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A Novel Approach to Facial Reanimation and Restoration Following Radical Parotidectomies
Lucia Pannuto1, Jun Yi Soh1, Kwaku Duah-Asante1
1Department of Plastic Surgery, Queen Victoria Hospital, East Grinstead RH19 3DZ, UK.
Journal of Clinical Medicine
|April 27, 2024
Summary
Facial reanimation after parotidectomy is crucial. While immediate nerve repair is ideal, this study shows delayed facial nerve repair also offers significant benefits for patients undergoing parotid gland removal.
Area of Science:
- Otolaryngology
- Plastic Surgery
- Neurosurgery
Background:
- Parotidectomies necessitate facial reanimation due to potential facial nerve damage.
- Immediate facial restoration is the standard of care following nerve sacrifice during parotidectomy.
- Delayed reanimation is less commonly attempted but may be viable.
Purpose of the Study:
- To evaluate the outcomes of facial restoration after parotidectomy.
- To compare immediate versus delayed facial nerve repair techniques.
- To assess the efficacy of an algorithmic approach to facial reanimation.
Main Methods:
- Retrospective review of 90 parotidectomy patients (2009-2022).
- Application of an algorithmic template assessing surgical techniques and outcomes.
- Utilized Sunnybrook, Terzis scores, and Smile Index for outcome evaluation.
Main Results:
- 17 radical and 73 total/superficial parotidectomies were performed.
- Eight patients (47.1%) with nerve sacrifice underwent facial restoration.
- Four patients each received immediate and delayed repairs, employing diverse grafting techniques.
Conclusions:
- Facial reanimation algorithms should consider patient age, comorbidities, defect size, and donor site factors.
- Immediate facial nerve repair is preferred, but delayed repair remains a beneficial option.
- Successful facial restoration is achievable through various techniques in both immediate and delayed settings.
