Facial nerve function in carcinoma of the parotid gland.
OBJECTIVE
To analyse, for patients with carcinoma of the parotid gland, the prognostic value for treatment outcome of the function of the facial nerve (NVII), and determining facial nerve dysfunction after treatment.


METHODS
In a retrospective study of the Dutch head and Neck cooperative group (NWHHT), data of 324 patients with parotid carcinoma were analysed. The function of N VII before treatment was intact in 77%, partially and completely impaired in 14% and 7%, respectively. Eighty-eight percent of the patients were treated surgically, and 77% of them were treated by a combination of postoperative radiotherapy. In 21% NVII was sacrificed, a reconstruction was performed in one of three.


RESULTS
Independent risk factors for N VII dysfunction before treatment were tumour localisation, positive neck nodes at presentation, pain, increasing age, and perineural invasion. Regional, not local, control was significantly impaired for complete facial paralysis. N VII dysfunction was an independent factor for disease free survival, and was 69%, 37% and 13% for normal, partially and completely impaired function, respectively. After treatment 22% of the patients experienced a partial paralysis, and 13% of the patients experienced a complete paralysis of N VII.


CONCLUSIONS
For patients with parotid carcinoma, facial nerve function before treatment is a strong prognostic factor for disease free survival.
Terhaard
Chris
C
Department of Radiotherapy, University Medical Center, UMC Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. C.H.J.Terhaard@azu.nl
Lubsen
Herman
H
Tan
Bing
B
Merkx
Thijs
T
van der Laan
Bernard
B
Baatenburg de Jong
Rob
R
Baatenburg-de Jong
Rob
R
Manni
Hans
H
Knegt
Paul
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D018572:Disease-Free Survival; D005154:Facial Nerve / Q000502:physiology*; D005155:Facial Nerve Diseases / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000401:mortality; D010307:Parotid Neoplasms / Q000401:mortality / Q000503:physiopathology*; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome