scholarly journals Parotidectomy and Facial Paralysis, A Retrospective Review at A Tertiary Care Hospital

2021 ◽  
Vol 10 (3) ◽  
pp. 164-168
Author(s):  
Israr ud Din ◽  
Muhammad Junaid ◽  
Imran Khan ◽  
Arshad Aziz ◽  
Sakhawat Khan ◽  
...  

Background: Facial Nerve is in close proximity with parotid gland and encountered during parotid surgery.  Facial nerve   paralysis   has   15 to 66% occurrence rate after parotidectomies. The objective of this study was to find out the frequency of facial paralysis resulting from superficial or total parotidectomies done for various parotid tumors. Material and Methods: This retrospective study was conducted at the Department of ENT, Khyber Teaching Hospital, Peshawar from January 2018 to May 2020. A total of 203 patients were reviewed for data on demographics, parotidectomies, histopathology and facial paralysis. The information on facial paralysis was compared against various parameters. Results:   The mean age of   the participants was 46.12 ± 11.11 years. The most common parotid tumor was pleomorphic adenoma (68.9%) followed by mucoepidermoid carcinoma. 57 (28.07%) patients showed facial paralysis with a higher rate of occurrence in total parotidectomy (40.90%). Among 57 patients with facial paralysis, 6 (10.53%) showed permanent facial paralysis. Conclusion: Tendency of permanent facial paralysis is high with total parotidectomies. Female population and elderly have a slightly higher rate of facial paralysis. The duration of procedure has no effect on the occurrence of facial paralysis.

2021 ◽  
Vol 8 (7) ◽  
pp. 2025
Author(s):  
Manivannan Dhanraj ◽  
Vinodh Duraisami ◽  
Maniselvi Samidurai ◽  
Kannan Ross

Background: Salivary gland tumors can arise from either the major salivary glands (parotid, submandibular and sublingual) or the minor salivary glands which are located throughout the submucosa of the upper aerodigestive tract. They can show a striking range of morphological diversity between different tumor types and sometimes within an individual tumor mass. Aim of the study was to study the role of fine needle aspiration cytology (FNAC) in the diagnosis of salivary gland tumors.Methods: This study was conducted comprising 34 patients attending the department of general surgery at Rajiv Gandhi government general hospital, MMC from January 2019 to December 2020 period of 24 months. A standard protocol was followed consisting of detailed history and physical examination, radiological evaluation followed by fine needle cytological examination. Histopathological examination was done in all the excised tumors for final diagnosis.Results: FNAC was done only in 20 out of 29 parotid tumors of which 12 were benign, 5 were malignant and 3 were inconclusive. In the present study superficial parotidectomy was done in 24 cases. Total parotidectomy was done in 3 out of 5 cases. Two patients refused surgery. Following surgery, 5 patients developed transient facial nerve paralysis and one patient developed permanent facial nerve paralysisConclusions: In tumors of the parotid gland, post-operative facial nerve palsy was rarely noticed. The best means of reducing iatrogenic facial nerve injury in parotid surgery remains an understanding of the anatomy coupled with a gentle technique.


2021 ◽  
Vol 15 (11) ◽  
pp. 3066-3068
Author(s):  
Liaquat Ali Bhatti ◽  
Muhammad Aslam Javed ◽  
Hina Khan ◽  
Muhammad Arshad ◽  
Khalid Javeed Khan

