Evaluation of risk factors of facial nerve palsy after parotidectomys

Abstract

Background: Up to date, surgery is still the standard treatment for most parotid canccrs. However, factors associated with postparotidectomy facial nerve palsy are still poorly understood. Objective: To identify the potential risk factors for facial nerve palsy after parotidectomy in King AbdulAziz Medical City (KAMC) National Guard, Jeddah, Saudi Arabia between 2006 and 2013. Subjects and Methods: We retrospectively reviewed charts of patients who had parotid tumor and underwent parotidectomy at KAMC from 2006 to 2013. The facial nerve trunk was assessed prior to parotid gland resection. The gender of patients, side and location (deep or superficial) of tumors and postoperative facial nerve function, and size as well as pathologies of tumors were collected. Facial nerve function was graded using the standard House Brackmann grading system, and those with greater than a grade II facial palsy were placed in the facial palsy group.Results: The study group consisted of 50 patients with newly diagnosed primary parotid gland tumor. The most common histopathology was a nleomornhic adenoma (23 cases (46%Vi. followed by Warthin’s tumor in 8 cases (16%) and mucoepidermoid carcinoma in 4 cases (8%). Post parotidectomy facial nerve palsy was reported among 6 patients (12%) temporary grade II-III, each has one branch only whereas none has neither complete nor permanent palsy. Regarding the three most common histopathologica! types, the incidence rates of postoperative facial palsy w ere 2 of 23 patients (8.7%) with pleomorphic adenoma, none of 8 patients with warthin’s tumor and 2 of 4 patients (50%) with mucoepidermoid carcinoma. These differences were statistically significant, p=0,029.Conclusion: The difference between size, site and gender did not increase the incidence of post parotidectomy facial palsy. While histopathology increased the incidence of facial palsy postoperative with malignancy.