Journal of Nippon Medical School: Vol.71 No.5 page.323

Journal of Nippon Medical School

Select Language
in Japanese < > in English

Full Text of this Article

in English PDF (67K)

ArticleTitle Significance of Preserving the Posterior Branch of the Great Auricular Nerve in Parotidectomy

AuthorList Kazuhiko Yokoshima, Munenaga Nakamizo, Chika Ozu, Akira Fukumoto, Shunta Inai, Shunkichi Baba and Toshiaki Yagi

Affiliation Department of Otolaryngology, Nippon Medical School

Language EN

Volume 71

Issue 5

Year 2004

Page 323-327

Received June 10, 2004

Accepted July 22, 2004

Keywords great auricular nerve, parotid tumor, preservation, complication

Abstract Objective: Sensory disturbance due to excision of the great auricular nerve in patients who have undergone parotidectomy sometimes causes discomfort to the patients. In order to reduce the postoperative discomfort of the pinna, we tried to preserve the posterior branch of the great auricular nerve.
Methods: Forty patients with parotid tumor were included in this study. Twenty-one of these patients had pleomorphic adenoma, 16 had adenolymphoma and 3 had a low grade malignant tumor. Sensations of the pinna and the quality of life (QOL) after parotidectomy were evaluated using a 0-100 Visual Analogue Scale (VAS) assessed at 2 weeks, 1 month, 2 months, 3 months and 6 months after parotidectomy.
Results: The posterior branch of the great auricular nerve was preserved in 26 out of 40 patients (65%). No difference was observed in the incidence of complications except sensory disturbance of the pinna with this surgical procedure as compared to the surgical technique where the great auricular nerve was excised. The VAS score for the sensation was significantly higher in the group of patients whose great auricular nerve was preserved at 2 months (35.0±20.8 vs. 18.5±9.2), 3 months (64.4±18.3 vs. 26.4±13.8) and 6 months (66.9±16.2 vs. 26.6±11.4) after parotidectomy. The VAS score for the QOL was also significantly higher in the group of patients whose great auricular nerve was preserved at 2 months (50.3±21.8 vs. 35.1±14.5), 3 months (69.5±27.5 vs. 45.9±22.6) as well as 6 months (71.9±24.1 vs. 45.7±19.1) after parotidectomy.
Conclusion: Preservation of the posterior branch of the great auricular nerve during parotidectomy is valuable in order to reduce the postoperative sensory disturbance of the pinna that follows conventional surgery. It further helps to improve the QOL of these patients after parotidectomy.

Correspondence to Kazuhiko Yokoshima, Department of Otolaryngology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
kyok@nms.ac.jp

ArticleTitle	Significance of Preserving the Posterior Branch of the Great Auricular Nerve in Parotidectomy
AuthorList	Kazuhiko Yokoshima, Munenaga Nakamizo, Chika Ozu, Akira Fukumoto, Shunta Inai, Shunkichi Baba and Toshiaki Yagi
Affiliation	Department of Otolaryngology, Nippon Medical School
Language	EN
Volume	71
Issue	5
Year	2004
Page	323-327
Received	June 10, 2004
Accepted	July 22, 2004
Keywords	great auricular nerve, parotid tumor, preservation, complication
Abstract	Objective: Sensory disturbance due to excision of the great auricular nerve in patients who have undergone parotidectomy sometimes causes discomfort to the patients. In order to reduce the postoperative discomfort of the pinna, we tried to preserve the posterior branch of the great auricular nerve. Methods: Forty patients with parotid tumor were included in this study. Twenty-one of these patients had pleomorphic adenoma, 16 had adenolymphoma and 3 had a low grade malignant tumor. Sensations of the pinna and the quality of life (QOL) after parotidectomy were evaluated using a 0-100 Visual Analogue Scale (VAS) assessed at 2 weeks, 1 month, 2 months, 3 months and 6 months after parotidectomy. Results: The posterior branch of the great auricular nerve was preserved in 26 out of 40 patients (65%). No difference was observed in the incidence of complications except sensory disturbance of the pinna with this surgical procedure as compared to the surgical technique where the great auricular nerve was excised. The VAS score for the sensation was significantly higher in the group of patients whose great auricular nerve was preserved at 2 months (35.0±20.8 vs. 18.5±9.2), 3 months (64.4±18.3 vs. 26.4±13.8) and 6 months (66.9±16.2 vs. 26.6±11.4) after parotidectomy. The VAS score for the QOL was also significantly higher in the group of patients whose great auricular nerve was preserved at 2 months (50.3±21.8 vs. 35.1±14.5), 3 months (69.5±27.5 vs. 45.9±22.6) as well as 6 months (71.9±24.1 vs. 45.7±19.1) after parotidectomy. Conclusion: Preservation of the posterior branch of the great auricular nerve during parotidectomy is valuable in order to reduce the postoperative sensory disturbance of the pinna that follows conventional surgery. It further helps to improve the QOL of these patients after parotidectomy.
Correspondence to	Kazuhiko Yokoshima, Department of Otolaryngology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan kyok@nms.ac.jp