Scientific paperA prospective controlled double-blind trial of great auricular nerve preservation at parotidectomy
Section snippets
Patients and methods
This was a prospective study. All patients who underwent superficial or total conservative parotidectomy from January 1995 to December 1998 in our department were recruited. Patients with preoperative clinical suspicion of malignancy, fine-needle aspiration cytology evidence of malignancy, redo parotid operations, age over 65 years, and those with mental disability were excluded.
In the preoperative period, all patients received explanation on the risks of parotidectomy including morbidity
Results
Eighty-one patients conformed to our inclusion criteria and their data were used for analysis. There were 59 male (73%) and 22 female (27%) patients. Mean overall age was 47.9 years (range 18 to 64, SD = 12.5). Preservation of the posterior branches was achieved in 56 patients (69%). The GAN was divided in the remaining 25 patients (31%). The two groups of patients were comparable in terms of age, sex distribution, pathology, and tumor characteristics (Table 1).
The pattern of change in skin
Comments
The side effects of GAN sacrifice are a result of hypoasthesia in the area of skin it supplied. Patients have been reported to be unable to wear earrings [17], to experience discomfort when being touched or kissed [18], to be susceptible to burns and injuries [15], [16], to sustain cuts when shaving [18], or even forced to give up skiing owing to the discomfort felt in cold weather [18]. Preservation therefore appeared to be desirable. Preservation of the posterior branches of the GAN was
Conclusions
Preservation of the GAN is achievable in 69% of patients. The additional time required for surgical dissection is estimated to be about 5 to 10 minutes. Patients with GAN preservation showed faster and more complete recovery in sensory function. For patients with the nerve divided, recovery remained incomplete after 2 years and the subjective feeling of numbness often persisted.
With the above finding, the authors recommended that the posterior branches of the GAN should always be preserved in
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Great auricular nerve conservation and parotidectomy for tumor
2023, Annales Francaises d'Oto-Rhino-Laryngologie et de Pathologie Cervico-FacialeGreat auricular nerve conservation and parotidectomy for tumor
2023, European Annals of Otorhinolaryngology, Head and Neck DiseasesSuperficial parotidectomy with or without great auricular nerve preservation. Is there a difference in postoperative sensory recovery rates and quality of life?
2022, British Journal of Oral and Maxillofacial SurgeryCitation Excerpt :The great auricular nerve (GAN) is a somatic sensory nerve that responds to tactile, thermal, pruritic (itchy), and pain sensations in the skin overlying the lower aspect of the pinna and angle of the mandible.1 Its main trunk follows a consistent course over the middle of the sternocleidomastoid muscle and bifurcates into anterior lobular and posterior auricular branches.2 It is frequently sacrificed or unintentionally injured during parotid surgery.
Impact of great auricular nerve sacrifice on sensory disturbance after parotidectomy
2022, American Journal of Otolaryngology - Head and Neck Medicine and SurgeryCitation Excerpt :The current body of literature shows somewhat conflicting evidence on whether GAN preservation is associated with improved sensation postoperatively. Most studies suggest a significant association between GAN sacrifice and postoperative sensory disturbance [1,2,3,5–11]. However, Porter et al. conducted a prospective study in 1997 with 31 patients which showed no statistically significant association between sensory loss and sacrificing the posterior branch of the GAN up to 12 months after surgery [12].
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