Facial Nerve Dissection Guided by Preoperative CT in Parotid Surgery

Abstract

Objective: The parotid gland is closely related to the facial nerve. Appropriate facial nerve dissection is helpful to protect facial nerve function. The purpose of this study is to evaluate the parotid gland and its adjacent structures by preoperative CT, so as to guide the dissection of facial nerve during parotid surgery. Method: A total of 45 patients with parotid benign tumor diagnosed by pathology were collected. According the preoperative CT, two dissection methods of facial nerve was used. Twenty-one patients in group A were dissected by anterograde method from the trunk of facial nerve. Other 24 patients in Group B was dissected by retrograde method through the branch of facial nerve. The occurrence of facial nerve function injury and the recovery time of facial nerve function were observed. Result: Preoperative CT can evaluate the nature and adjacent relationship of parotid tumors. Anatomical localization markers of facial nerve can be evaluated. Group A has 1 case of facial nerve function injury (4.8%) occurred after surgery, and nerve function recovery time was (2.6 ± 0.5) m. Group B has 7 cases of facial nerve function damage (29.1%) occurred after surgery, and nerve function recovery time was (3.3 ± 0.7) m. Compared with Group A, the incidence of facial nerve function injury in Group B was higher, the nerve function recovery time was longer. Conclusion: Preoperative CT evaluation is helpful to the optimal selection of facial nerve anatomical pathway during parotid gland surgery. The anterograde and retrograde dissection of facial nerve can complete the operation successfully. The anterograde methods is the first choice as the lesser nerve function damage and faster recovery time.