Great auricular nerve morbidity after nerve sacrifice during parotidectomy.
OBJECTIVE
To clarify the extent, timing, and patient perspectives of great auricular nerve (GAN) morbidity and recovery after nerve sacrifice during parotidectomy during the first postoperative year.


METHODS
Prospective series.


METHODS
Tertiary care academic medical center. Patients Twenty-seven consecutive patients who underwent parotidectomy with GAN sacrifice.


METHODS
Preoperatively and at 3, 6, 9, and 12 months postoperatively, we performed light touch sensation tests on each patient to develop an ink map representing anesthesia and paresthesia in the GAN sensory territory; patients also completed an outcomes questionnaire.


RESULTS
Twenty-two (81%) of 27 patients completed follow-up. The prevalence and average area of anesthesia decreased continually during the first year according to sensory testing and patient scoring. Half of the patients had no anesthesia at 12 months. The prevalence and average area of paresthesia increased during the first year according to sensory testing; however, the contiguity and subjective scoring of paresthesia peaked at 6 months and decreased in subsequent follow-up points. Throughout the first year, patients had difficulty using the telephone, shaving, combing their hair, wearing earrings, and sleeping on the operative side because of both anesthesia and paresthesia.


CONCLUSIONS
The impact of GAN sacrifice morbidity on patient quality of life is tolerable and improves during the first postoperative year. However, we feel that GAN morbidity may be bothersome enough to warrant efforts to preserve the posterior branch of the GAN when possible and appropriate.
Ryan
William R
WR
Department of Otolaryngology-Head and Neck Surgery, Stanford University Medical Center, Stanford, Calif, USA. williamryan@stanford.edu
Fee
Willard E
WE
D000368:Aged; D000369:Aged, 80 and over; D003391:Cranial Nerves / Q000601:surgery*; D004423:Ear / Q000294:innervation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010292:Paresthesia / Q000209:etiology*; D010306:Parotid Gland / Q000294:innervation* / Q000601:surgery*; D011183:Postoperative Complications; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome