title: A prospective controlled double-blind trial of great auricular nerve preservation at parotidectomy.
abstract: BACKGROUND
  Earlier reports of the advantages of preservating the posterior branches of the great auricular nerve (GAN) at parotidectomy were conflicting. This prospective study was aimed at clarifying the controversy.
  
  
  METHODS
  Eighty-one patients in a university otolaryngology department were recruited. The posterior branches were preserved whenever initial dissection showed that tumor clearance would not be compromised. Touch-pressure sensation was monitored in predefined territories supplied by the GAN using a Semmes-Weinstein aesthesiometer, preoperatively and postoperatively. Minimal pressure thresholds obtained were compared between the two groups.
  
  
  RESULTS
  Preservation of the GAN was achievable in 69% of patients; sensory deficit was transient. With the GAN divided, measurable sensory depression occurred up to 2 years after surgery. The difference is statistically significant. Patients' subjective assessment of numbness also conformed to these trends. Additional time taken for preservation of the GAN was about 10 minutes.
  
  
  CONCLUSIONS
  The posterior branches should always be preserved if tumor clearance is not compromised.
authors.affiliation: Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, 102 Pokfulam Rd., Hong Kong, PR China. yhui@hkucc.hku.hk
authors.forename: Yau
authors.initials: Y
authors.lastname: Hui
authors.forename: David S Y
authors.initials: DS
authors.lastname: Wong
authors.forename: Ling-Yuen
authors.initials: LY
authors.lastname: Wong
authors.forename: Wai-Kuen
authors.initials: WK
authors.lastname: Ho
authors.forename: William I
authors.initials: WI
authors.lastname: Wei
mesh_terms: D000293:Adolescent; D000328:Adult; D002610:Cheek; D004311:Double-Blind Method; D004431:Ear, External / Q000294:innervation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010036:Otolaryngology / Q000379:methods; D010306:Parotid Gland / Q000294:innervation* / Q000601:surgery*; D010307:Parotid Neoplasms / Q000503:physiopathology / Q000601:surgery*; D010525:Peripheral Nerves / Q000502:physiology*; D011183:Postoperative Complications; D011446:Prospective Studies; D020127:Recovery of Function; D012684:Sensory Thresholds / Q000502:physiology; D012867:Skin / Q000294:innervation; D020886:Somatosensory Disorders / Q000517:prevention & control; D016896:Treatment Outcome