Morales-Cadena GM, Azcona-Martínez DE, Lazo-Jiménez P

Language: Spanish
References: 9
Page: 11-17
PDF size: 359.31 Kb.

ABSTRACT

Background: The monitoring of the seventh cranial nerve (CN VII) during a parotidectomy should never substitute a detailed anatomic knowledge; the manipulation of the nerve could generate neuropraxia with a complete neural shead that only generates facial paresis with a complete recovery. The reported incidence of complete facial paralysis after a parotidectomy varies from 0.5% to 4%. It is known that 100% of patients with parotid tumors greater than 4cm have neural weakness that isn’t always clinically evident. It has been established that neural preservation is in close relation with initial tumor size.
Objective: To determine if parotidectomy assisted with facial nerve monitoring is associated with a lower risk of facial paralysis compared with parotidectomy without monitoring.
Patients and methods: A retrospective, longitudinal, descriptive and observational study was issued among 78 patients that underwent parotidectomy from 1994 to 2008. Then, clinical files were reviewed and we identified which procedures were assisted with facial nerve monitoring and which did not. Facial function was assessed between groups in the immediate postoperative and one and three months later.
Results: The global incidence of postoperative facial paralysis in patients that underwent parotidectomy without facial monitoring was 2.5% compared with 0% in patients assisted with facial monitoring. The results obtained were comparable with various literature reports.
Conclusions: The criteria and indications considered to use facial nerve monitoring during parotidectomy are not completely clear and it is only considered when a tumor larger than 6cm displaces neural pad ways. The comparison between both groups demonstrated that the use of facial monitoring minimally changes the incidence of postoperatory morbidity.

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