Randomized prospective study of the validity of the great auricular nerve preservation in parotidectomy

To evaluate the feasibility and validity of great auricular nerve preservation during parotidectomy.

Thirty patients with parotid tumors were randomized to 2 groups. Sixteen patients (group A) underwent classic parotidectomy with sacrifice of the great auricular nerve. The surgeon tried to spare the nerve in the 14 patients (group B). Tactile sensitivity, pain sensitivity, and tactile discrimination were evaluated preoperatively and at 7 days, 30 days, 6 months, and 12 months after surgery. The regions examined were the superior helix, lobule, and infra-auricular and posterior auricular regions.

After surgery, both groups showed lower levels of sensitivity, mainly in the lobule and in the infra-auricular region. These alterations were less pronounced in group B. Both groups showed improvement over time. In group B the tactile sensitivity reached preoperative levels by 6 months after surgery. The recuperation in group A was partial and stabilized at 6 months after surgery.

Great auricular nerve preservation is technically feasible during parotidectomy, with a decrease of the sensitivity alterations in the early postoperative period and avoidance of the permanent sequelae that occur when the nerve is sacrificed.