Abstract
Objective: The purpose of this study was to analyze the incidence of postparotidectomy facial nerve dysfunction in pediatric patients and to evaluate the association between patient demographics or underlying pathology and functional outcomes.
Method: We retrospectively reviewed charts of patients under 18 years who underwent parotidectomy between 1999 and 2011 at a tertiary pediatric center by a pediatric otolaryngologist. Distribution of dysfunction and timing of recovery were noted. Chi-square and t-test analyses were conducted to determine association between demographics or pathology and functional outcomes.
Results: Forty-three patients met inclusion criteria. Forty-one underwent superficial parotidectomy, and 2 underwent total parotidectomy. Leading indications for surgery were atypical mycobacterium (16/4 [37.2%]) and branchial cleft anomaly (8/43 [18.6%]). The incidence of immediate facial nerve paralysis was 2% (1/43).The incidence of facial nerve paresis was 21% (9/43), distributed in the marginal mandibular nerve (n = 7), buccal branch (n = 1), and marginal mandibular nerve and frontal branch (n = 1). Full recovery of nerve function in patients with paresis occurred by 1 month (n = 2), 2 months (n = 1), 6 months (n = 3), or 10 months (n = 2). No association was revealed between age, gender, or pathology and postoperative facial nerve function.
Conclusion: Transient postparotidectomy paresis of distal branches of the facial nerve is common in the pediatric population and should be discussed in the preoperative evaluation. The risk is comparable to that of the adult population. Although malignant disease would seem to portend greater risk of dysfunction, underlying pathology was not predictive.
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