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

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.

[1]  G. Lamas,et al.  Supramaximal stimulation during intraoperative facial nerve monitoring as a simple parameter to predict early functional outcome after parotidectomy , 2013, Acta oto-laryngologica.

[2]  P. Piller,et al.  [Giant pleomorphic adenoma of the deep lobe of the parotid gland: role of MRI and nerve monitoring in facial nerve localization]. , 2011, Revue de laryngologie - otologie - rhinologie.

[3]  Dong-Hee Lee In reference to Electromyographic facial nerve monitoring during parotidectomy for benign lesions does not improve the outcome of postoperative facial nerve function: A prospective two‐center trial , 2010, The Laryngoscope.

[4]  L. Orloff,et al.  Electrophysiologic facial nerve monitoring during parotidectomy , 2009, Head & neck.

[5]  Y. Pons,et al.  [Facial nerve monitoring in the parotidectomy]. , 2010, Revue de laryngologie - otologie - rhinologie.

[6]  S. Albert,et al.  Management of parotid gland surgery in a university teaching hospital , 2010, European Archives of Oto-Rhino-Laryngology.

[7]  O. Guntinas-Lichius,et al.  Electromyographic facial nerve monitoring during parotidectomy for benign lesions does not improve the outcome of postoperative facial nerve function: A prospective two‐center trial , 2009, The Laryngoscope.

[8]  O. Dassonville,et al.  [2008 Update of Standards, Options: recommendations for management of patients with salivary gland malignant tumours (excluding lymphoma, sarcoma and melanoma), summary report]. , 2008, Bulletin du Cancer.

[9]  E. Nénonéné,et al.  Continuous Intraoperative Facial Nerve Monitoring in Predicting Postoperative Injury During Parotidectomy , 2006, The Laryngoscope.

[10]  O. Guntinas-Lichius,et al.  Parotidectomy for Benign Parotid Disease at a University Teaching Hospital: Outcome of 963 Operations , 2006, The Laryngoscope.

[11]  R. Garrel,et al.  Continuous Facial Nerve Monitoring during Pleomorphic Adenoma Recurrence Surgery , 2005, The Laryngoscope.

[12]  D. Myssiorek,et al.  Facial Nerve Stimulation and Postparotidectomy Facial Paresis , 2003, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[13]  E. Moore,et al.  Prospective Analysis of The Efficacy of Continuous Intraoperative Nerve Monitoring During Thyroidectomy, Parathyroidectomy, and Parotidectomy , 2001, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[14]  M. Quer,et al.  [Usefulness of facial nerve monitoring during parotidectomy]. , 2001, Acta Otorrinolaringológica Española.

[15]  P. Dulguerov,et al.  A complication of intraoperative facial nerve monitoring: facial skin burns. , 1999, The American journal of otology.

[16]  P. Dulguerov,et al.  Postparotidectomy facial nerve paralysis: Possible etiologic factors and results with routine facial nerve monitoring , 1999, The Laryngoscope.

[17]  R. Witt Facial nerve monitoring in parotid surgery: The standard of care? , 1998, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[18]  C. Bradford,et al.  Clinical outcome of continuous facial nerve monitoring during primary parotidectomy. , 1997, Archives of otolaryngology--head & neck surgery.

[19]  W. Thumfart,et al.  Monitoring the facial nerve during parotidectomy. , 1991, Archives of otolaryngology--head & neck surgery.