A RETROSPECTIVE ANALYSIS OF INCIDENCE OF FACIAL NERVE DYSFUNCTION IN SUPERFICIAL PAROTIDECTOMY PATIENTS

Abstract

Salivary gland neoplasms constitute 5 percent of head and neck tumors. Among them 80% arise from parotid gland , 10% from submandibular gland, 10% from sublingual and other minor salivary glands.In parotid neoplasms, 80% are benign and 20% are malignant. Most common benign tumor is pleomorphic adenoma, which accounts for 40-70% of all salivary gland neoplasms. Other benign parotid tumors are various monomorphic adenomas (warthin tumor, oncocytoma, basal cell adenoma, canalicular adenoma), ductal papilloma and capillary hemangioma. Most common malignant tumor is mucoepidermoid carcinoma, which is further divided into low and high grade tumors. Adenoid cystic carcinoma constitute 10% of all salivary gland neoplasms with characteristic indolent growth and perineural invasion. Rapid increase in size, pain and facial nerve palsy are signs of malignancy.Based on the location of tumor and pathological status supercial or total conservative parotidectomy can be done. Facial nerve as well as it's branches are very close to the gland, they are at high risk of injury.Therefore successful surgery depends on the indentication and preservation of facial nerve. Marginal mandibular nerve damage is most commonly encountered complication. Temporary neuropraxia is common and expected to recover with in few months following Surgery. It is mainly due to stretching of Vasa vasorum. The main objective of this AIMS AND OBJECTIVES: study is to access the incidence of facial nerve dysfunction as temporary or permanent, complete or incomplete in post supercial parotidectomy Patients. MATERIALS AND METHODS: A retrospective study was conducted from June 2016 to June 2019 in the department of general surgery, government general hospital, kakinada among the Patients who underwent surgery for parotid neoplasms. Am RESULTS: ong 50 remaining Patients, 36 were female and 14 were male patients with male to female ratio of 1:2.5. The mean age was 39+/-9 years. Among 54 Patients 50 underwent supercial parotidectomy .Among 50 Patients who underwent surgery, 18 were observed to have no complications in the immediate postoperative period. And 28 patients presented with transient facial weakness, which was incomplete and temporary in the immediate postoperative period. Only 4 patients had permanent facial weakness which was complete Overall inc CONCLUSION: idence of temporary and permanent facial nerve dysfunction in this study is 63.3% and 6.6% respectively without using any intraoperative monitoring with a nerve stimulator or magnication.And the incidence is mainly depending on the location of the tumor, extent of the surgery, excessive traction, proper anatomical knowledge and experience of the surgeon.