There seems to be a lot of parotid tumors in Nigeria. The disease is usually advanced and the patients often have had a previous surgery. Many of the tumors are mucoepidermoid carcinomas and the patients usually die within a year or two. The surgery is difficult as the facial nerve courses under, over or through the tumor. We always attempt to save the nerve but it is not always possible. If the nerve is injured, the patient loses the function of many facial muscles. One of the most serious is loss of innervation of the orbicularis oculi muscle, which closes the eye. As a result, the cornea is not adequately protected and lubricated. This causes a dry eye feeling and can result in corneal ulcers. A tarsorrhaphy can be performed to correct this problem, if necessary.
The young woman pictured here had a recurrent parotid tumor. The tumor invaded the facial nerve and the masseter muscle. We did a radical resection, including the facial nerve, masseter and also performed a modified radical neck dissection. She is doing well.