title: Recurrent Pleomorphic Adenoma of the Parotid Gland: Intraoperative Facial Nerve Monitoring during Parotidectomy.
abstract: To determine the benefit to postoperative facial function of intraoperative facial nerve monitoring (IFNM) during recurrent pleomorphic adenoma (RPA) parotid surgery.
  
  
  
  Cohort study with planned data collection.
  
  
  
  Chinese PLA General Hospital.
  
  
  
  Fifty-eight RPA parotidectomies were performed between 2004 and 2012. Recurrence was confirmed by histopathologic examination. None of the patients had preoperative facial palsy. Electromyography-based IFNM was used in 28 patients; 30 patients were unmonitored. The durations of surgery and the severity of postoperative facial nerve palsy were compared between the 2 groups.
  
  
  
  There were no significant differences between the 2 groups in the incidence of immediate or permanent facial paralysis after RPA parotidectomy (P = .95 and P = .36, respectively). However, the differences in the average duration of surgery and the severity of postoperative facial nerve palsy after total parotidectomy or wide resection were significant (P < .01 and P = .01, respectively). In contrast, these differences were not significant after superficial parotidectomies (P = .43 and P = .49, respectively). The average recovery time of temporary facial nerve paralysis was significantly shorter in the monitored group compared with the unmonitored group, independent of surgical technique (P < .01).
  
  
  
  The use of IFNM during total or wide resection RPA parotidectomy reduced the duration of surgery and the incidence of postoperative facial paralysis and enhanced recovery. However, there was little impact on facial nerve outcomes when IFNM was used during superficial RPA parotidectomy.
authors.affiliation: Department of Stomatolagy, Chinese PLA General Hospital, Beijing, China.
authors.forename: Huawei
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Stomatolagy, Chinese PLA General Hospital, Beijing, China.
authors.forename: Weisheng
authors.initials: W
authors.lastname: Wen
authors.affiliation: Department of Stomatolagy, Chinese PLA General Hospital, Beijing, China.
authors.forename: Haitao
authors.initials: H
authors.lastname: Huang
authors.affiliation: College of Stomatology, Hebei United University, Tangshan, China.
authors.forename: Yongqiang
authors.initials: Y
authors.lastname: Liang
authors.affiliation: Department of Stomatolagy, Chinese PLA General Hospital, Beijing, China.
authors.forename: Xinying
authors.initials: X
authors.lastname: Tan
authors.affiliation: Department of Stomatolagy, Chinese PLA General Hospital, Beijing, China.
authors.forename: Sanxia
authors.initials: S
authors.lastname: Liu
authors.affiliation: Department of Stomatolagy, Chinese PLA General Hospital, Beijing, China.
authors.forename: Changkui
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Stomatolagy, Chinese PLA General Hospital, Beijing, China humin48@vip.163.com.
authors.forename: Min
authors.initials: M
authors.lastname: Hu
mesh_terms: D008949:Adenoma, Pleomorphic / Q000601:surgery*; D000328:Adult; D015331:Cohort Studies; D004576:Electromyography; D005158:Facial Paralysis / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D010307:Parotid Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: facial nerve; intraoperative monitoring; palsy; parotid gland; pleomorphic adenoma; recurrence