Great auricular nerve preservation in parotid surgery: rationale and long-term results insights

Moretti, Antonio; Citraro, Leonardo; Petrucci, Anna Grazia; Giovanni, Pamela Di; Mauro, Roberta Di; Giacomini, P

doi:10.1007/s00405-014-3342-6

Cited by 20 publications

(13 citation statements)

References 12 publications

(16 reference statements)

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“…We often experienced that the identified small branches of the GAN had to be removed during further dissection. However, similar patients' distribution into the GAN and non‐GAN groups was present in previously published prospective studies, indicating the complexity of randomization. The time needed for GAN dissection was not investigated in this trial.…”

Section: Discussionmentioning

confidence: 92%

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Sensation loss after superficial parotidectomy: A prospective controlled multicenter trial

et al. 2017

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Section: Discussionmentioning

confidence: 92%

“…In agreement with previous reports, the dissection and preservation of the posterior GAN branch was feasible in 61% of patients in this study. However, a preoperative randomization of patients into the non‐GAN and GAN groups as an alternative study design would have been challenging.…”

Section: Discussionmentioning

confidence: 99%

Sensation loss after superficial parotidectomy: A prospective controlled multicenter trial

et al. 2017

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“…Therefore, iatrogenic injury to smaller nerve branches, such as the great auricular nerve, is common during head and neck surgery. Although functional consequences may not be as debilitating as those caused by damage to larger nerves in the head and neck, postoperative quality of life can be improved by preservation of small nerves . Importantly, we were able to show significantly improved small nerve visualization with FL through thin layers of overlying tissue.…”

Section: Discussionmentioning

confidence: 69%

“…Although functional consequences may not be as debilitating as those caused by damage to larger nerves in the head and neck, postoperative quality of life can be improved by preservation of small nerves. 12,33,34 Importantly, we were able to show significantly improved small nerve visualization with FL through thin layers of overlying tissue. Covered small nerve branches were mostly not visible at all under WL; therefore, this particular finding may have substantial value in the more complex human anatomical setting, even for larger nerve branches, particularly where the anatomy has been distorted.…”

Section: Discussionmentioning

confidence: 76%

Improved facial nerve identification during parotidectomy with fluorescently labeled peptide

et al. 2016

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Objectives/Hypothesis Additional intraoperative guidance could reduce the risk of iatrogenic injury during parotid gland cancer surgery. We evaluated the intraoperative use of fluorescently labeled nerve binding peptide NP41 to aid facial nerve identification and preservation during parotidectomy in an orthotopic model of murine parotid gland cancer. We also quantified the accuracy of intraoperative nerve detection for surface and buried nerves in the head and neck with NP41 versus white light (WL) alone. Study Design Twenty-eight mice underwent parotid gland cancer surgeries with additional fluorescence (FL) guidance versus WL reflectance (WLR) alone. Eight mice were used for additional nerve-imaging experiments. Methods Twenty-eight parotid tumor-bearing mice underwent parotidectomy. Eight mice underwent imaging of both sides of the face after skin removal. Postoperative assessment of facial nerve function measured by automated whisker tracking were compared between FL guidance (n = 13) versus WL alone (n = 15). In eight mice, nerve to surrounding tissue contrast was measured under FL versus WLR for all nerve branches detectable in the field of view. Results Postoperative facial nerve function after parotid gland cancer surgery tended to be better with additional FL guidance. Fluorescent labeling significantly improved nerve to surrounding tissue contrast for both large and smaller buried nerve branches compared to WLR visualization and improved detection sensitivity and specificity. Conclusions NP41 FL imaging significantly aids the intraoperative identification of nerve braches otherwise nearly invisible to the naked eye. Its application in a murine model of parotid gland cancer surgery tended to improve functional preservation of the facial nerve.

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“…This is particularly relevant in young to middle‐aged patients with benign disease where recurrence is unlikely . Other complications of parotid surgery, such as dysaesthesia and Frey's syndrome, are rarely major issues but can still adversely impact quality of life …”

Section: Introductionmentioning

confidence: 99%

Reconstruction of limited parotidectomy defects using the dermofat graft

Pham

Eviston

Clark

2016

ANZ Journal of Surgery

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Great auricular nerve preservation in parotid surgery: rationale and long-term results insights

Cited by 20 publications

References 12 publications

Sensation loss after superficial parotidectomy: A prospective controlled multicenter trial

Sensation loss after superficial parotidectomy: A prospective controlled multicenter trial

Improved facial nerve identification during parotidectomy with fluorescently labeled peptide

Reconstruction of limited parotidectomy defects using the dermofat graft

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