Microscopic Parotidectomy: A Prospective Study
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ORIGINAL ARTICLE
Microscopic Parotidectomy: A Prospective Study Abhishek Bhardwaj1 • Rachit Sood1 • Manu Malhotra1 • Madhu Priya1 • Amit Kumar Tyagi1 • Amit Kumar1 • Saurabh Varshney1 • Arpana Singh2
Received: 10 August 2020 / Accepted: 25 August 2020 © Association of Otolaryngologists of India 2020
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
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12070-020-02106-2) contains supplementary material, which is available to authorized users. & Manu Malhotra [email protected] Abhishek Bhardwaj [email protected] Rachit Sood [email protected]
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 1.39and 3.29; magnifications of 1.39 and 1.89 were preferred from incision to separation of parotid from sternocleidomastoid muscle, 1.8 9 and 29 for dissection of the facial nerve trunk, and 29 and 3.29 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. Keywords Microscope · Parotid gland · Parotidectomy · Facial nerve
Madhu Priya [email protected] Amit Kumar Tyagi [email protected]
Introduction
Amit Kumar [email protected]
The majority of salivary gland neoplasms originate from parotid [1]. Complete tumor removal with preservation of all facial nerve branches is the primary goal of surgery for parotid neoplasms. Temporary and permanent facial nerve paralysis have been reported following parotidectomies and are considered the most troublesome complications for surgeons as well as patients. The reported incidence of temporary facial paresis is 25 and 60% while permanent facial palsy is 2–6% [2–6]. Malignant parotid neoplasms are usually associated with a higher rate of postoperative
Saurabh Varshney [email protected] Arpana Singh [email protected] 1
Department of Otorhinolaryngology & Head-Neck
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