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Great auricular nerve preservation in parotid surgery: rationale and long-term results insights

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Abstract

Great auricular nerve (GAN) is frequently sacrificed during parotid surgery. GAN preservation during parotidectomy is advised to avoid complications such as sensitive disorders, but debate still exists. In this study, our experience is reported on the matter. From a cohort of 173 parotidectomies carried out in the period 2005–2010, we studied 60 patients: 20 patients in which we preserved only the posterior branch of GAN (group A), 20 patients in which we preserved also the lobular branch (group B) and 20 patients in which the main trunk of GAN was sectioned (group C); we evaluated tactile sensitivity in all the skin supplied by GAN at 1 week, 1 month, 6 months and 1 year after surgery. Group B is the best in terms of loss and recovery of sensitivity after 1-year post-surgery, followed closely by group A, on the contrary group C confirmed to be the worst. Results suggest that saving as many branches of the GAN as possible during parotid surgery could be useful for reducing hypo-dysesthesia. Preserving posterior and lobular branches of the GAN, when possible, improves the sensitivity of the preauricular area with better quality of life for the patient.

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References

  1. Hu J, Ye W, Zheng J et al (2010) The feasibility and significance of preservation of the lobular branch of the great auricular nerve in parotidectomy. Int J Oral Maxillofac Surg 39(7):684–689

    Article  CAS  PubMed  Google Scholar 

  2. Min HJ, Lee HS, Lee YS et al (2007) Is it necessary to preserve the posterior branch of the great auricular nerve in parotidectomy? Otolaryngol Head Neck Surg 137(4):636–641

    Article  PubMed  Google Scholar 

  3. Biglioli F, D’Orto O, Bozzetti A et al (2002) Function of the great auricular nerve following surgery for benign parotid disorders. J Craniomaxillofac Surg 30(5):308–317

    Article  PubMed  Google Scholar 

  4. Yokoshima K, Nakamizo M, Ozu C et al (2004) Significance of preserving the posterior branch of the great auricular nerve in parotidectomy. J Nihon Med Sch 71(5):323–327

    Article  Google Scholar 

  5. Brown AM, Wake MJ (1990) Accidental full thickness burn of the ear lobe following division of the great auricular nerve at parotidectomy. Br J Oral Maxillofac Surg 28(3):178–179

    Article  CAS  PubMed  Google Scholar 

  6. Ferreria JL, Mauriño N, Michael E et al (1990) Surgery of the parotid region: a new approach. J Oral Maxillofac Surg 48(8):803–807

    Article  CAS  PubMed  Google Scholar 

  7. Brown JS, Ord RA (1989) Preserving the great auricular nerve in parotid surgery. Br J Oral Maxillofac Surg 27(6):459–466

    Article  CAS  PubMed  Google Scholar 

  8. Christensen NR, Parotidectomy Jacobsen SD (1997) Preserving the posterior branch of the great auricular nerve. J Laryngol Otol 111(6):556–559

    CAS  PubMed  Google Scholar 

  9. Porter MJ, Wood SJ (1997) Preservation of the great auricular nerve during parotidectomy. Clin Otolaryngol Allied Sci 22(3):251–253

    Article  CAS  PubMed  Google Scholar 

  10. Sand T, Becser N (1998) Neurophysiological and anatomical variability of the greater auricular nerve. Acta Neurol Scan 98(5):333–339

    Article  CAS  Google Scholar 

  11. George M, Karkos PD, Dwivedi RC, Leong SC, Kim D, Repanos C (2014) Preservation of greater auricular nerve during parotidectomy: sensation, quality of life, and morbidity issues. A systematic review. Head Neck 36(4):603–608

    Article  PubMed  Google Scholar 

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Antonio Moretti and co-authors have no conflicts of interest to declare.

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Correspondence to Pier Giorgio Giacomini.

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Moretti, A., Citraro, L., Petrucci, A.G. et al. Great auricular nerve preservation in parotid surgery: rationale and long-term results insights. Eur Arch Otorhinolaryngol 272, 3515–3520 (2015). https://doi.org/10.1007/s00405-014-3342-6

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  • DOI: https://doi.org/10.1007/s00405-014-3342-6

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