Year: 2026
Type: article
Abstract: Objective: Advanced malignant tumours of the parotid gland often extend to the skull base and adjacent soft tissues. Conventional extended parotidectomy has shown limitations in achieving radical margins. Temporo-parotid resection (TPR) was developed to ensure oncological continuity of the specimen in an en bloc fashion and to achieve reliable surgical margins. A detailed description of the surgical technique has not been reported in the literature to date and is the aim of the present work. Methods: Thirty-four patients with malignant parotid tumours were treated with TPR between 2019 and 2025. The surgical technique is detailed step-by-step herein. The procedure begins with a combined cervico-parotid incision, followed by total parotidectomy with preservation or sacrifice of the facial nerve according to tumour involvement. A selective or modified radical neck dissection is carried out en bloc. Temporal bone resection is then performed according to 3 reproducible osteotomy patterns: type 1 (partial tympano-mastoidectomy running lateral to fallopian canal); type 2 (partial mastoidectomy, radical tympanectomy medial to fallopian canal and lateral to the labyrinth); type 3 (radical tympano-mastoidectomy, medial to fallopian canal and variably extending to the spheno-temporal bone, labyrinth, jugular fossa, carotid canal). The parotid, neck and temporal bone components are removed in continuity, without specimen disruption, thereby ensuring accurate deep margin assessment. Results: TPR type 1 was performed in 10 cases (29.4%), type 2 in 20 cases (58.8%), and type 3 in 4 cases (11.8%). Outcome analysis was beyond the scope of the present study and will be reported separately. Conclusions: TPR provides a reproducible en bloc approach to parotid malignancies with skull base extension, optimises oncological radicality, facilitates processing and assessment of surgical specimens, and enables standardisation of bone resections.
Institutions: University of Padua, Azienda Ospedale - Università Padova
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $323
OpenAlex ID: W7225126344