title: [Intraoperative facial nerve monitoring for parotid gland surgery].
abstract: BACKGROUND
  The route of the facial nerve in its extracranial part determines the technique of parotid gland surgery. Permanent facial nerve paralysis after parotidectomy is not rare. It is the most devastating complication for the patient and surgeon. Facial nerve monitoring by observing or palpating the face during the surgery is a long-standing practice. Using an EMG device is a standard procedure at present.
  
  
  OBJECTIVE
  Evaluation of the effectiveness of intraoperative facial nerve monitoring for parotid gland surgery.
  
  
  METHODS
  Fifty three patients operated on due to parotid gland tumour in the Head and Neck Surgery and Laryngological Oncology Department of the Greater Poland Cancer Center in 2007-2008. All patients had been provided with EMG and ENG examinations of the facial nerve before the surgery and continuous facial nerve monitoring during the operation. Facial nerve function after surgery was assessed according to the House-Brackmann grading system.
  
  
  RESULTS
  Six (12%) patients presented facial nerve dysfunction after surgery. Three (6%) patients had temporary paralysis grade III H-B with complete recovery in 6 weeks. Three (6%) patients with deep lobe tumour had grade V H-B with complete recovery in one patient after 3 months, and two (4%) patients had grade III H-B after one year since the surgery.
  
  
  CONCLUSIONS
  Intraoperative facial nerve monitoring should be a standard procedure during parotid gland surgery in most clinical situations.
authors.affiliation: Oddzial Chirurgii Glowy i Szyi i Onkologii, Laryngologicznej Wielkopolskiego Centrum, Onkologii. piotr.pienkowski@wco.pl
authors.forename: Piotr
authors.initials: P
authors.lastname: Pieńkowski
authors.forename: Wojciech
authors.initials: W
authors.lastname: Golusiński
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Wiertel-Krawczuk
authors.forename: Juliusz
authors.initials: J
authors.lastname: Huber
mesh_terms: D004566:Electrodes; D004568:Electrodiagnosis / Q000295:instrumentation; D004576:Electromyography / Q000379:methods; D005154:Facial Nerve / Q000502:physiology*; D020220:Facial Nerve Injuries / Q000175:diagnosis / Q000517:prevention & control*; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D016343:Monitoring, Intraoperative / Q000379:methods*; D010306:Parotid Gland / Q000294:innervation* / Q000601:surgery; D010307:Parotid Neoplasms / Q000473:pathology / Q000601:surgery*; D011044:Poland; D012189:Retrospective Studies