Facial nerve morbidity after retrograde nerve dissection in parotid surgery for benign disease: A 10-year prospective observational study of 136 cases

O’Regan, Barry; Bharadwaj, Girish; Bhopal, Sats; Cook, Victoria

doi:10.1016/j.bjoms.2006.03.009

Cited by 34 publications

(26 citation statements)

References 16 publications

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“…Department of Otolaryngology and Head and Neck Surgery, Addenbrooke's Hospital, Cambridge, UK e-mail: friffat@gmail.com dissection related injury [5]. Although a large percentage of these recover, the short-term and unfortunately some longterm palsies can have profound impacts on a patient's quality of life especially in the setting of an apparent small and innocuous lesion [6,7].…”

Section: Introductionmentioning

confidence: 99%

Safety of Extracapsular Dissection in Benign Superficial Parotid Lesions

Riffat

Mahrous

Buchanan

et al. 2012

J. Maxillofac. Oral Surg.

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Introduction The current practice for removal of clinically benign superficial parotid lesions is an appropriate superficial parotidectomy with a cuff of normal parotid tissue for complete pathological clearance. This technique requires the identification of the facial nerve at the main trunk and dissection of the segment of the facial nerve deep to the lesion. The reported major complications of this procedure include temporary or permanent facial nerve weakness, Frey's syndrome and salivary leaks. In order to avoid these complications, a local extracapsular dissection technique can be utilised in the management of small inferiorly located benign lesions of the parotid gland. Methods A retrospective case note review was performed for all parotidectomies between 2004 and 2009 in Addenbrooke's Hospital, Cambridge by the senior authors. Results A total of 172 cases were identified out which 46 underwent an extracapsular dissection. The average size of these lesions was 1.9 cm (0.9-2.4 cm) with all universally located inferior or posterior to the angle of the mandible. The pathologies were 14 pleomorphic adenomas, 24 Warthin's tumours, 6 lymphangiomas and 2 simple cysts. There were no post-operative facial nerve weaknesses, Frey's syndrome or salivary leaks within the extracapsular dissection group. The median follow-up of these patients were 4.6 years (2-6 years) with 6 patients lost to followup. No recurrences have been noted in the cohort at followup.

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Section: Introductionmentioning

confidence: 99%

Safety of Extracapsular Dissection in Benign Superficial Parotid Lesions

Riffat

Mahrous

Buchanan

et al. 2012

J. Maxillofac. Oral Surg.

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“…Similar to our study Patel DK et al performed superficial parotidectomy among 214 cases with retrograde dissection of the facial nerve for clinically benign parotid tumor and found low facial nerve morbidity and optimal tumor clearance, irrespective of tumor size 10 . In another prospective study performed by O' Regan B et al in 138 patients with retrograde facial nerve dissection for benign parotid tumor, 66% had facial nerve weakness in first week, 38% had remained with the complication up to first month and of these 99% were fully recovered within six months 8 . A recent study by Scarpini M et al found that retrograde parotidectomy, reducing the extent of normal parotid gland removal, permit a more conservative approach than standard parotidectomy, with the same complication rates and surgical effectiveness 11 .…”

Section: Discussionmentioning

confidence: 95%

“…The retrograde approach involves identification of the peripheral branches of the facial nerve, using soft tissue landmarks. It has been observed that soft tissue landmarks of the peripheral branches are easier to identify than is commonly thought, especially with the aid of the facial nerve stimulator 8,9 . This study includes all 60 patients who underwent superficial parotidectomy by retrograde facial nerve dissection at Western Regional Hospital during 10 years time period.…”

Section: Discussionmentioning

confidence: 99%

Superficial Parotidectomy by Retrograde Facial Nerve Dissection

Gurung

Shrestha

Acharya

et al. 2017

J. Gandaki Med. Coll. Nepal

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Introduction: Tumors of the salivary gland are relatively uncommon and represent less than two percentage of all head and neck neoplasms. Parotid gland tumor comprises 85% of the salivary gland tumors of which 80% are being benign. Superficial parotidectomy is the commonest procedure done for parotid tumors which can be performed by either anteretrograde or retrograde facial nerve dissection technique.

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“…Advantages of this procedure includes avoidance of injury to the main trunk and unexposed branches of the facial nerve, less blood loss, shorter operative time, removal of less normal parotid tissue and a more favourable cosmetic outcome. [1,6] This technique also offers wide operative field visibility for both surgeons and the assistants thus resulting in less traction induced nerve injuries. [7] A wider operative field will help in easier dissection and better haemostasis.…”

Section: Discussionmentioning

confidence: 99%

“…The lower border of the zygomatic arch is a reliable bony landmark for the zygomatic branches. [6] Many studies have shown that retrograde technique reduces duration of surgery. [1,5,9,17] In the present study mean surgery duration is 88 minutes and is comparable with observations in the above studies.…”

Section: Discussionmentioning

confidence: 99%

Retrograde Facial Nerve Dissection Using Zygomatic Branch as Landmark in Parotid Gland Surgery for Pleomorphic Adenoma: A 4 Year Prospective Study of 40 Cases

Biswal¹,

Sebastian²

2018

AIMDR

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Background: The retrograde dissection for doing parotidectomy is technically easier and surgeon can limit the dissection to 1 or 2 branches of facial nerve if required and hence avoids injury to the trunk or other branches of facial nerve, aiming at removal of only the parotid parenchymal area that bears the tumour. Objectives: To compare our results with those of similar studies in the recent literature. To compare nerve recovery rates when zygomatic branch is used as landmark with that of other techniques from literature. Methods: In this study 40 patients with pleomorphic adenoma of parotid gland underwent superficial parotidectomy at V.S.S Medical College hospital Burla and S.C.B medical college Cuttack in a 4 year period between 2013 and 2016. All 40 patients underwent retrograde superficial parotidectomy. We compared our results with results of similar studies in the recent literature. Results: Although all 40 patients experienced paresis immediately after surgery, 25% patients completely recovered and 75% patients had facial nerve weakness at the end of first week. Among this 60% patients were having H.B-2 weakness, 7.5% had H.B-3 weakness, 5% had H.B-4 and 2.5% had H.B-5 weakness. Any injury equal to or more than H.B-3 was considered serious. 15% patients were having serious injury. None of the patients had H.B-6 (severe) facial nerve weakness. Conclusion: Transient nerve weakness after retrograde parotidectomy is common but recovery will be faster than that of ante grade technique and within 6 months to 1 year all patients should recover nerve function completely.

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Facial nerve morbidity after retrograde nerve dissection in parotid surgery for benign disease: A 10-year prospective observational study of 136 cases

Cited by 34 publications

References 16 publications

Safety of Extracapsular Dissection in Benign Superficial Parotid Lesions

Safety of Extracapsular Dissection in Benign Superficial Parotid Lesions

Superficial Parotidectomy by Retrograde Facial Nerve Dissection

Retrograde Facial Nerve Dissection Using Zygomatic Branch as Landmark in Parotid Gland Surgery for Pleomorphic Adenoma: A 4 Year Prospective Study of 40 Cases

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