Facial paralysis risk factors in benign parotid surgery
Reviewed by Madhup K Chaurasia

The literature shows that the risk of facial paralysis following benign parotid surgery can be as high as 57% for temporary weakness and 7% for permanent facial nerve damage. It is generally thought that the factors involved may be related to age, sex, types of benign tumours, indications for the procedure, histological diameter, tumour location and the extent of parotidectomy. In this retrospective study involving 150 patients over a 10 year period the authors have assessed these factors and compared their findings with other studies. Of these patients, 26.7% had temporary weakness and 2.6% had permanent weakness. The age of these patients ranged from 15-80 years but this factor did not influence this risk nor did their gender. Different types of benign tumours and their size did not add to the risk of facial paralysis and the same was the case with location of the tumour in the parotid gland. The study included 10 cases in whom parotidectomy was done for sialadenitis and this did not add to the risk of facial nerve paralysis. The grade of the surgeon performing the parotidectomies was also taken into account but this did not matter thus making the authors feel reassured of the training and supervision. The most interesting aspect of this study is that facial nerve monitoring was used in only 44% of cases and authors do not feel the lack of it affects the risk of facial nerve paralysis. This does appear reassuring but how it stands from the medico-legal point of view is another matter.

Stratifying the risk of facial nerve palsy after benign parotid surgery.
Sethi N, Tay PH, Scally A, Sood S.
JOURNAL OF LARYNGOLOGY AND OTOLOGY
2014;128:150-62.