What do you do when you’re in the OR and the tumor you thought was cleanly resectable suddenly doesn’t have a clean plane from the facial nerve? This discussion confronts the nightmare scenario of balancing oncologic principles against facial nerve preservation, covering decision-making for nerve sacrifice, immediate reconstruction options like sural nerve grafting, and management of resultant paralysis. Learn which neck dissection levels matter for parotid malignancies, when intermediate or high-grade pathology triggers adjuvant radiation, and what role emerging systemic therapies might play in your postoperative treatment algorithm.
Contributors:
Dr. Ashley Agan is an otolaryngologist in Dallas, TX.
Dr. Mirabelle Sajisevi is an ENT practicing at University of Vermont Health in Burlington, Vermont.
Dr. Gopi Shah is a pediatric otolaryngologist and the co-host of BackTable ENT.
