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Facial nerve monitoring during parotid gland surgery: a systematic review and meta-analysis

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A Correction to this article was published on 13 August 2020

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Abstract

Introduction

Facial nerve injury remains the most severe complication of parotid gland surgery. However, the use of intraoperative facial nerve monitoring (IFNM) during parotid gland surgery among Otolaryngologist—Head and Neck Surgeons continues to be a matter of debate.

Materials and methods

A systematic review and meta-analysis of the literature was conducted including articles from 1970 to 2019 to try to determine the effectiveness of intraoperative facial nerve monitoring in preventing immediate and permanent postoperative facial nerve weakness in patients undergoing primary parotidectomy. Acceptable studies included controlled series that evaluated facial nerve function following primary parotidectomy with or without intraoperative facial nerve monitoring.

Results

Ten articles met inclusion criteria, with a total of 1069 patients included in the final meta-analysis. The incidence of immediate and permanent postoperative weakness following parotidectomy was significantly lower in the IFNM group compared to the unmonitored group (23.4% vs. 38.4%; p = 0.001) and (5.7% vs. 13.6%; p = 0.001) when all studies were included. However, when we analyze just prospective data, we are not able to find any significant difference.

Conclusion

Our study suggests that IFNM may decrease the risk of immediate post-operative and permanent facial nerve weakness in primary parotid gland surgery. However, due to the low evidence level, additional prospective-randomized trials are needed to determine if these results can be translated into improved surgical safety and improved patient satisfaction.

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Authors and Affiliations

  1. Otorhinolaryngology-Head and Neck Surgery Department, Hospital Universitario Donostia, Calle Doctor Begiristain, #1. CP. 20014, San Sebastian-Donostia, Guipuzkoa, Basque Country, Spain

    Carlos Miguel Chiesa-Estomba & Ekhiñe Larruscain-Sarasola

  2. Department of Human Anatomy and Experimental Oncology, University of Mons, Mons, Belgium

    Jérome Rene Lechien

  3. Department of Otorhinolaryngology-Head and Neck Surgery, CHRU de Lille, Lille, France

    Francois Mouawad

  4. Department of Otolaryngology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain

    Christian Calvo-Henriquez

  5. ENT and Head and Neck Departement, CHU de La Paix, UFR Santé de l’Université Assane Seck, Ziguinchor, Sénégal

    Evelyne Siga Diom

  6. Head and Neck Surgery, Clinica Medilaser Neiva, Neiva, Colombia

    Adonis Ramirez

  7. Division of Otolaryngology-Head and Neck Surgery, Center Hospitalier de l’Université de Montréal, Montreal, Canada

    Tareck Ayad

  8. Head and Neck Study Group of Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), Paris, France

    Carlos Miguel Chiesa-Estomba, Jérome Rene Lechien, Christian Calvo-Henriquez & Tareck Ayad

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  1. Carlos Miguel Chiesa-Estomba
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Correspondence to Carlos Miguel Chiesa-Estomba.

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The original version of this article was revised due to the order of figures was published incorrectly and corrected in this version.

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Chiesa-Estomba, C.M., Larruscain-Sarasola, E., Lechien, J.R. et al. Facial nerve monitoring during parotid gland surgery: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol 278, 933–943 (2021). https://doi.org/10.1007/s00405-020-06188-0

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