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BMC Surgery
Published in: BMC Surgery 1/2019

Open Access 01-12-2019 | Facial Palsy | Research article

Incidence of postoperative facial weakness in parotid tumor surgery: a tumor subsite analysis of 794 parotidectomies

Authors: Hokyung Jin, Bo Young Kim, Heejung Kim, Eunkyu Lee, Woori Park, Sungyong Choi, Man Ki Chung, Young-Ik Son, Chung-Hwan Baek, Han-Sin Jeong

Published in: BMC Surgery | Issue 1/2019

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Abstract

Background

The reported incidence of facial weakness immediately after parotid tumor surgery ranges from 14 to 65%. The purpose of this study was to evaluate the incidence of postoperative facial weakness related to parotidectomy with use of preoperative computed tomography (CT), intraoperative facial nerve monitoring, and surgical magnification. Also, we sought to elucidate additional information about risk factors for postoperative facial weakness in parotid tumor surgery, particularly focusing on the tumor subsites.

Methods

We retrospectively reviewed 794 cases with parotidectomy for benign and malignant tumors arising from the parotid gland (2009–2016). Patients with pretreatment facial palsy were excluded from the analyses. Tumor subsites were stratified based on their anatomical relations to the facial nerve as superficial, deep, or both. Multivariable logistic regression analyses were conducted to identify risk factors for postoperative facial weakness.

Results

The overall incidences of temporary and permanent (more than 6 months) facial weakness were 9.2 and 5.2% in our series utilizing preoperative CT, intraoperative facial nerve monitoring, and surgical magnification. Multivariable analysis revealed that old age, malignancy, and recurrent tumors (revision surgery) were common independent risk factors for both temporary and permanent postoperative facial weakness. In addition, tumor subsite (tumors involving superficial and deep lobe) was associated with postoperative facial weakness, but not tumor size. Extent of surgery was strongly correlated with tumor pathology (malignant tumors) and tumor subsite (tumors involving deep lobe).

Conclusion

Aside from risk factors for facial weakness in parotid tumor surgery such as old age, malignant, or recurrent tumors, the location of tumors was found to be related to postoperative facial weakness. This study result may provide background data in a future prospective study and up-to-date information for patient counseling.
Appendix
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Metadata
Title
Incidence of postoperative facial weakness in parotid tumor surgery: a tumor subsite analysis of 794 parotidectomies
Authors
Hokyung Jin
Bo Young Kim
Heejung Kim
Eunkyu Lee
Woori Park
Sungyong Choi
Man Ki Chung
Young-Ik Son
Chung-Hwan Baek
Han-Sin Jeong
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2019
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/s12893-019-0666-6

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