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Long-term great auricular nerve morbidity after sacrifice during parotidectomy

Authors

  • William R. Ryan MD,

    Corresponding author
    1. Department of Otolaryngology/Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, U.S.A
    • Department of Otolaryngology/Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Road, Stanford, CA 94305

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  • Willard E. Fee MD

    1. Department of Otolaryngology/Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, U.S.A
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  • This study was funded by the Otolaryngology Research and Education Fund at Stanford University.

    Dr. Ryan had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Abstract

Objectives/Hypothesis:

To clarify the extent and patient perspectives of great auricular nerve (GAN) morbidity and recovery after nerve sacrifice during parotidectomy 4 to 5 years after surgery.

Study Design:

Prospective series.

Methods:

Twenty-two patients who underwent parotidectomy with GAN sacrifice and were previously studied for GAN sensory outcome during the first postoperative year. We performed light touch sensation tests on each patient to develop an ink map representing anesthesia and paresthesia in the GAN sensory territory; patients also completed an outcomes questionnaire.

Results:

Nineteen (86%) of 22 patients completed follow-up. One patient completed the questionnaire over the phone. The prevalence and average areas of anesthesia and paresthesia decreased since the first postoperative year according to sensory testing and patient scoring. At 4 to 5 years, 47% (9 of 19) of the patients had anesthesia, 58% (11 of 19) had paresthesia, and 26% (5 of 19) had neither anesthesia nor paresthesia during sensory testing. Patients reported that the GAN dysfunction brought them no to mild inference with their daily activities. At a mean point of 2 years, 70% (14 of 20) patients felt that their sensory symptoms had either completely abated or stabilized.

Conclusions:

The posterior branch of the GAN should be preserved if it does not compromise tumor resection. If this is not possible, the patient and surgeon should be comforted in that only minor, if any, long-term disability will ensue. Laryngoscope, 2009

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