Predictive factors of facial palsy after parotidectomy: analysis of 166 operations

Abstract

A B S T R A C TObjectives: Facial nerve injury is one of the most important complications in parotid gland surgery. This study aims to identify possible predictive factors for iatrogenic facial paralysis in parotidectomy. Material and method:We performed a retrospective analysis of cases of parotidectomy in the treatment of parotid tumors carried out at a Portuguese Oncology Institute, during a period of 25 years. Socio-demographic data, patient's comorbidities, surgical procedure and tumor histopathology were reviewed. Results:The study sample consisted of a total of 166 patients (86 males and 80 females), with a mean age of 56.9 ± 16.8 years. In 62 cases (37.4 %), some degree of postoperative facial palsy was observed. The extent of surgery (rho = 0.177; p = 0.023) and tumor size (rho = 0.159; p = 0.045) showed correlation with facial nerve injury. The factors malignancy of the lesion (rho = 0.568; p < 0.001), extension of the surgery (rho = 0.485; p < 0.001) and enlargement of the excision to the skin (rho = 0.7211; p < 0.001) correlated with the facial nerve sacrifice. The percentage of persistent facial palsy was only 7.6%. Conclusions: Tumors of larger size and with extension to the deep lobe of the parotid are significantly correlated with iatrogenic facial palsy. Malignancy of the lesion and greater extension of surgery correlate with facial nerve sacrifice. 1130-0558/

Pattern of facial nerve palsy during parotidectomy: a single-center experience

“…The marginal branch of the facial nerve was the most frequently involved branch. 18 In the current series, the prevalence of temporary facial nerve paresis was 9.0%, and permanent facial nerve damage occurred only in two (1.6%) patients. In both patients, only the cervical branch was damaged.…”