Objectives/Hypothesis
To determine immediate postoperative and long-term facial nerve dysfunction after parotid cancer surgery, risk factors, and the role of facial reanimation surgery.
Study Design
Population-based long-term analysis for all new primary parotid carcinoma cases in Thuringia from 1996 to 2019.
Methods
Data of the cancer registries of Thuringia, a federal state in Germany, were analyzed in combination with hospital-based data on facial function.
Results
About 477 patients (42.3% women; median age: 68 years) were included. It was observed that 6.7% had a preoperative facial nerve dysfunction, 11.7% received a radical parotidectomy, that is, that 5% had a normal preoperative facial function but needed radical surgery because of intraoperative detection of tumor infiltration into the facial nerve. About 10.2% received facial nerve reconstruction surgery. Immediate postoperative facial nerve dysfunction in the other patients was observed in 34.4% of the patients. Advanced T classification (odds ratio [OR] = 2.140; confidence interval [CI] = 1.268–3.611; P = .004) and neck dissection (OR = 2.012; CI = 1.027–3.940; P = .041) were independent risk factors for immediate postoperative facial nerve dysfunction. In addition, 22.0% showed no recovery during follow-up. Advanced T classification (OR = 2.177; CI = 1.147–4.133; P = .017) and postoperative radiotherapy (OR = 2.695; CI = 1.244–5.841; P = .012) were independent risk factors for permanent postoperative facial nerve dysfunction.
Conclusion
Patients with primary parotid cancer are at high risk for long-term facial nerve dysfunction. It seems that the possibilities of facial reanimation surgery needs to be utilized even more effectively.
Level of Evidence
3 Laryngoscope, 2021
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