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Facial nerve grading after parotidectomy.

Stodulski D, Skorek A, Mikaszewski B, Wiśniewski P, Stankiewicz C - Eur Arch Otorhinolaryngol (2014)

Bottom Line: The post-parotidectomy facial nerve grading system (PPFNGS) was created based on these three grading systems and also used for this study.A deficit in the facial nerve function was found in 54 patients (27 %).Although results were consistent in all tested scales, the PPFNGS had a higher interrater agreement than the other three scales.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology, Medical University of Gdańsk, ul. Smoluchowskiego 17, 80-214, Gdańsk, Poland, dstodulski@amg.gda.pl.

ABSTRACT
Dysfunction of the facial nerve is a common complication of parotidectomy. The functional deficit may be total or partial, and may include all or a single branch of the nerve. Despite a wide variety of the facial nerve grading systems, most of them have a limited utility in patients after parotidectomy. Therefore, existing scales assessing facial nerve function are compared to describe facial nerve outcomes after parotidectomy. The regional House-Brackmann, Sydney, and Yanagihara classification systems were utilized. The post-parotidectomy facial nerve grading system (PPFNGS) was created based on these three grading systems and also used for this study. The facial nerve function was assessed and recorded on the first postoperative day following conservative parotidectomy in 200 patients using all 4 scales by 3 otolaryngologists. The validity of the PPFNGS and existing facial nerve grading systems was examined by assessment of interrater agreement, intraclass correlation coefficient, internal consistency and construct validity. A deficit in the facial nerve function was found in 54 patients (27 %). Although results were consistent in all tested scales, the PPFNGS had a higher interrater agreement than the other three scales. PPFNGS is a new grading system designed for assessing the facial nerve function after parotidectomy in a quantitative and qualitative way and has a higher interrater agreement than other scales used to examine function of the 7th nerve.

No MeSH data available.


Related in: MedlinePlus

Patient with right-sided post-parotidectomy facial nerve paresis: at rest (a), during raising the eyebrows (b), closing the eyes (c), wrinkling the nose (d), showing the teeth (e), and whistling (f)
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Fig1: Patient with right-sided post-parotidectomy facial nerve paresis: at rest (a), during raising the eyebrows (b), closing the eyes (c), wrinkling the nose (d), showing the teeth (e), and whistling (f)

Mentions: Mean duration of the facial nerve examination was approximately 3 min. In the postoperative assessment of the facial nerve, a function deficit was found in 54 patients (27 %). The marginal mandibular branch was involved in 29 patients, the temporal in 4 patients, temporal and zygomatic in 4 other patients, and all branches in 17 patients. In the remaining 146 patients who underwent surgery, according to all the examining specialists, the facial nerve function was unaffected. Records of the analyzed group of patients in four tested systems by a single observer are shown in Table 3. Figure 1 presents the patient with post-parotidectomy facial nerve paresis at rest and during voluntary movements. Table 4 shows the recorded function of the facial nerve of the patient from the figure in four tested systems assessed by one observer.Table 3


Facial nerve grading after parotidectomy.

Stodulski D, Skorek A, Mikaszewski B, Wiśniewski P, Stankiewicz C - Eur Arch Otorhinolaryngol (2014)

Patient with right-sided post-parotidectomy facial nerve paresis: at rest (a), during raising the eyebrows (b), closing the eyes (c), wrinkling the nose (d), showing the teeth (e), and whistling (f)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4526578&req=5

Fig1: Patient with right-sided post-parotidectomy facial nerve paresis: at rest (a), during raising the eyebrows (b), closing the eyes (c), wrinkling the nose (d), showing the teeth (e), and whistling (f)
Mentions: Mean duration of the facial nerve examination was approximately 3 min. In the postoperative assessment of the facial nerve, a function deficit was found in 54 patients (27 %). The marginal mandibular branch was involved in 29 patients, the temporal in 4 patients, temporal and zygomatic in 4 other patients, and all branches in 17 patients. In the remaining 146 patients who underwent surgery, according to all the examining specialists, the facial nerve function was unaffected. Records of the analyzed group of patients in four tested systems by a single observer are shown in Table 3. Figure 1 presents the patient with post-parotidectomy facial nerve paresis at rest and during voluntary movements. Table 4 shows the recorded function of the facial nerve of the patient from the figure in four tested systems assessed by one observer.Table 3

Bottom Line: The post-parotidectomy facial nerve grading system (PPFNGS) was created based on these three grading systems and also used for this study.A deficit in the facial nerve function was found in 54 patients (27 %).Although results were consistent in all tested scales, the PPFNGS had a higher interrater agreement than the other three scales.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology, Medical University of Gdańsk, ul. Smoluchowskiego 17, 80-214, Gdańsk, Poland, dstodulski@amg.gda.pl.

ABSTRACT
Dysfunction of the facial nerve is a common complication of parotidectomy. The functional deficit may be total or partial, and may include all or a single branch of the nerve. Despite a wide variety of the facial nerve grading systems, most of them have a limited utility in patients after parotidectomy. Therefore, existing scales assessing facial nerve function are compared to describe facial nerve outcomes after parotidectomy. The regional House-Brackmann, Sydney, and Yanagihara classification systems were utilized. The post-parotidectomy facial nerve grading system (PPFNGS) was created based on these three grading systems and also used for this study. The facial nerve function was assessed and recorded on the first postoperative day following conservative parotidectomy in 200 patients using all 4 scales by 3 otolaryngologists. The validity of the PPFNGS and existing facial nerve grading systems was examined by assessment of interrater agreement, intraclass correlation coefficient, internal consistency and construct validity. A deficit in the facial nerve function was found in 54 patients (27 %). Although results were consistent in all tested scales, the PPFNGS had a higher interrater agreement than the other three scales. PPFNGS is a new grading system designed for assessing the facial nerve function after parotidectomy in a quantitative and qualitative way and has a higher interrater agreement than other scales used to examine function of the 7th nerve.

No MeSH data available.


Related in: MedlinePlus