Facial Nerve Monitoring During Parotidectomy: A Two-Center Retrospective Study

Document Type: Original

Authors

1 Department of Otorhinolaryngology – Head and Neck Surgery, Military Training Hospital Percy 101, avenue Henri Barbusse 92140 Clamart, France.

2 Department of Otorhinolaryngology – Head and Neck Surgery, Versailles Hospital Center, André Mignot Hospital 177, rue de Versailles 77157 Le Chesnay cedex, France.

3 Department of Otorhinolaryngology – Head and Neck Surgery, Military Training Hospital Val de Grâce74, boulevard de Port Royal 75005 Paris, France.

Abstract

Introduction:
We present a retrospective two-center study series and discussion of the current literature to assess the benefits of facial nerve monitoring during parotidectomy.
Materials and Methods:
From 2007 to 2012, 128 parotidectomies were performed in 125 patients. Of these, 47 procedures were performed without facial nerve monitoring (group 1) and 81 with facial nerve monitoring (group 2). The primary endpoint was the House-Brackmann classification at 1 month and 6 months. Facial palsy was determined when the House-Brackmann grade was 3 or higher.
Results:
In group 1, 15 facial palsies were noted; 8 were transient and 7 were definitive. In group 2, 19 facial palsies were noted; 12 were transient and 7 were definitive. At both one and six months after parotidectomy, the rate of facial palsy in reoperation cases was significantly higher in group 1 than in group 2.
Conclusion:
Facial nerve monitoring is a simple, effective adjunct method that is available to surgeons to assist with the functional preservation of the facial nerve during parotid surgery. Although it does not improve the facial prognosis in first-line surgery, it does improve the facial prognosis in reoperations.

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