Facial nerve rehabilitation after radical parotidectomy.
OBJECTIVE
Examine functional outcomes in patients undergoing radical parotidectomy and facial nerve grafting. Identify factors that may affect rehabilitation in these patients.


METHODS
Retrospective chart review and photographic analyses of 12 patients undergoing radical parotidectomy with interposition nerve grafts for facial nerve reconstruction.


METHODS
Data obtained for each patient regarding age, sex, histology of parotid neoplasm, cable graft source, administration of postoperative radiotherapy, and treatment for eye rehabilitation. Functional outcomes were assessed with the House-Brackmann grading system at 6 months, 1 year, and 2 years after surgery.


RESULTS
All nerve grafts were harvested from cervical plexus sensory nerves with microscopic epineural repair performed for all neurorrhaphies. Overall, 9 of 12 patients achieved a grade III 2 years after surgery. All patients under age 30 obtained a grade III. Of the seven patients receiving postoperative radiation, five achieved a grade III. Older patients often required surgical procedures to facilitate eye closure.


CONCLUSIONS
Facial nerve rehabilitation after radical parotidectomy can be successfully achieved with cervical plexus interposition nerve grafts. Postoperative radiotherapy did not appear to affect return of function, and younger patients consistently achieved good functional outcomes after nerve grafting. Older patients frequently require surgical procedures for eye rehabilitation after radical parotidectomy.
Reddy
P G
PG
Department of Otolaryngology-Head and Neck Surgery, Wayne State University, Detroit, Michigan 48201, USA.
Arden
R L
RL
Mathog
R H
RH
D000293:Adolescent; D000328:Adult; D000368:Aged; D004431:Ear, External / Q000294:innervation; D005145:Face / Q000294:innervation*; D005154:Facial Nerve / Q000503:physiopathology* / Q000528:radiation effects / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009416:Nerve Regeneration; D016067:Nerve Transfer; D010307:Parotid Neoplasms / Q000503:physiopathology / Q000532:radiotherapy / Q000601:surgery*; D013497:Sural Nerve / Q000637:transplantation; D016896:Treatment Outcome