Removal of an intra-parotid foreign body without parotidectomy and dissection of the facial nerve.

Abstract

At the conclusion of this presentation, the participants should be able to discuss how imaging and intra-operative facial nerve monitoring may be used in the removal of selected intraparotid foreign body without parotidectomy and dissection of the facial nerve. 1) To present a rare case of a metallic intraparotid foreign body introduced as a projectile; 2) to discuss how CT images were used to guide the surgical exploration; and 3) To discuss the surgical approach used to retrieve an intraparotid foreign body without facial nerve dissection. This is a clinical case report with a review of literature. We present the pertinent history and physical examination findings. We discuss the CT images. The technique of surgical exploration and foreign body retrieval is presented. This is the case of a man who presented to the emergency department with a metallic foreign body lodged in the parotid introduced accidentally as a projectile. CT images were analyzed and the patient underwent successful removal of the intraparotid foreign body with out parotidectomy and facial nerve dissection via a posterior approach and using facial nerve monitoring. Selected intraparotid foreign bodies may be removed without parotidectomy and facial nerve dissection if imaging shows it can be approached safely and intra-operative facial nerve monitoring is used.