural extension, and metastasis. Although uncommon, these malignant tumors require complex surgical treatment sometimes involving a total parotidectomy including a complete facial nerve resection. Severe functional and aesthetic facial defects are the result of a complete sacrifice or injury to isolated branches becoming an uncomfortable distress for patients and a major challenge for reconstructive surgeons.   Case Report: A case of a 54-year-old, systemically healthy male patient with a 4 month complaint of pain and swelling on the right side of the face is presented. The patient reported a rapid increase in the size of the lesion over the past 2 months. Imaging tests and histopathological analysis reported an adenoid cystic carcinoma. A complete parotidectomy was carried out with an intraoperative notice of facial nerve infiltration requiring a second intervention for nerve and defect reconstruction. A free ALT flap with vascularized nerve grafts was the surgical choice. A 6 month follow-up showed partial facial movement recovery and the facial defect mended.   Conclusion:  It is of critical importance to restore function to patients with facial nerve injury.  Vascularized nerve grafts, in many clinical and experimental studies, have shown to result in better nerve regeneration than conventional non-vascularized nerve grafts. Nevertheless, there are factors that may affect the degree, speed and regeneration rate regarding the free fasciocutaneous flap. In complex head and neck defects following a total parotidectomy, the extended free fasciocutaneous ALT (anterior-lateral thigh) flap with a vascularized nerve graft is ideally suited for the reconstruction of the injured site.  Donor–site morbidity is low and additional surgical time is minimal compared with the time of a single ALT flap transfer.  UR - https://ijorl.mums.ac.ir/article_5446.html L1 - https://ijorl.mums.ac.ir/article_5446_8c535b8aed6a774c8eda68fe96ced7b3.pdf ER -