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Clinical outcome of continuous facial nerve monitoring during primary parotidectomy.

Publication ,  Journal Article
Terrell, JE; Kileny, PR; Yian, C; Esclamado, RM; Bradford, CR; Pillsbury, MS; Wolf, GT
Published in: Arch Otolaryngol Head Neck Surg
October 1997

OBJECTIVES: To assess whether continuous facial nerve monitoring during parotidectomy is associated with a lower incidence of facial nerve paresis or paralysis compared with parotidectomy without monitoring and to assess the cost of such monitoring. DESIGN: A retrospective analysis of outcomes for patients who underwent parotidectomy with or without continuous facial nerve monitoring. SETTING: University medical center. PATIENTS: Fifty-six patients undergoing parotidectomy in whom continuous electromyographic monitoring was used and 61 patients in whom it was not used. MAIN OUTCOME MEASURES: (1) The incidence of early and persistent facial nerve paresis or paralysis and (2) the cost associated with facial nerve monitoring. RESULTS: Early, unintentional facial weakness was significantly lower in the group monitored by electromyograpy (43.6%) than in the unmonitored group (62.3%) (P=.04). In the subgroup of patients without comorbid conditions or surgeries, early weakness in the monitored group (33.3%) remained statistically lower than the rate of early weakness in the unmonitored group (57.5%) (P=.03). There was no statistical difference in the final facial nerve function or incidence of permanent nerve injury between the groups or subgroups. After multivariate analysis, nonmonitored status (odds ratio [OR], 3.22), advancing age (OR, 1.47 per 10 years), and longer operative times (OR, 1.3 per hour) were the only significant independent predictive variables significantly associated with early postoperative facial weakness. The incremental cost of facial nerve monitoring was $379. CONCLUSIONS: The results suggest that continuous electromyographic monitoring of facial muscle during primary parotidectomy reduces the incidence of short-term postoperative facial paresis. Advantages and disadvantages of this technique need to be considered together with the additional costs in deciding whether routine use of continuous monitoring is a useful, cost-effective adjunct to parotid surgery.

Duke Scholars

Published In

Arch Otolaryngol Head Neck Surg

DOI

ISSN

0886-4470

Publication Date

October 1997

Volume

123

Issue

10

Start / End Page

1081 / 1087

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Postoperative Complications
  • Parotid Gland
  • Parotid Diseases
  • Otorhinolaryngology
  • Monitoring, Intraoperative
  • Middle Aged
  • Male
  • Incidence
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Terrell, J. E., Kileny, P. R., Yian, C., Esclamado, R. M., Bradford, C. R., Pillsbury, M. S., & Wolf, G. T. (1997). Clinical outcome of continuous facial nerve monitoring during primary parotidectomy. Arch Otolaryngol Head Neck Surg, 123(10), 1081–1087. https://doi.org/10.1001/archotol.1997.01900100055008
Terrell, J. E., P. R. Kileny, C. Yian, R. M. Esclamado, C. R. Bradford, M. S. Pillsbury, and G. T. Wolf. “Clinical outcome of continuous facial nerve monitoring during primary parotidectomy.Arch Otolaryngol Head Neck Surg 123, no. 10 (October 1997): 1081–87. https://doi.org/10.1001/archotol.1997.01900100055008.
Terrell JE, Kileny PR, Yian C, Esclamado RM, Bradford CR, Pillsbury MS, et al. Clinical outcome of continuous facial nerve monitoring during primary parotidectomy. Arch Otolaryngol Head Neck Surg. 1997 Oct;123(10):1081–7.
Terrell, J. E., et al. “Clinical outcome of continuous facial nerve monitoring during primary parotidectomy.Arch Otolaryngol Head Neck Surg, vol. 123, no. 10, Oct. 1997, pp. 1081–87. Pubmed, doi:10.1001/archotol.1997.01900100055008.
Terrell JE, Kileny PR, Yian C, Esclamado RM, Bradford CR, Pillsbury MS, Wolf GT. Clinical outcome of continuous facial nerve monitoring during primary parotidectomy. Arch Otolaryngol Head Neck Surg. 1997 Oct;123(10):1081–1087.

Published In

Arch Otolaryngol Head Neck Surg

DOI

ISSN

0886-4470

Publication Date

October 1997

Volume

123

Issue

10

Start / End Page

1081 / 1087

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Postoperative Complications
  • Parotid Gland
  • Parotid Diseases
  • Otorhinolaryngology
  • Monitoring, Intraoperative
  • Middle Aged
  • Male
  • Incidence
  • Humans