Abstract
To assess the parameters’ setting of the microscope during parotidectomy and the impact of microscopic parotidectomy on facial nerve functional status. A prospective study was conducted on 28 patients in a tertiary care center, who underwent microscopic parotidectomy. Microscope’s settings’ like magnification, focal length, diameter of the visualized field, and clock position were recorded. Facial nerve functional status was also recorded. All surgeries were performed by right-handed surgeons using Leica F 20 M525 microscope. Clock position of microscope for right parotidectomy ranged between 7 and 10 o clock and for left, it ranged between 7 and 12 o clock. Magnification ranged between 1.3 × and 3.2 ×; magnifications of 1.3 × and 1.8 × were preferred from incision to separation of parotid from sternocleidomastoid muscle, 1.8 × and 2 × for dissection of the facial nerve trunk, and 2 × and 3.2 × for individual branches of the facial nerve. Focal length ranged between 251 and 410 mm and the diameter of the visualized field ranged between 7 and 14.7 cm. Out of 24 cases of benign lesions, 2 (8.3%) developed facial paresis which resolved in 3 months. Two out of four cases of malignancy developed permanent palsy as nerve branches were sacrificed to achieve tumor clearance. Using a microscope for parotidectomy is advantageous for facial nerve dissection, reducing chances of facial paralysis. The microscope was also found to be useful for teaching. The use of appropriate microscopic parameters avoids the glitch of transition from open to microscopic approach.
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AB: Conceptualization, Methodology, Original draft preparation. RS: Data collection, Methodology. MM: Methodology, Review, Editing. MP: Methodology, Review. AKT: Draft revision, study design. AK: Draft revision, study design. SV: Supervision, Review. AS: Original draft preparation
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All of the procedures performed in this study were in accordance with the ethical standards of our institution and with the Helsinki Declaration of 1975, as revised in 2008. The protocol for the investigation has been approved by the Institutional Review Board and written informed consent was obtained from each participant or each participant’s guardian.
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This retrospective review study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Study has been approved by Institutional review board (letter no. 3017396/2020/05/03/2020).
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ESM_1 Dissection of facial nerve branch using bipolar cautery (MP4 30927 kb)
ESM_2 Facial nerve functional assessment in immediate post-operative period (MP4 9726 kb)
ESM_3 Facial nerve branching pattern as visualized under the microscope (MP4 63455 kb)
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Bhardwaj, A., Sood, R., Malhotra, M. et al. Microscopic Parotidectomy: A Prospective Study. Indian J Otolaryngol Head Neck Surg 74 (Suppl 2), 2273–2280 (2022). https://doi.org/10.1007/s12070-020-02106-2
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DOI: https://doi.org/10.1007/s12070-020-02106-2