Comparison of facial nerve injury and recovery rates after antegrade and retrograde nerve dissection in parotid surgery for benign disease: prospective study over 4 years

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

“…O' regan et al in 2011 studied on outcome and recovery of facial nerve injuries after both ante grade and retrograde parotidectomies and concluded that temporary paresis after retrograde dissection recovers more faster at 3 months post-operative than those after ante grade dissection. [11] Section: Surgery 73% of patients recovered their facial paresis at the end of 3 months in the present study. In our study only 15% of patients had serious facial nerve injury at week 1.…”

“…Wang etal also reported no incidence of facial nerve paresis on his study of 383 patients. [12] Even though in almost all recent studies buccal branch or marginal mandibular branch of facial nerve is mentioned as the most reliable branch for retrograde facial nerve dissection, [11,15,16] in the present study we followed zygomatic branch of facial nerve and concluded that the later is also dependable for the retrograde dissection. The lower border of the zygomatic arch is a reliable bony landmark for the zygomatic branches.…”

“…In recent literature studies showing significant reduction in complication rates by retrograde technique when compared with ante grade technique for doing parotidectomy were published, which again attracted attention towards this "older" technique. [1,5,10,11,15] The retrograde dissection 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. A retrograde approach may conserve normal parotid tissue, result in a more favourable cosmetic outcome and reduce operative time.…”

Nimodipine promotes regeneration of peripheral facial nerve function after traumatic injury following maxillofacial surgery: An off label pilot-study

“…The beginning of FN recovery after the anterograde technique for FN dissection is reported within 3 months (O'Regan and Bharadwaj, 2011), while traumatic FN injuries showed a recovery by half a grade in HB-classification after 3 months and an improvement by 1.5e2.5 grades to HB grade II eIII after 6e9 months (Popovic et al, 2003). The time of spontaneous FN recovery after sagittal split osteotomy is reported within 4 months (Dendy, 1973).…”

“…The frequency of FN injury depends on the surgical approach and the FN dissection technique during the operation (O'Regan and Bharadwaj, 2011). After parotid gland surgery even well-trained surgeons, who have safely dissected and preserved the FN, report postoperative FN branch paresis occurring at least temporarily in half of their operations (Conley, 1975;Fee and Handen, 1984).…”