Incidence of Facial Nerve Paralysis After Parotidectomy: Our Experience

Abstract

Facial nerve palsy (FNP) is a well-recognized complication following parotidectomy, with varying reported incidence rates in the literature. Understanding the incidence and factors contributing to FNP is crucial for optimizing patient care and surgical outcomes. A retrospective analysis was conducted on 78 patients who underwent parotidectomy at a tertiary care institution (Hospital de Especialidades Carlos Andrade Marin, Quito) over a 36-month period. Demographic data, preoperative pathology reports, surgical details, and postoperative outcomes, including FNP incidence and severity, were analyzed. The mean age of the cohort was 53 years, with a male-to-female ratio of 0.8:1. Fine needle aspiration revealed benign pathology in 70.5% of cases, with superficial parotidectomy being the most common surgical approach (84.6%). Postoperatively, FNP was observed in 51.2% of cases, with transient paralysis in 62.5% and persistent paralysis in 37.5%. The majority of FNP cases were classified as grade II and III according to the House-Brackmann grading system. A tumor size larger than 4 cm was associated with a higher incidence of FNP (57.5%). This study provides valuable insights into the incidence and severity of FNP following parotidectomy. Despite efforts to standardize surgical techniques, persistent paralysis remains a significant concern.

Keywords: facial nerve paralysis; parotid gland tumor; parotid surgery; salivary gland surgery; salivary gland tumor.

Figure 1. Tumor size and facial nerve palsy

FNP: Facial nerve palsy