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

Head and Neck Surgery

(511) Trends in Facial Nerve Dissection During Parotidectomy over Four Periods

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

    Presenting Author(s)

  • SY

    Sofiya Yusina, BS

    Medical student
    Department of Otolaryngology - Head and Neck Surgery, New York University Grossman School of Medicine
    New York, New York, United States

    • Co-Author(s)

  • AS

    Arman Saeedi, BS, MPH

    Department of Otolaryngology – Head and Neck Surgery, New York University Grossman School of Medicine, USA

    • Co-Author(s)

  • DAVID Strum, MD

    Resident Physician
    NYU Grossman School of Medicine Department of Otolaryngology Head and Neck Surgery
    New York, New York, United States

  • GM

    Ghayoour Mir, DO

    Assistant Professor
    Rutgers New Jersey Medical School
    Newark, New Jersey, United States

    • Senior Author(s)

  • AJ

    Adam S. Jacobson, MD

    Associate Professor
    NYU Grossman School of Medicine Department of Otolaryngology Head and Neck Surgery
    New York, New York, United States

Disclosure(s):
DAVID Strum, MD: No relevant relationships to disclose.
Ghayoour Mir, DO: No relevant relationships to disclose.


Introduction: Outcomes and recurrence research help inform optimal techniques for salivary gland surgery. Extracapsular dissection(ECD) without nerve dissection, when appropriate, may decrease patterns of recurrence, nerve deficits, operative time, and incidence of Frey Syndrome. In this study, we investigate trends in parotidectomy techniques over four time periods in a national database

Methods: We queried the National Surgical Quality Improvement Program(NSQIP) by Current Procedure Terminology(CPT) codes for adults who had superficial parotidectomy(SP) with or without facial nerve dissection for parotid lesions between 2005 and 2021. χ2 and logistic regression were used to analyze demographics, comorbidities, and 30-day complication trends over four time periods(2005-2008, 2009-2012, 2013-2016, and 2017-2021).

Results: A total of 7771 patients were included. Mean age was 56.9±15.2 years old. Most patients were male(53.0%), Caucasian(67.3%), and treated by otolaryngologists(92.8%). Surgery with nerve dissection occurred less than surgery without nerve dissection in 2005-2008(p=0.006) and 2013-2017(p < 0.001). Surgery without nerve dissection had mean duration of 119.1±69.47 compared to 142.3±71.9 minutes with nerve dissection(p < 0.001). Readmission was associated with smoking(p=0.001), dialysis requirement(p=0.008), and older age(p=0.029).Reoperation was associated with inpatient status(p=0.001), malignant tumor(p=0.048), CHF(p=0.004), and male sex(p=0.038) but not procedure.

Conclusions: SP with nerve dissection occurred less frequently from 2005-2008 and 2013-2017 than in 2009-2012 and 2017-2021. Without a specific ECD CPT code, it is hard to deduce its true frequency. Ultimately, no significant differences were found in 30-day outcomes between surgery with or without nerve dissection in all periods. Nerve dissection predicted longer operative time overall. Hence, given shorter operative time and data from retrospective cohort studies, surgery without nerve dissection should be considered in appropriate patients.