| After skin incision, a skin flap
is developed anteriorly revealing the superficial portion of the parotid gland. The
sternocleidomastoid is then identified near it's insertion into the mastoid process. The
posterior belly of the digastric muscle is identified just anterior to this and marks the
plane of the facial nerve, which can be located just cephalad to the tendonous insertion
of the digastric muscle into the mastoid process. Landmarks
for the facial nerve include the posterior belly of the digastric muscle, external
auditory canal and the mastoid process.
In these photos the superficial portion of the parotid
gland has been dissected off the underlying facial nerve. The facial nerve trunk and it's
two branches, the temporal-zygomatic and the mandibular branches are displayed.
In this case, a tumor of the deep portion parotid gland was
found. The specimen was removed in it's entirety after dissection and elevation of the
facial nerve. Pathologic examination of the specimen confirmed the clinical suspicion of
pleomorphic adenoma.
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