title: Preservation of greater auricular nerve during parotidectomy: sensation, quality of life, and morbidity issues. A systematic review.
abstract: BACKGROUND
  Our objectives were to assess the evidence of preservation of the greater auricular nerve in parotidectomy with regard to morbidity and quality of life.
  
  
  METHODS
  This was a systematic review. Inclusion criteria were: English literature, prospective and retrospective studies. Exclusion criteria were: single case reports, "teaching" reviews. Outcome measures were: tactile sensation, pain, thermal sensitivity, and quality of life.
  
  
  RESULTS
  Although quality of life does not seem to be adversely affected when the greater auricular nerve is sacrificed, preservation of the posterior branch was recommended in 8 studies. When preserving the nerve, the incremental operative time increase is no more than 10 to 5 minutes after a rapid learning curve.
  
  
  CONCLUSIONS
  There is level Ib evidence that preservation of the greater auricular nerve minimizes the postoperative sensory disturbance and should be considered whenever tumor clearance is not compromised. There is no evidence that overall quality of life is affected when the greater auricular nerve is sacrificed.
authors.affiliation: Department of Otolaryngology-Head Neck Surgery, Queen Alexandra Hospital, Portsmouth, United Kingdom.
authors.forename: Michael
authors.initials: M
authors.lastname: George
authors.forename: Petros D
authors.initials: PD
authors.lastname: Karkos
authors.forename: Raghav C
authors.initials: RC
authors.lastname: Dwivedi
authors.forename: Samuel C
authors.initials: SC
authors.lastname: Leong
authors.forename: Dae
authors.initials: D
authors.lastname: Kim
authors.forename: Costa
authors.initials: C
authors.lastname: Repanos
mesh_terms: D002572:Cervical Plexus; D004431:Ear, External / Q000294:innervation*; D006801:Humans; D010306:Parotid Gland / Q000294:innervation* / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control; D011788:Quality of Life; D012678:Sensation Disorders / Q000517:prevention & control; D014110:Touch
keywords: greater auricular nerve; morbidity; nerve preservation; nerve sacrifice; paresthesia; parotidectomy; quality of life