Background: Superficial parotidectomy is associated with a decreased incidence of transient facial nerve paralysis compared with that of total parotidectomy. Aim: To analyze the clinical presentation, histopathology and complications following superficial parotidectomy performed for benign parotid tumors. Methods: Two center study data was collected from the Surgical Unit I, Department of Surgery AIMC/Jinnah Hospital Lahore (1st January 2012 to October 2018) and Surgical Unit II, Department of Surgery, Sir Ganga Ram Hospital Lahore (November 2018 to 31st December 2020). All patients who underwent superficial Parotidectomy surgery for benign parotid tumors, from 1st January 2012 to 31st December 2020 were assessed for intra-operative and post-operative complications. Demographic data, intraoperative details, and postoperative outcomes of all patients who underwent superficial parotidectomy were collected. Patients with benign parotid tumors on FNAC were included while patients with malignant cells on histopathology were excluded. Results: A total of 50 patients having benign parotid tumors on FNAC underwent superficial parotidectomy during this study period. There were 35 female patients (70%) and 15 male (30%), with female to male ratio of 2.3:1. The age range was 23-70 years with mean age of patients 35.6 years (5.65±SD). In 48% cases the tumor was on left side of face and in 52% cases it was on right side. Amongst 50 cases, on postoperative histopathology, 2 patients had malignant change. Key words: Superficial parotidectomy, pleomorphic adenoma, facial nerve paralysis.


Author(s):  
Shilpa K. Sudhakaran ◽  
Sagesh Madayambath

<p class="abstract"><strong>Background:</strong> A facial paralysis is one of the most emotionally traumatic deficits a person can experience. It is essential to understand the cause and nature of nerve injury and undertake proper measures for restoration and rehabilitation of facial symmetry. The present study was conducted to evaluate the various aetiologies of lower motor neuron facial paralysis that presented to our department. The aim of the present study is to investigate into the demographic data and etiology associated with peripheral facial nerve paralysis and to assess the site of lesion, severity grade and treatment outcome of peripheral facial nerve paralysis.</p><p class="abstract"><strong>Methods:</strong> A prospective longitudinal study conducted in a tertiary care hospital, over a time period of one and a half years from November 2014 to April 2016. All the patients were assessed regarding the time of onset of symptoms, rapidity of progression, duration and completeness of paralysis. Topo diagnostic tests were done to assess the site of lesion and response to treatment monitored.  </p><p class="abstract"><strong>Results:</strong> The most common cause for LMN facial nerve paralysis was external trauma and Bell’s palsy. The mean age group was 37.5 years with a male preponderance. Majority of the lesions were suprageniculate and had a House Brackmann grade IV severity score.</p><p class="abstract"><strong>Conclusions:</strong> Peripheral facial paralysis showed a good response to treatment and timely intervention would result in a full or partial recovery at the end of a follow up.</p><p align="left"> </p>


2017 ◽  
Vol 3 (4) ◽  
pp. 1
Author(s):  
Shahad T. Ghandoura ◽  
Mahmood Z. Al-Madani ◽  
Qusai A. Tawakul ◽  
Nada J. Farsi ◽  
Rolina K. Alwassia ◽  
...  

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.


1995 ◽  
Vol 104 (7) ◽  
pp. 574-581 ◽  
Author(s):  
Toshiaki Sugita ◽  
Yasuo Fujiwara ◽  
Shingo Murakami ◽  
Yoshinari Hirata ◽  
Naoaki Yanagihara ◽  
...  

We have been the first to succeed in producing an acute and transient facial paralysis simulating Bell's palsy, by inoculating herpes simplex virus into the auricles or tongues of mice. The KOS strain of the virus was injected into the auricle of 104 mice and the anterior two thirds of the tongue in 30 mice. Facial paralysis developed between 6 and 9 days after virus inoculation, continued for 3 to 7 days, and then recovered spontaneously. The animals were painlessly sacrificed between 6 and 20 days after inoculation for histopathologic and immunocytochemical study. Histopathologically, severe nerve swelling, inflammatory cell infiltration, and vacuolar degeneration were manifested in the affected facial nerve and nuclei. Herpes simplex virus antigens were also detected in the facial nerve, geniculate ganglion, and facial nerve nucleus. The pathophysiologic mechanisms of the facial paralysis are discussed in light of the histopathologic findings, in association with the causation of Bell's palsy.


1989 ◽  
Vol 98 (8) ◽  
pp. 644-647 ◽  
Author(s):  
Howard L. DeLozier ◽  
Martin J. Spinella ◽  
Glenn D. Johnson

Facial paralysis in the presence of a parotid mass has been associated classically with a presumed diagnosis of malignancy. However, isolated case reports have documented the occurrence of paresis or paralysis secondary to pathologically benign, nonneurogenic parotid lesions. These previous cases have been reviewed and three additional cases are described. Comparisons are made on age, sex, symptoms, physical findings, pathologic findings, and prognosis. Involvement of the seventh nerve may be explained on the basis of compression, especially in association with local inflammation. Although facial paralysis still should be considered indicative of a malignancy, it also may be caused by benign masses, particularly those associated with rapid enlargement and/or infection.


2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P154-P154
Author(s):  
Carrie Flanagan ◽  
Shaw Gerry ◽  
Rick Odland

Objectives 1) To determine whether a novel biomarker (hyperphosphorlyated neurofilament-heavy subunit) is able to be quantitated in patients with idiopathic facial nerve paralysis. 2) To determine whether correlation exists between biomarker quantitation and clinical parameters in patients with idiopathic facial nerve paralysis. Methods This is a prospective pilot study that assesses the utility of the serum biomarker hyperphosphorylated neurofilament-heavy subunit protein(NF-H) in evaluating patients with idiopathic facial nerve paralysis. From May 2006 to August 2007, 12 patients that presented to the Emergency, Neurology, and Otolaryngology departments at a county hospital with acute onset unilateral facial paralysis were enrolled into the study. Serum samples at the time of presentation were obtained, and the following additional data was recorded and analyzed: age, sex, severity of paralysis at presentation, duration between time of onset of paralysis and presentation, side of paresis, associated comorbidities, time to recovery, and ancillary testing results. Data analysis was performed using Student's T-test and analysis of variance; linear regression models and correlation coefficients were calculated using Microsoft Excel computer software. Results There was no significant relationship between patient age (r2=0.20), sex (p=0.19), and side of paralysis (p=0.49) and biomarker level. The biomarker level increased with increasing facial paresis severity (p=0.002, r2=0.17), and had a more pronounced correlation when patients presented within the first 24 to 48 hours of paralysis (p=0.006, r2=0.59). There was no correlation between biomarker and prognosis or ancillary testing results. Conclusions Hyperphosphorylated neurofilament-heavy subunit levels correlated with initial severity of facial paralysis, but were time-dependent.


2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P152-P152 ◽  
Author(s):  
Marc Cohen ◽  
Claudia Kirsch ◽  
Abie Mendelsohn ◽  
Akira Ishiyama

Objectives 1) To retrospectively review the pathophysiology and radiologic features of delayed facial palsy after stapedectomy. 2) To discuss the management strategy of this unusual problem. Methods 450 stapedectomies performed at our institution were retrospectively reviewed from 1997 to 2007. A total of 2 patients in this series developed a delayed facial paralysis postoperatively. The clinical presentation, radiographic characteristics on magnetic resonance imaging (MRI), and the management of these patients are presented. Results A total of 2 patients out of 450 stapedectomies within a 10-year period developed the rare complication of delayed facial paralysis (postoperative days 12 and 41, respectively). Both patients developed rapidly progressive complete facial nerve paralysis preceded by periauricular pain and dysguesia. No sign of infection was present in the operated ear. MRI with gadolinium of the internal auditory canal demonstrated gadolinium enhancement of the labyrinthine portion of the facial nerve as seen in Bell's palsy. Both patients were treated with oral corticosteroids and antiviral medications. Subsequent imaging revealed decreased enhancement of the facial nerve with complete resolution of facial paralysis. Conclusions In the rare complication of delayed facial paralysis after stapedectomy, MR imaging is a useful diagnostic tool to dictate the treatment strategy. Delayed facial paralysis following stapedectomy can be treated medically when the MRI scan demonstrates enhancement of the facial nerve in the labyrinthine segment.


1996 ◽  
Vol 110 (1) ◽  
pp. 91-92 ◽  
Author(s):  
Y. T. Pang ◽  
C. H. Raine

AbstractA case of facial nerve paralysis secondary to acute suppurative parotitis is described. This is a rare complication in the absence of malignant processes in the parotid.


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