Skip to main content
AAO-HNSF 2023 Annual Meeting & OTO Experience Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Back
Rate ePoster

Facial Plastic and Reconstructive Surgery

(201) Factors Influencing the Incidence of Facial Nerve Neuropraxia After Parotidectomy

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time
Has Audio

    Presenting Author(s)

  • Sabrina L. Maoz, PhD

    Medical Student
    University of California, Los Angeles
    Los Angeles, California, United States

    • Senior Author(s)

  • Ashley E. Kita, MD

    Assistant Professor-in-Residence
    University of California, Los Angeles
    Los Angeles, California, United States

Disclosure(s):
Sabrina L. Maoz, BS: No relevant relationships to disclose.
Ashley E. Kita, MD: No relevant relationships to disclose.


Introduction: Facial nerve neuropraxia is a devastating complication after parotidectomy. Although facial nerve neuropraxia impairs patients' quality of life, the specific time course of this complication and the patient, treatment, and demographic factors that influence the incidence and time to recovery of neuropraxia have been poorly characterized.

Methods: Patients that underwent parotidectomies between 2006 – 2021 and had full baseline facial nerve strength were included in this retrospective study. Exclusion criteria was recurrent disease or revision surgery. 530 patients were analyzed, of which 245 underwent superficial and 284 underwent deep lobe parotidectomies. Facial nerve weakness (quantified as grade 2 or greater on the House-Brackmann scale), numbness, Frey’s syndrome, infection, and seromas were documented over follow up visits in the retrospective study period. Patient demographics, lesion size, histopathology, and past medical history information were also collected.

Results: The overall incidence of facial nerve weakness was 31.9% and mean time to recovery of facial nerve strength was 84 days (standard error 11 days). The trajectory of facial nerve neuropraxia differed based on the type of parotidectomy. The incidence and mean time to recovery was 20.5% (40.2 ± 4.1 days) for superficial and 42.9% (84.4 ± 4.9 days) for deep parotidectomies, with a significant difference in incidence (F = 116.21, p < 0.001, X2 test) and time to recovery (p < 0.001, permutation test). Over a one-year post-operative period, the incidence of facial nerve weakness peaked in the 1-3 month timeframe (overall: 28.8%, superficial: 9.2% deep: 19.6%). Time to recovery was not correlated with lesion size (R2 < 0.001) or age (R2 = 0.009).

Conclusions: The peak incidence of facial nerve neuropraxia occurs between 1-3 months postoperatively and the mean time to recovery is 2.7 months. Both incidence and time to recovery are elevated in deep relative to superficial parotidectomy but not related to age nor lesion size. These results will better inform patients regarding the risk and recovery from neuropraxia when discussing parotidectomy.