Impact of dysfunction of the facial nerve after superficial parotidectomy: a prospective study

Prats-Golczer, Victoria-Eugenia; Gonzalez-Cardero, Eduardo; Tirado, J.A. Expósito; Montes-Latorre, Enrique; González-Pérez, L.M.; Infante-Cossio, Pedro

doi:10.1016/j.bjoms.2017.07.006

Cited by 18 publications

(16 citation statements)

References 14 publications

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“…After 12 and 24 months, respectively, 59 and 71% of the patients showed positive sensory test results in the lobule if the nerve branch was preserved, versus 24 and 31% if the nerve branch was not preserved ( 150 ). Finally, one recent prospective study on 79 patients used the Facial Disability Index (FDI) as a patient-related outcome measure and the Short-Form 36-Item (SF-36) questionnaire for measurement of general quality of life after superficial parotidectomy ( 151 ). Whereas general quality of life was unchanged, physical values on the FDI decreased during the first 3 months and psychosocial values improved significantly from then onwards to 12 months.…”

Section: Resultsmentioning

confidence: 99%

Contemporary Management of Benign and Malignant Parotid Tumors

Thielker

Grosheva

Ihrler³

et al. 2018

Front. Surg.

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To report the standard of care, interesting new findings and controversies about the treatment of parotid tumors.Relevant and actual studies were searched in PubMed and reviewed for diagnostics, treatment and outcome of both benign and malignant tumors.Prospective trials are lacking due to rarity of the disease and high variety of tumor subtypes.The establishment of reliable non-invasive diagnostics tools for the differentiation between benign and malignant tumors is desirable. Prospective studies clarifying the association between different surgical techniques for benign parotid tumors and morbidity are needed. The role of adjuvant or definitive radiotherapy in securing loco-regional control and improving survival in malignant disease is established. Prospective clinical trials addressing the role of chemotherapy/molecular targeted therapy for parotid cancer are needed. An international consensus on the classification of parotid surgery techniques would facilitate the comparison of different trials. Such efforts should lead into a clinical guideline.

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Section: Resultsmentioning

confidence: 99%

Contemporary Management of Benign and Malignant Parotid Tumors

Thielker

Grosheva

Ihrler³

et al. 2018

Front. Surg.

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“…However, one of the most common postoperative complications is FN weakness [4-6]. In most benign tumor treatment cases, the FN weakness is temporary, and full recovery is usually achieved within six months after the surgery [7-8]. According to P. Wolber and colleagues, for 40.2% of patients who had undergone superficial parotidectomy, the FN dysfunction developed on the first day and for 14%, it persisted after six months post-surgery [9].…”

Section: Introductionmentioning

confidence: 99%

“…Fortunately, the permanent FN paralysis after parotidectomy is far less common. Recently published papers revealed that FN paralysis persists for 0% to 9.0% of patients 12 months post-surgery [5,7-9]. The identification of FNT during parotidectomy is essential to avoid this complication.…”

Section: Introductionmentioning

confidence: 99%

Variations in Facial Nerve Branches and Anatomical Landmarks for Its Trunk Identification: A Pilot Cadaveric Study in the Lithuanian Population

Stankevicius¹,

Suchomlinov²

2019

Cureus

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ObjectiveThe purpose of this study was to evaluate facial nerve (FN) branching variations based on Davis and Kopuz classifications in the Lithuanian population and measure the shortest distance from the facial nerve trunk (FNT) to its anatomical landmarks.MethodsTwenty-two hemifaces of 11 cadavers were dissected. The preauricular skin cut was made and extended behind the ear lobe and along the inferior border of the mandible. The skin with subcutaneous tissue and superficial fascia were separated and medially retracted, and the parotid gland was dissected anterogradely. The FNT and its furcation type and branching pattern were disclosed and noted based on Davis and Kopuz classifications. Further, the shortest distance from the FNT to the anatomical landmarks of the tragal pointer (TP), the angle of mandible (AM), and the tip of mastoid process (TMP) was measured.ResultsThe prevalence of branching patterns did not differ significantly compared to Davis classification. Based on Kopuz, type IVA pattern was the most common in six cases (27%). Eighteen (82%) trunks split as bifurcations and two (9%) trifurcations, while two (9%) had separate double trunks. The shortest distance (mm) from the FNT to the TP is 9.30 ± 0.93, AM 36.45 ± 4.14, and TMP 12.52 ± 2.30.ConclusionThe prevalence of FN variations in the Lithuanian population is similar to Davis classification. The AM and TMP are consistent superficial bony landmarks for trunk identification, while the distance from the TP highly varies among studies. Surgeons should be aware of double FNT during parotidectomy, which is described in Kopuz classification.

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“…The most significant complication is the facial nerve dysfunction that can appear as paralysis (complete loss of function) or paresis (partial loss) ( 2 , 3 ). In most cases, this facial paresis is temporary and recovery of nerve function is achieved before 6 months after surgery, usually within the first two months ( 4 , 5 ). Other postparotidectomy complications include infection, salivary fistula, hemorrhage, hematoma, sialocele/seroma, aesthetic deformity, numbness around the earlobe and Frey’s syndrome ( 2 , 6 - 8 ).…”

Section: Introductionmentioning

confidence: 99%

Complications after superficial parotidectomy for pleomorphic adenoma

et al. 2018

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BackgroundThe significance of complications after superficial parotidectomy remains unclear, since prospective studies are lacking. The aim of this study was to evaluate facial nerve dysfunction and other postoperative complications after superficial parotidectomy for pleomorphic adenoma of the superficial lobe and to identify the associated risk factors.Material and MethodsProspective and descriptive clinical study on 79 patients undergoing formal superficial parotidectomy with the modified facelift incision, dissection of the facial nerve and reconstruction with the superficial musculoaponeurotic system flap. Function of the facial nerve using the House-Brackmann scale and the intra- and postoperative complications were recorded at 1 week and 1, 3, 6 and 12 months. A descriptive, inferential and binary logistic regression analysis were performed for the variables facial nerve dysfunction, tumor size and location, clinical presentation and duration of surgery.Results77.2% of the patients presented facial paresis at 1 week, with the marginal-mandibular branch being the most commonly affected (64.5%). 94.9% recovered the facial function at 6 months and 100% at 12 months. A statistically significant relationship was found between the appearance of facial paresis and tumor location in the superior lateral area of the superficial lobe, size >2 cm and prolonged operative time. None of the remaining variables showed significant differences at any study timepoint. At 12 months, 57% of patients had recovered tactile sensitivity in the earlobe. The clinical occurrence of Frey’s syndrome was 11.4%.ConclusionsDespite the high incidence of postoperative facial paresis at 1 week, its magnitude was low and the recovery time was short. Tumor location in the parotid superficial lobe upper area, size and prolonged operative time are risk factors that can worsen facial paresis at different study timepoints. The knowledge of these complications is relevant for patient´s counseling and to achieve better long-term outcomes. Key words:Superficial parotidectomy, pleomorphic adenoma, parotid gland, facial nerve paralysis, postoperative complications.

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Impact of dysfunction of the facial nerve after superficial parotidectomy: a prospective study

Cited by 18 publications

References 14 publications

Contemporary Management of Benign and Malignant Parotid Tumors

Contemporary Management of Benign and Malignant Parotid Tumors

Variations in Facial Nerve Branches and Anatomical Landmarks for Its Trunk Identification: A Pilot Cadaveric Study in the Lithuanian Population

Complications after superficial parotidectomy for pleomorphic adenoma

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