Sensory dysfunction and quality of life after great auricular nerve sacrifice during parotidectomy: our experience

Galli, Jacopo; Pandolfini, Manlio; Rigante, Mario; Schinaia, Lorenzo; Guidi, Maria Lavinia; Almadori, Giovanni; Paludetti, Gaetano

doi:10.1017/s0022215115001863

Cited by 9 publications

(3 citation statements)

References 14 publications

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“…Less attention is paid to the management of the great auricular nerve (GAN) and the possible morbidity associated with its sacrifice . These can include anaesthesia, paraesthesia, discomfort, increased risk of neuromas, traumatic injuries and functional deficits (eg difficulties in using telephone, wearing ear rings) . The effect of sacrifice or preservation of the GAN on patients' quality of life remains unclear …”

Section: Introductionmentioning

confidence: 99%

Long‐term quality of life and sensory impact of great auricular nerve preservation in parotid surgery as measured with the Parotidectomy Outcome Inventory‐8

Bulut

Hohenberger

Oladokun

et al. 2019

Clinical Otolaryngology

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Objectives: This study aimed to evaluate sensory dysfunction resulting from great auricular nerve (GAN) sacrifice versus preservation in parotid surgery for benign lesions and its imact on long-term health-related quality of life (QOL). Design: Retrospective.Setting/main outcome measures: Participants were divided into two groups (GAN and non-GAN), and both short-term (two postoperative weeks) and long-term (at least 5 years) QOL were assessed. The second item of the Parotidectomy Outcome Inventory-8 (POI-8) was used to analyse postoperative sensory loss. All items of the POI-8 questionnaire were used to determine health-related QOL.We used t test for dependent samples and Mann-Whitney U-test to compare patient groups Participants: A total of 137 patients (65 male and 72 female) enrolled in this study.Average age at the time of surgery was 53 years (±12.8).Results: The GAN preservation group had significantly better sensation than the GAN sacrifice in short term (2.8 vs 2.1; P = 0.017). Both groups experienced improved sensation in the long term, and there was a trend towards better QOL in the GAN-preservation group. However, the difference in sensation was not statistically significant (1.7 vs 1.3; P = 0.145). Health-related QOL also increased in the long term (compared to short term) for both groups (7.6 ± 6.2 to 12 ± 7.6; P < 0.0001) postoperatively. GAN preservation did not significantly improve sensation in long term, nor did it increase health-related QOL postoperatively. Conclusion:Although GAN preservation was easily feasible, it only improved sensation in short term. We report a negative result: GAN preservation did not significantly improve sensation in long-term, nor did it increase health-related QOL postoperatively when compared to GAN sacrifice.

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Section: Introductionmentioning

confidence: 99%

Long‐term quality of life and sensory impact of great auricular nerve preservation in parotid surgery as measured with the Parotidectomy Outcome Inventory‐8

Bulut

Hohenberger

Oladokun

et al. 2019

Clinical Otolaryngology

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“…The GAN is frequently sacrificed during parotid surgery especially if runs close to the tumour, with consequent numbness around the ear lobe but a modest impact on patient quality of life 46 . Moretti et al suggest that saving as many branches of the GAN as possible during parotid surgery could be useful in reducing hypo-dysaesthesia 47 .…”

Section: Discussionmentioning

confidence: 99%

Parotid tumours: clinical and oncologic outcomes after microscope-assisted parotidectomy with intraoperative nerve monitoring

