Preoperative electroneurography (ENoG) in parotid surgery: Assessment of facial nerve outcome and involvement by tumor—A preliminary study

Abstract Objective The Harmonic Scalpel and Ligasure (Covidien) devices are commonly used in head and neck surgery. Parotidectomy is a complex and intricate surgery that requires careful dissection of the facial nerve. This study aimed to compare surgical outcomes in parotidectomy using these haemostatic devices with traditional scalpel and cautery. Method A systematic review of the literature was performed with subsequent meta-analysis of seven studies that compared the use of haemostatic devices to traditional scalpel and cautery in parotidectomy. Outcome measures included: temporary facial paresis, operating time, intra-operative blood loss, post-operative drain output and length of hospital stay. Results A total of 7 studies representing 675 patients were identified: 372 patients were treated with haemostatic devices, and 303 patients were treated with scalpel and cautery. Statistically significant outcomes favouring the use of haemostatic devices included operating time, intra-operative blood loss and post-operative drain output. Outcome measures that did not favour either treatment included facial nerve paresis and length of hospital stay. Conclusion Overall, haemostatic devices were found to reduce operating time, intra-operative blood loss and post-operative drain output.

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Facial nerve paralysis postparotidectomy: A retrospective review of the prevalence and risk factors at a tertiary center

Case Studies in Surgery ◽

10.5430/css.v3n4p1 ◽

2017 ◽

Vol 3 (4) ◽

pp. 1

Author(s):

Shahad T. Ghandoura ◽

Mahmood Z. Al-Madani ◽

Qusai A. Tawakul ◽

Nada J. Farsi ◽

Rolina K. Alwassia ◽

...

Keyword(s):

Risk Factors ◽

Facial Nerve ◽

Retrospective Review ◽

Categorical Variables ◽

Facial Nerve Paralysis ◽

Tumor Characteristics ◽

Nerve Paralysis ◽

Operative Duration ◽

Parotid Surgery ◽

Tertiary Center

Objective: Facial nerve paralysis is one of the most devastating complications after parotid gland surgery. We aimed to determine the prevalence and risk factors of facial palsy after parotidectomy.Methods: We performed a retrospective review of the data from 54 patients who underwent parotid surgery between 2004 and 2015 at a tertiary medical care center. The prevalence of facial nerve paralysis and possible risk factors (demographic characteristics, tumor characteristics, and operative factors) associated with postoperative paralysis were assessed. Categorical variables were evaluated using the Fisher’s exact test, and a two-tailed t-test was used to assess the associations between continuous and binary outcome variables.Results: The postparotidectomy prevalence of temporary and permanent facial nerve paralysis were 26% and 13%, respectively. Tumors involving both lobes were significantly associated with permanent facial nerve paralysis (p = .048). Long operative duration (> 164 minutes) was associated with both temporary and permanent facial nerve paralysis (p = .040).Conclusions: Operative factors such as operative duration and tumor characteristics such as bilobal involvement increased the risk of postparotidectomy facial nerve paralysis. Such factors should be considered to reduce the risk of palsy in patients undergoing parotidectomy.

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