Functional Outcomes Of Superficial & Conservative Total Parotidectomy; Four Years Experience From Benha-Egypt
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Purposes: The aim of this study was to find out the frequency of the functional outcomes related to the superficial & conservative total parotidectomy. Background: Functional outcomes especially facial nerve injury & Frey's syndrome during the parotid surgery represent annoying problem; as it is associated with cosmetic problems & multiple physician visits; "to minimize this outcomes" remains in question. Patients and methods: The study included 52 patients; 6 (11.5%) <35 years old, 28 (53.8%) between 35-50 years old and 18 (34.7%) above 50 years old. All patients underwent clinical evaluation, laboratory assessment, U/S, CT scan & MRI examination. All patients undergoing either 'superficial or conservative total parotidectomy. Results: In this study; immediately postoperative; facial nerve injury was observed in 20 patients; in this series, 14 (?0%) developed temporary facial palsy, whereas 6 (30%) developed permanent facial paralysis. Cervical branch was the most commonly injured nerve 8 (40%). Symptomatic Frey's syndrome was observed in 5 (9.6%) & Parotid leak was observed in 11 (27.5%); all were observed in superficial parotidectomy; as sialocele in 5 (12.5%) or fistula; glandular 4 (10%) or ductal 2 (5%). Conclusions: Facial nerve injury is more common in total conservative parotidectomy than in superficial parotidectomy. Early detection of nerve injury, is quite helpful to reduce the facial deformity by early reconstruction and other procedures. But Parotid leak only is observed in superficial parotidectomy; most of this leak can be managed conservatively except ductal fistula. Symptomatic Frey's syndrome is more common in superficial parotidectomy.