Greater Auricular Nerve Neuromas Post Superficial Parotidectomy: Case Report

Abstract

Amputation neuromas, also known as traumatic neuromas, are a rare but not uncommon occurrence following parotid gland surgery, with an incidence of up to 6% as the greater auricular nerve is often sacrificed to facilitate access to the parotid region.1,2 We present the case of a 65-year-old who presented with a 1 cm palpable, tender nodule 1-year post left superficial parotidectomy. These lesions can mimic recurrent tumors or secondary reactive Lymph nodes. The presence of amputation neuromas can be prevented by burying the greater auricular nerve under sternocleidomastoid muscle at the time of surgery, preventing the need for surgical excision and repeated general anesthesia. Surgical excision of amputation neuromas is rationalized when there is persistent tenderness, a suspicion of tumor recurrence or suspected lymph node metastasis. The use of imaging techniques to confirm diagnosis may eliminate the need for surgical removal.3 References: 1. Colella G, Borriello C, Lanza A, Rossiello R, Siniscalchi G. Neuroma traumatico del nervo grande auricolare. Caso clinico Traumatic neuroma of the great auricular nerve. A clinical case]. Minerva Stomatol. 2002;51(6):279-83. In Italian. PMID: 12147981 2. Moss CE, Johnston CJ, Whear NM. Amputation neuroma of the great auricular nerve after operations on the parotid gland. Br J Oral Maxillofac Surg. 2000;38(5):537-8. PMID: 11010790 doi: 10.1054/bjom.2000.0466 3. Falcon CS, Falcon MD, Villaverde RR, Solano JL, Ortega SS. Amputation neuromas after neck surgery. Dermatology Online J. 2005;11(2):24. PMID: 16150232