A prospective controlled double-blind trial of great auricular nerve preservation at parotidectomy.
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.
Hui
Yau
Y
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
Wong
David S Y
DS
Wong
Ling-Yuen
LY
Ho
Wai-Kuen
WK
Wei
William I
WI
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