title: Distal facial nerve exposure: a key to partial parotidectomy.
abstract: OBJECTIVE
  1) Compare outcomes of distal facial nerve identification with antegrade exposure in partial parotidectomy; 2) Be able to incorporate other modifications of parotidectomy including preservation of the great auricular nerve, superficial musculo-aponeurotic system (SMAS), and parotid duct.
  
  
  METHODS
  Case series with chart review of partial parotidectomy for benign neoplasms and intraparotid lymph nodes, using antegrade (Group 1) or distal (Group 2) facial nerve exposure, and those conserving the great auricular nerve, SMAS, and parotid duct (Group 3).
  
  
  METHODS
  Outcomes for the three groups were reviewed. The great auricular nerve, parotid duct, and SMAS were preserved when possible. Outcomes examined included postoperative facial nerve function, earlobe sensation, allograft use for SMAS defects, surgical duration, sialocele, or salivary fistula.
  
  
  RESULTS
  No difference in facial nerve function was found between the groups. Group 3 had better ear lobule cutaneous sensation. No sialoceles occurred in the 10 of 14 Group 3 cases in which parotid ducts were preserved.
  
  
  CONCLUSIONS
  Partial parotidectomy utilizing distal facial nerve exposure can reduce the extent of surgical dissection, facilitate preservation of the parotid duct and great auricular nerve, and allow greater flexibility in the choice of skin and SMAS incisions.
authors.affiliation: Division of Otolaryngology, Department of Surgery, University of Nevada School of Medicine, Las Vegas, NV 89102, USA. rcywang@earthlink.net
authors.forename: Robert C
authors.initials: RC
authors.lastname: Wang
authors.forename: Annabel E
authors.initials: AE
authors.lastname: Barber
authors.forename: Marcia
authors.initials: M
authors.lastname: Ditmyer
authors.forename: Paul
authors.initials: P
authors.lastname: Vantine
mesh_terms: D005154:Facial Nerve / Q000033:anatomy & histology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D010307:Parotid Neoplasms / Q000601:surgery*; D016896:Treatment Outcome