title: Postoperative facial nerve function in pediatric parotidectomy: a 12-year review.
abstract: OBJECTIVE
  To analyze the incidence of postparotidectomy facial nerve dysfunction in pediatric patients and to evaluate the association between patient demographics or underlying pathology and functional outcomes.
  
  
  METHODS
  Case series with chart review.
  
  
  METHODS
  Tertiary-care pediatric hospital.
  
  
  METHODS
  We reviewed charts of patients younger than 18 years who underwent parotidectomy performed by a pediatric otolaryngologist between 1999 and 2011 at a tertiary pediatric center. Distributions of postoperative facial nerve dysfunction and timing of recovery were noted. Chi-square and t-test analyses were conducted to determine the association between demographics or pathology and functional outcomes.
  
  
  RESULTS
  Forty-three patients met inclusion criteria: 41 underwent superficial parotidectomy, and 2 underwent total parotidectomy. Leading indications for surgery were atypical mycobacterial infection (16/43 [37.2%]) and first branchial cleft anomaly (8/43 [18.6]). The facial nerve was sacrificed in 1 (2%) patient with Ewing's sarcoma involving the nerve. The incidence of immediate facial nerve paresis was 21% (9/43), involving the marginal mandibular nerve (n = 7), buccal branch (n = 1), and both marginal mandibular and frontal branches (n = 1). Full recovery of nerve function in patients with paresis occurred within 1 month (n = 2), 2 months (n = 1), 6 months (n = 3), or 10 months (n = 2).
  
  
  CONCLUSIONS
  Postparotidectomy paresis of distal branches of the facial nerve is a common occurrence in the pediatric population and should be discussed during preoperative evaluation. The risk is comparable to that of the adult population. Age, gender, and pathologic diagnosis were not predictive of postoperative nerve dysfunction.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, MN 55455, USA. usuja@gmail.com
authors.forename: James A
authors.initials: JA
authors.lastname: Owusu
authors.forename: Noah P
authors.initials: NP
authors.lastname: Parker
authors.forename: Frank L
authors.initials: FL
authors.lastname: Rimell
mesh_terms: D000293:Adolescent; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D020220:Facial Nerve Injuries / Q000209:etiology* / Q000503:physiopathology*; D005158:Facial Paralysis / Q000209:etiology* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010305:Parotid Diseases / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology*