Anonsen C, Patterson H C
J Otolaryngol. 1984 Jun;13(3):137-40.
Because squamous carcinoma of the face is usually recognized and treated early, regional metastasis occurs infrequently. However, due to neglect or initial treatment failure, aggressive lesions of the temporal-zygomatic area may metastasize to parotid nodes. These tumors are most effectively treated with en bloc primary excision and regional node dissection, which includes superficial parotidectomy with or without neck dissection. Closure of such large defects presents a technical challenge and often skin grafts are utilized. This report deals with our experience with a large lateral facial squamous carcinoma with parotid metastasis. Surgical options and a method of primary closure with cheek-neck rotation flap are discussed. Controversy exists regarding elective neck dissection and/or postoperative irradiation. Postoperative irradiation is advised for pathological evidence of perineural invasion, multiple positive nodes, extranodal spread, or questionable margins.
由于面部鳞状细胞癌通常能被早期识别和治疗，区域转移很少发生。然而，由于忽视或初始治疗失败，颞颧部的侵袭性病变可能转移至腮腺淋巴结。这些肿瘤最有效的治疗方法是整块原发灶切除和区域淋巴结清扫，包括伴有或不伴有颈部清扫的腮腺浅叶切除术。闭合如此大的缺损是一项技术挑战，通常需要使用皮肤移植。本报告阐述了我们处理一例伴有腮腺转移的大型面部外侧鳞状细胞癌的经验。讨论了手术选择以及使用颊颈旋转皮瓣进行一期闭合的方法。关于选择性颈部清扫和/或术后放疗存在争议。对于有神经周围侵犯、多个阳性淋巴结、结外扩散或切缘可疑的病理证据，建议进行术后放疗。
