title: Predictors and timing of recovery in patients with immediate facial nerve dysfunction after parotidectomy.
abstract: BACKGROUND
  Identification of predictors for permanent facial nerve dysfunction and timing of recovery are important for the management of patients who experience immediate facial nerve dysfunction after parotidectomy.
  
  
  METHODS
  In this 6-year retrospective cohort study, 54 such patients were analyzed to determine the associated prognostic factors and timing of recovery.
  
  
  RESULTS
  All 54 patients with immediate postparotidectomy facial nerve dysfunction experienced weakness of the marginal mandibular branch; 7% had coexisting zygomatic branch dysfunction. Forty-five patients (83%) achieved complete recovery. The cumulative rates of recovery at 1 month, 3 months, 6 months, and 1 year postparotidectomy were 31%, 70%, 81%, and 83%, respectively. Immediate postparotidectomy facial nerve dysfunction higher than House-Brackmann (H-B) grade III was the only poor prognostic factor (odds ratio, 6.6; 95% confidence interval, 1.2-35.4). Advanced age, malignant tumor, larger tumor size, and postoperative steroids did not exert significant effect on the recovery of facial nerve dysfunction.
  
  
  CONCLUSIONS
  Immediate postparotidectomy facial nerve dysfunction greater than H-B grade III was a significant predictor of permanent dysfunction. Only 2% of patients achieved any improvement beyond 6 months postoperatively.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Otolaryngology, National Yang Ming University, Taipei, Taiwan.
authors.forename: Bau-Kuei
authors.initials: BK
authors.lastname: Tung
authors.forename: Pen-Yuan
authors.initials: PY
authors.lastname: Chu
authors.forename: Shyh-Kuan
authors.initials: SK
authors.lastname: Tai
authors.forename: Yi-Fen
authors.initials: YF
authors.lastname: Wang
authors.forename: Tung-Lung
authors.initials: TL
authors.lastname: Tsai
authors.forename: Tsung-Lun
authors.initials: TL
authors.lastname: Lee
authors.forename: Yen-Bin
authors.initials: YB
authors.lastname: Hsu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020220:Facial Nerve Injuries / Q000175:diagnosis / Q000209:etiology* / Q000534:rehabilitation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000009:adverse effects*; D010306:Parotid Gland / Q000601:surgery*; D011237:Predictive Value of Tests; D011379:Prognosis; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors
keywords: facial nerve dysfunction; parotidectomy; permanent facial paralysis; risk factors; timing of recovery