Management ofparotidectomy with facialnerve preservation for thetreatment of pleomorphicadenoma of the parotid gland

Objectives: Facial paralysis is recognized as the most prevalent complication following parotidectomy. This study aimed to evaluate the symptoms and post-operative complications of parotidectomy while employing facial nerve preservation techniques. Methods: The study involved 14 patients (9 men and 5 women) with a mean age of 53.0 ± 16.5 years. Clinical characteristics, facial paralysis, and other complications in these patients were monitored at three post-operative intervals: 1 week, 1 month, and 3 months. Results: Following ultrasonography, homogeneous echo textures were observed in 64.3% of tumors compared with 35.7% with heterogeneous textures. Regarding tumor locations, 50% were found in the superficial lobe, 14.3% in the deep lobe, and 35.7% involving both lobes. The FNA (Fine Needle Aspiration) test identified 64.3% of the tumors as pleomorphic, 13.3% as oncocytomas, 7.1% as Warthin tumors, and 14.3% as other benign tumors, with no cases suspected of cancer. Post-operative complications: Temporary facial paralysis was noted in 57.1% of cases at one week post-operation, declining to 28.6% after one month and 14.3% after three months. Hemorrhage occurred in 7.1% of patients, with no reports of infection, skin flap necrosis, or postoperative seroma. Additionally, 92.9% of patients experienced ear numbness at one week post-operation, decreasing to 21.4% by three months. Conclusion: the study demonstrates that parotidectomy, when performed with careful preservation of the facial nerve, is an effective and constructive approach for removing pleomorphic tumors in the parotid gland.