Postparotidectomy facial nerve paralysis: peripheral versus proximal identification

Area of Science:

• Otolaryngology
• Neurosurgery
• Surgical Outcomes

Background:

• Facial nerve palsy is a significant complication following parotid surgery.
• Identifying risk factors for facial nerve palsy in district general hospitals is crucial.

Purpose of the Study:

• To analyze parotid surgery outcomes and identify local risk factors for facial nerve palsy.
• To compare the efficacy of peripheral versus proximal facial nerve identification in preventing nerve damage.

Main Methods:

• Retrospective analysis of 64 patient records from an Otolaryngology department over six years.
• Utilized the Neurosign400 facial nerve monitor for nerve identification.
• Assessed facial nerve paralysis using the House Brackmann (HB) classification.

Main Results:

• Sixty-four parotidectomies were performed; 32 with peripheral and 32 with proximal facial nerve identification.
• Six patients experienced temporary HB grade 2 facial nerve palsy, all recovering within six months.
• Four of the six patients with palsy had undergone peripheral nerve identification.

Conclusions:

• Peripheral facial nerve identification was associated with a higher incidence of temporary palsy but full recovery.
• Peripheral identification using Neurosign400 is a viable option for parotidectomy when proximal identification is not possible.