Impact of great auricular nerve preservation status post parotidectomy on quality of life

Parotidectomy is a common surgery to treat parotid neoplasms. While much discussion has been invested in complications such as facial nerve injury and Frey syndrome, outcomes arising from great auricular nerve (GAN) sacrifice are not well studied. The present study aims to investigate quality of life outcomes post-parotidectomy according to GAN preservation status.

A cross-sectional study of parotidectomy patients between 2011-2020 for benign tumours was performed. Data on quality of life (QoL) was collected through a composite questionnaire (Douleur Neuropathique 4 [DN4] and Leeds Assessment of Neuropathic Symptoms and Signs [LANSS]).

To assess patient quality of life post-parotidectomy according to GAN preservation status.

Among the contacted patients, 76/205 (37.1%) responded. Of these, 38/76 were categorised as GAN-preserved, 34/76 as GAN-sacrificed and 4/76 were excluded as GAN status could not be ascertained. All patients were >6months post-operation. On a scale of 0-10, for pain, the mean values were 2.21/10 (GAN-sacrificed) and 1.32/10 (GAN-preserved) (P=0.645), and for numbness 4.47/10 (GAN-sacrificed), and 4.34/10 (GAN-preserved) (P=0.645). The angle of mandible was the most reported area for neuropathic sensations (42.1% (16/38) of GAN-preserved; 50.0% (17/34) of GAN-sacrificed). Tingling sensation was the most frequent sensation described. On a scale of 0-10 for effect on general QoL, the mean was 1.08/10 for GAN-preserved, and 1.62/10 GAN-sacrificed cohort (P=0.29). No statistical differences for specific QoL measures were found.

Our results suggest that GAN sacrifice is not associated with increased sensory defects and does not negatively impact on quality of life.

III.