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Stratifying the risk of facial nerve palsy after benign parotid surgery

Published online by Cambridge University Press:  24 January 2014

N Sethi ,
P H Tay ,
A Scally  and
S Sood
N Sethi*
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Bradford Teaching Hospitals and School of Health Research, University of Bradford, UK
P H Tay
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Bradford Teaching Hospitals and School of Health Research, University of Bradford, UK
A Scally
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Bradford Teaching Hospitals and School of Health Research, University of Bradford, UK
S Sood
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Bradford Teaching Hospitals and School of Health Research, University of Bradford, UK
*
Address for correspondence: Mr Neeraj Sethi, 3 Victoria St, Leeds LS7 4PA, UK Fax: +44 (0)113 269 8885 E-mail: [email protected]
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Abstract

Introduction:

Post-operative facial palsy is the most important potential complication of parotid surgery for benign lesions. The published prevalence of facial weakness is up to 57 per cent for temporary weakness and up to 7 per cent for permanent weakness. We aimed to identify potential risk factors for post-operative facial palsy.

Materials and methods:

One hundred and fifty patients who had undergone parotid surgery for benign disease were retrospectively reviewed. Tumour factors (size, location and histopathology), patient factors (age and sex) and operative factors (operation, surgeon grade, surgeon specialty and use of intra-operative facial nerve monitoring) were all analysed for significant associations with post-operative facial palsy.

Results and analysis:

The overall incidence of facial palsy was 26.7 per cent for temporary weakness and 2.6 per cent for permanent weakness. The associations between facial palsy and all the above factors were analysed using Pearson's chi-square test and found to be non-significant.

Conclusion:

These outcomes compare favourably with the literature. No significant risk factors were identified, suggesting that atraumatic, meticulous surgical technique is still the most important factor affecting post-operative facial palsy.

Keywords

Parotid DiseasesParotid GlandParotid NeoplasmsFacial PalsyRisk Factors
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 2 , February 2014 , pp. 159 - 162
Copyright
Copyright © JLO (1984) Limited 2014 

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References

1Hugo, NE, McKinney, P, Griffith, BH. Management of tumors of the parotid gland. Surg Clin North Am 1973;53:105–111CrossRefGoogle ScholarPubMed
2Spiro, RH. Salivary neoplasms: overview of a 35-year experience with 2807 patients. Head Neck Surg 1986;8:177–84Google Scholar
3Eveson, JW, Cawson, RA. Salivary gland tumours. A review of 2410 cases with particular reference to histopathologic type, site, age and sex distribution. J Pathol 1985;146:51–8Google Scholar
4Carwardine, T. Excision of the parotid gland with preservation of the facial nerve. Lancet 1907;ii:892Google Scholar
5Janes, RM. The treatment of tumours of the salivary glands by radical excision. Can Med Assoc J 1940;43:554–9Google Scholar
6Laccourreye, H, Laccourreye, O, Regis, C, Jouffre, V, Menard, M, Brasnu, D. Total conservative parotidectomy for primary benign pleomorphic adenoma of the parotid gland: a 25-year experience with 229 patients. Laryngoscope 1994;104:1487–94Google Scholar
7Lin, CC, Ming-Hsui, T, Huang, CC, Hua, CH, Tseng, HC, Huang, ST. Parotid tumour: a 10-year experience. Am J Otolaryngol 2008;29:94–100Google Scholar
8Dulguerov, P, Marchal, F, Lehmann, W. Postparotidectomy facial nerve paralysis: possible etiologic factors and results with routine facial nerve monitoring. Laryngoscope 1999;109:754–62Google Scholar
9Eng, CY, Evans, AS, Quraishi, MS, Harkness, PA. A comparison of the incidence of facial palsy following parotidectomy performed by ENT and non-ENT surgeons. J Laryngol Otol 2007;141:40–3Google Scholar
10Yuan, X, Gao, Z, Jiang, H, Yang, H, Lv, W, Wang, Z et al. Predictors of facial palsy after surgery for benign parotid disease: multivariate analysis of 626 operations. Head Neck 2009;31:1588–92Google Scholar
11Snow, GB. The surgical approaches to the treatment of parotid pleomorphic adenomas. In: McGurk, M, Renehan, AG, eds. Controversies in the Management of Salivary Gland Disease. Oxford: Oxford University Press, 2001;58Google Scholar
12House, JW, Brackmann, DE. Facial nerve grading system. Otolaryngol Head Neck Surg 1985;93:146–7Google Scholar
13Ellingson, TW, Cohen, JL, Andersen, P. The impact of malignant disease on facial nerve function after parotidectomy. Laryngoscope 2003;113:1299–303Google Scholar
14Guntinas-Lichius, O, Gabriel, B, Klussman, JP. Risk of facial palsy and severe Frey's syndrome after conservative parotidectomy for benign disease: analysis of 610 operations. Acta Otolaryngol 2006;126:1104–9CrossRefGoogle ScholarPubMed
15Mra, Z, Komisar, A, Blaugrund, SM. Functional facial nerve weakness after surgery for benign parotid tumours: a multivariate statistical analysis. Head Neck 1993;15:147–52Google Scholar
16Gaillard, C, Perie, S, Susini, B, St Gully, JL. Facial nerve dysfunction after parotidectomy: the role of local factors. Laryngoscope 2005;115:287–91Google Scholar
17Upton, DC, McNamar, JP, Connor, NP, Harari, PM, Hartig, GK. Parotidectomy: ten-year review of 237 cases at a single institution. Otolaryngol Head Neck Surg 2007;136:788–92CrossRefGoogle Scholar
18Grosheva, M, Klussmann, JP, Grimminger, C, Wittekindt, C, Beutner, D, Pantel, M 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. Laryngoscope 2009;119:2299–305Google Scholar