Carta

Chuchueva

Gerosa

et al. 2017

Acta Otorhinolaryngol Ital

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I pazienti sottoposti ad intervento chirurgico di parotidectomia per lesioni benigne e maligne possono presentare disfunzioni temporanee o permanenti del nervo facciale. Il monitoraggio intraoperatorio della motilità facciale è uno strumento ampiamente riconosciuto per la sua utilità nella preservazione del nervo, mentre lefficacia del microscopio operatorio è stata raramente discussa. Gli autori riportano la loro esperienza su 198 parotidectomie consecutive eseguite su 196 pazienti con lausilio del microscopio operatorio e del monitoraggio intraoperatorio del nervo facciale. Centoqurantacinque interventi sono stati eseguiti per lesioni benigne e 53 per neoplasie maligne. Tredici pazienti operati per lesioni benigne hanno presentato un deficit della funzionalità del nervo facciale: 11 hanno sofferto di paralisi temporanea e 2 di paralisi permanente (entrambe di secondo grado). Dieci pazienti affetti da patologia maligna presentavano un interessamento preoperatorio del nervo facciale. Cinque e sei pazienti affetti da patologia maligna senza interessamento preoperatorio del nervo hanno presentato un deficit rispettivamente temporaneo e definitivo (in 2 casi il sacrificio di un ramo del nervo macroscopicamente infiltrato dalla neoplasia fu deciso solo durante la procedura chirurgica). Lincidenza di paralisi definitiva di una singola branca del nervo facciale dopo interventi eseguiti per lesioni che non originavano dal nervo facciale o che non lo infiltravano macroscopicamente (n = 185) è stata del 2,7%. I pazienti trattati per tumori benigni non flogistici del lobo superficiale della ghiandola parotide (n = 91) hanno presentato una paralisi facciale postoperatoria temporanea nel 4,4% dei casi e nessun deficit permanente. Luso combinato del microscopio operatorio e del monitoraggio intraoperatorio del nervo sembra garantire la preservazione del nervo facciale nei pazienti sottoposti a parotidectomia.

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“…Im Zur Messung der gesundheitsbezogenen Lebensqualität bei Speicheldrüsenerkrankungen wurden bislang zumeist allgemeine Fragebögen zur Lebensqualität in retrospektiven Kohortenstudien eingesetzt [40][41][42][43][44]. Eine Übersicht über die verwendeten PROMs gibt ▶ tab.…”

Section: Weitere Symptome Von Speicheldrüsenerkrankungen Sowie Nebenwunclassified

Qualität der Therapie von Speicheldrüsenerkrankungen

Guntinas‐Lichius

2020

Laryngo-Rhino-Otol

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ZusammenfassungDie Behandlung von Speicheldrüsenerkrankungen stellt ein wichtiges Segment der HNO-Heilkunde dar. Von der Vielzahl von Speicheldrüsenerkrankungen sieht der einzelne HNO-Arzt allerdings möglicherweise nur wenige Fälle pro Jahr und chirurgische oder endoskopisch minimal-invasive Therapiekonzepte spielen eine wichtige Rolle. Daher kann der Erkenntnisgewinn nicht nur von prospektiven klinischen Studien getragen werden, sondern heute im Wesentlichen durch Meta-Analysen und potentiell auch von Registerdaten. Während eine Vielzahl guter Indikatoren vorhanden ist, um die Funktion der erkrankten Speicheldrüse und deren Besserung unter Therapie zu messen, sind Patient-reported outcome measures (PROMs) bislang nicht ausreichend entwickelt worden. Es ist zu fordern, dass diese Indikatoren auch konsequent in klinischen Studien eingesetzt werden. Perspektivisch könnten dieselben Indikatoren auch für Qualitätskontrollen in der ambulanten und stationären Routine angewandt werden. Die Rahmenbedingungen für einen qualitativ hochwertigen Wissenserwerb sind durch die HNO-Facharzt-Ausbildung, die Verpflichtung der Weiterbildung und durch zertifizierte Speicheldrüsen-Kurse prinzipiell sehr gut, die Vorgaben für spezifische Qualitätsstandards für die Behandlung von Patienten sind jedoch wenig ausgearbeitet. In Abgrenzung zu anderen Fachgebieten, die sich mit Speicheldrüsenerkrankungen beschäftigen, sollte die HNO-Heilkunde Standards mit hoher Qualitätsforderung für die Behandlung von Patienten mit Speicheldrüsenerkrankungen entwickeln.

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Sensory dysfunction and quality of life after great auricular nerve sacrifice during parotidectomy: our experience

Abstract: Sacrifice of the great auricular nerve has only a small impact on patient quality of life; their daily activities are not significantly affected.

Cited by 9 publications

References 14 publications

Long‐term quality of life and sensory impact of great auricular nerve preservation in parotid surgery as measured with the Parotidectomy Outcome Inventory‐8

Long‐term quality of life and sensory impact of great auricular nerve preservation in parotid surgery as measured with the Parotidectomy Outcome Inventory‐8

Parotid tumours: clinical and oncologic outcomes after microscope-assisted parotidectomy with intraoperative nerve monitoring

Qualität der Therapie von Speicheldrüsenerkrankungen

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