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Intraoperative Facial Nerve Involvement in Parotid Tumours – A Retrospective Analysis in a Tertiary Care Centre

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Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

Purpose

The study aims to provide a comprehensive overview of the various malignant and benign parotid tumours and evaluate the predictive factors for intraoperative nerve involvement leading to facial palsy (FP).

Methods

It is a single-centre retrospective analysis for reviewing the involvement of facial nerve in post- parotidectomy patients. The clinical database from January 2012 to December 2020 was included in the study with a follow-up period of a minimum of 2 years. To maintain homogeneity, all squamous cell carcinomas of level 2 nodes involving parotid or residual/recurrent disease of the oral cavity requiring parotid dissection were excluded.

Results

A total of 248 patients (171 benign; 77 malignant) were evaluated with a mean age of 46.48 ± 10.76 years. The presence of malignancy increases the risk of FP (p = 0.027). 37 (14.92%) patients with FP were detected which included 34 with partial [32.35% in malignant; 62.16% in recurrent pleomorphic adenoma (RPA)] and 3 with total paralysis (66.67% in malignant; 33.33% in RPA). The recurrence of pleomorphic adenoma increases FP. While old age, larger size, hard fixed swelling with masseteric space (MS) infiltration appeared as risk factors for FP in malignant tumours (p = 0.047; p = 0.004; p < 0.00001 respectively).

Conclusion

Tumour size, malignancy, hard fixed mass, masseteric space infiltration, recurrence, and age > 45yrs have been statistically significant predictive factors for intraoperative facial nerve involvement leading to FP. The study also revealed that FP occurred more commonly when there was concurrent involvement of both superficial and deep lobes but was not statistically significant.

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Authors and Affiliations

  1. Otolaryngology & Head Neck Surgery, Sri Guru Ram Das Institute of Medical Sciences, Amritsar, India

    Pooja Pal

  2. Otolaryngology & Head Neck Surgery, AIIMS Bathinda, Bathinda, India

    Ankur Mohan

  3. Surgical Oncology, Government Medical College Amritsar, Amritsar, India

    Rupinder Kaur

  4. Otolaryngology & Head Neck Surgery, Postgraduate Institute of Medical Education & Research (PGIMER), Sangrur, India

    Gurkiran Kaur

  5. Professor & Head of Department, Surgical Oncology, Government Medical College Amritsar, Amritsar, India

    Bikramjit Singh

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  1. Pooja Pal
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  4. Gurkiran Kaur
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Contributions

PP: Study design, data acquisition, analysis, and interpretation, drafting the article and revising it critically for intellectual content. AM: Conception of the study, data acquisition and its interpretation, revising the draft critically for important intellectual content and final approval of the version to be published. RK: Study design, data acquisition, analysis, and interpretation, drafting the article and revising it critically for intellectual content. GK: Study design, data acquisition, analysis, and interpretation, drafting the article, literature search and revising it critically for intellectual content. BS: Conception of the study, Study design, data acquisition, analysis, and interpretation, drafting the article and revising it critically for intellectual content.

Corresponding author

Correspondence to Gurkiran Kaur.

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Ethical Approval

Approval was obtained from the Institutional Ethics Committee, and all procedures contributing to this work comply with the ethical standards of the relevant national and institutional guidelines and with the Helsinki Declaration of 1975 as revised in 2008.

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The authors have no conflict of interest to declare.

Medical Records and Data

Medical records and data regarding every patient is available. Code no.- GMC/IEC/23/BJS/101.

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Pal, P., Mohan, A., Kaur, R. et al. Intraoperative Facial Nerve Involvement in Parotid Tumours – A Retrospective Analysis in a Tertiary Care Centre. Indian J Otolaryngol Head Neck Surg 76, 1972–1978 (2024). https://doi.org/10.1007/s12070-024-04478-1

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