Abstract: Objective: To summarize the clinical manifestations, diagnosis, and surgical treatment methods of recurrent malignant tumors of parotid gland involving lateral skull base. Methods: A retrospective analysis was conducted on the clinical data and treatment methods of patients with recurrent parotid gland malignant tumors involving the lateral skull base admitted to the First Ward of Nanjing University Affiliated Stomatological Hospital from October 2019 to October 2024. Results: All 9 patients underwent surgical treatment, with the resection scope including the lesion and the affected structures such as the zygomatic arch, temporalis muscle, condyle, masseter muscle, medial and lateral pterygoid muscles, and part of the external auditory canal. The surgical resection reached the lateral skull base, with 2 cases undergoing lesion resection under computer-assisted navigation guidance. Postoperative tissue defects were repaired with adjacent flaps in 2 cases and with anterior lateral thigh muscle flaps in 7 cases. All flaps survived after surgery. Conclusion: Surgical treatment for recurrent malignant tumors of the parotid gland involving the lateral skull base is relatively complex, involving numerous important anatomical structures, including the parotid bed, internal and external pterygoid muscles, pterygoid plexus, trigeminal nerve, zygomatic arch, jawbone, etc. After recurrence, tissue structure deformation should be observed. Before surgery, a clear understanding of the tumor scope and involved anatomical structures should be obtained, and personalized plans should be designed for tumor invasion structures. During surgery, bleeding should be controlled, and postoperative vital signs and flap condition should be closely monitored, supplemented by radiotherapy and chemotherapy.

Key words: recurrent malignant tumors of the parotid gland, lateral skull base, surgical safety margin, computer navigation technology