Facial nerve morbidity following parotid surgery for benign disease: The cleveland clinic foundation experience

Mehle, Mark E.; Kraus, Dennis H.; Wood, Benjamin G.; Benninger, Michael S.; Eliachar, Isaac; Levine, Howard L.; Tucker, Harvey M.

doi:10.1002/lary.5541030404

Cited by 130 publications

(111 citation statements)

References 7 publications

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“…The incidence of transient facial nerve palsy was 68.26% in our study, higher than studies reported by Laccorreye [15] & Mehle [16]. Permanent facial nerve palsy was seen in 0.04% of our patients.…”

Section: Images In Surgerycontrasting

confidence: 61%

A clinicopathological study on morphological pattern and management of parotid tumours: a multicentric experience

et al. 2017

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Section: Images In Surgerycontrasting

confidence: 61%

A clinicopathological study on morphological pattern and management of parotid tumours: a multicentric experience

et al. 2017

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“…14 In another study it was mentioned that most of the patients with post operative facial nerve paresis, regained their normal function within 12-14 months after surgery, regardless of the pathology and that a slower recovery occurred for up to two years after surgery. 15 In this study, majority of patients showed significant functional recovery within three months after the surgery and all recovery occurred within six months after surgery.…”

Section: Discussionmentioning

confidence: 52%

Study of the Nerve Injury in Parotid Gland Surgery

Rahman

Joarder

2012

Nepalese J ENT Head Neck Surg

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Tumors of the parotid glands are believed to represent approximately 2% of tumors of the head and neck. Parotid gland tumors also accounts for 70% to 80% of all tumors of the salivary glands. 1 Approximately, 80% of parotid tumors are benign and 80% of benign tumours are pleomorphic adenomas and 80% arise from the superficial lobe of the parotid gland. 2 Less commonly, tumours may arise from the accessory lobe of the gland and present as a persistent swelling in the cheek. Rarely, tumours may arise from the deep lobe of the parotid gland and present as parapharyngeal masses. 3 The facial nerve is a very important nerve which exits through the skull base, below the ear lobule and travels through the parotid gland, separating the gland into superficial and deep lobes. 4 The hazardous course of the facial nerve through the parotid has evoked considerable risk of nerve injury. 2 The incidence of facial nerve paralysis is higher in total than in superficial parotidectomy, which may be related to stretch injury or as a result of surgical interference with the vasa nervosum. Among the branches of facial nerve which is the most at risk for injury during parotidectomy, is the marginal mandibular branch. 5 Parotid duct ligation increases the risk of nerve palsy in the distribution of zygomatic and buccal branches. Operations for Warthins tumour were associated with the increased risk of dysfunction of the cervical branch of the facial nerve. 6 Advanced age, longer operation time and larger specimen will have the significant risk for transient facial palsy after conservative parotidectomy. 7 There are two basic techniques for the identification and dissection of the facial nerve. One is the forward or antegrade dissection, where the approach to the main trunk is taken as an early step of tracing it to the bifurcation and peripheral branches. Retrograde dissection of the facial nerve is more popular in china with encouraging results. 1 Function preserving parotid surgery has relatively low complication rate like the use of a modified facelift incision, preservation of the great auricular nerve and normal parotid parenchyma. Ear sensation returned more rapidly and more completely in patients in whom the posterior branch of the great auricular nerve is preserved than in those in whom the nerve is sacrificed. 8 The auriculotemporal nerve provides both parasympathetic innervations to the parotid gland and sympathetic innervations to sweat glands and subcutaneous blood vessels. Freys syndrome is due to regrowth of the secretomotor parasympathetic fibers into the distal cut ends of the sympathetic fibers into the skin. 9 The objective of this study is to find out the frequency of nerve injuries after parotid surgery. O b j e c t i v e :To find out the frequency of nerve injuries after parotid surgery M a t e r i a l a n d m e t h o d s :A Cross sectional study was done from January 2008 to December 2009, in the Department of Otolaryngology and Head Neck Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU) & Dhaka Medical ...

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“…Permanent facial nerve dysfunction is reported in 0-4 % of cases following facial nerve dissection procedures [45][46][47]. A meta-analysis showed twice the chance of permanent facial nerve dysfunction with ECD compared with superficial parotidetomy and a three times higher chance following total parotidectomy compared to superficial parotidectomy [1].…”

Section: Permanent Facial Nerve Dysfunctionmentioning

confidence: 99%

The Role of Extracapsular Dissection for Benign Parotid Tumors

Witt

Iro

McGurk

2014

Curr Otorhinolaryngol Rep

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Surgical treatment of benign parotid tumors has been debated for decades. Extracapsular dissection (ECD) differs markedly from classic surgical approaches to the parotid neoplasm because facial nerve dissection is not performed. ECD, its advantages, disadvantages, indications, and contra-indications for benign tumors with an emphasis on benign mixed tumor will be comprehensively explored in this chapter. Factors noted to favor this approach include mobility of the tumor within the gland, a thin covering of capsule and glandular tissue, and a tumor large enough to allow digital manipulation during dissection. Imaging, fine needle aspiration cytology, and neuromonitoring play a heightened role in ECD. Recurrence and permanent facial nerve dysfunction with ECD are not higher in high volume centers performed by experienced surgeons. Transient facial nerve dysfunction, Frey's syndrome, sensory deficits, and sialocele are lower with ECD. Devastating adverse outcomes of permanent facial nerve dysfunction and recurrence should be considered by the occasional and inexperienced parotid surgeon.

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Facial nerve morbidity following parotid surgery for benign disease: The cleveland clinic foundation experience

Cited by 130 publications

References 7 publications

A clinicopathological study on morphological pattern and management of parotid tumours: a multicentric experience

A clinicopathological study on morphological pattern and management of parotid tumours: a multicentric experience

Study of the Nerve Injury in Parotid Gland Surgery

The Role of Extracapsular Dissection for Benign Parotid Tumors

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