Patterns of Use of Facial Nerve Monitoring During Parotid Gland Surgery

Abstract

with organ-sparing intent and to analyze the risk factors and management issues.Methods: A total of 129 patients with Stage III and IV squamous cell carcinoma of the larynx or hypopharynx were treated with concurrent radiotherapy and targeted with intraarterial infusion of cisplatin for definitive curative treatment and larynx preservation over a 9-year period. The research database pertaining to these patients and their hospital and outpatient charts was reviewed.Results: Twelve of 129 patients (9.3%) developed Chandler Grade III or IV chondroradionecrosis of the larynx in the posttreatment period; 3/12 (25%) required total laryngectomy for resolution of the necrosis and 1/12 (8.3%) underwent a surgical procedure for aspiration control. This represents an overall need for nonmalignant laryngectomy in this treatment population of 2.3%.Conclusions: The percentage of chemoradiotherapy patients with chondroradionecrosis appears increased as compared to previous patients treated with radiotherapy alone. However, the risk (2.3%) of total laryngectomy for chondroradionecrosis may be acceptable to many or most individuals with advanced head and neck cancer. It is imperative that this issue be discussed in advance to allow patients to make informed treatment decisions.

Continuous Intraoperative Facial Nerve Monitoring in Predicting Postoperative Injury During Parotidectomy

“…In a recent survey by Lowry et al, 15 60% of practicing otolaryngologists used facial nerve monitoring during parotid surgery some or all of the time in their current practice. The most common reasons cited for use of the nerve monitor were to aid in identification of the nerve, medicolegal reasons, increased safety, and the belief that it was the standard of care.…”

Electrophysiologic facial nerve monitoring during parotidectomy

“…15 In addition, U.S. surgeons who use facial nerve monitoring in their practice are less likely to have a history of a parotid surgery-related lawsuit. 15 Facial Nerve Monitoring Methods. Several methods of facial nerve monitoring during parotidectomy exist.…”

Association Between Facial Nerve Monitoring With Postoperative Facial Paralysis in Parotidectomy

“…In a postal survey to all UK consultant otolaryngologists, 7 82% of respondents performing parotid surgery reported monitoring facial nerve function during the procedure. In a similar US survey, 8 60% of respondents who performed parotidectomy used facial nerve monitoring some or all of the time. In a nationwide survey of ear, nose, and throat hospitals in Germany in 2006, 9 75% of respondents routinely used facial nerve monitoring in parotid surgery.…”