[Usefulness of facial nerve monitoring during parotidectomy]

Abstract

Objective: To analyse the usefulness of facial nerve monitoring by continuous electromyography during parotidectomy.

Patients and methods: Fifty-two consecutive patients who underwent parotidectomy (27 unmonitored and 25 monitored) between 1987 and 1998. Both groups had a similar distribution of superficial and total parotidectomy.

Results: Facial nerve monitoring reduced the incidence and severity of facial nerve paralysis independently of the kind of surgery performed. The incidence of temporary facial paralysis was significantly lower in the monitored group (36%) than in the unmonitored group (70%) (p = 0.013). The rates of permanent deficit were 4% for the monitored group and 30% for the unmonitored group (p = 0.025).

Conclusions: The results suggest that intraoperative facial nerve monitoring reduces the incidence of postoperative facial deficit. The routine use of facial nerve monitoring is controversial. However, it is considered useful in surgery where there is a higher risk of injury to the facial nerve such as total parotidectomy, re-interventions or chronic inflammatory conditions.