Significance of preserving the posterior branch of the great auricular nerve in parotidectomy.
OBJECTIVE
Sensory disturbance due to excision of the great auricular nerve in patients who have undergone parotidectomy sometimes causes discomfort to the patients. In order to reduce the postoperative discomfort of the pinna, we tried to preserve the posterior branch of the great auricular nerve.


METHODS
Forty patients with parotid tumor were included in this study. Twenty-one of these patients had pleomorphic adenoma, 16 had adenolymphoma and 3 had a low grade malignant tumor. Sensations of the pinna and the quality of life (QOL) after parotidectomy were evaluated using a 0-100 Visual Analogue Scale (VAS) assessed at 2 weeks, 1 month, 2 months, 3 months and 6 months after parotidectomy.


RESULTS
The posterior branch of the great auricular nerve was preserved in 26 out of 40 patients (65%). No difference was observed in the incidence of complications except sensory disturbance of the pinna with this surgical procedure as compared to the surgical technique where the great auricular nerve was excised. The VAS score for the sensation was significantly higher in the group of patients whose great auricular nerve was preserved at 2 months (35.0+/-20.8 vs. 18.5+/-9.2), 3 months (64.4+/-18.3 vs. 26.4+/-13.8) and 6 months (66.9+/-16.2 vs. 26.6+/-11.4) after parotidectomy. The VAS score for the QOL was also significantly higher in the group of patients whose great auricular nerve was preserved at 2 months (50.3+/-21.8 vs. 35.1+/-14.5), 3 months (69.5+/-27.5 vs. 45.9+/-22.6) as well as 6 months (71.9+/-24.1 vs. 45.7+/-19.1) after parotidectomy.


CONCLUSIONS
Preservation of the posterior branch of the great auricular nerve during parotidectomy is valuable in order to reduce the postoperative sensory disturbance of the pinna that follows conventional surgery. It further helps to improve the QOL of these patients after parotidectomy.
Yokoshima
Kazuhiko
K
Department of Otolaryngology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan. kyok@nms.ac.jp
Nakamizo
Munenaga
M
Ozu
Chika
C
Fukumoto
Akira
A
Inai
Shunta
S
Baba
Shunkichi
S
Yagi
Toshiaki
T
D000235:Adenolymphoma / Q000601:surgery*; D008949:Adenoma, Pleomorphic / Q000601:surgery*; D000328:Adult; D000368:Aged; D018267:Carcinoma, Acinar Cell / Q000601:surgery*; D018277:Carcinoma, Mucoepidermoid / Q000601:surgery*; D004431:Ear, External / Q000294:innervation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures; D010306:Parotid Gland / Q000294:innervation / Q000601:surgery*; D010307:Parotid Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control; D011788:Quality of Life; D012678:Sensation Disorders / Q000517:prevention & control; D016896:Treatment Outcome