Sie befinden Sich nicht im Netzwerk der Universität Paderborn. Der Zugriff auf elektronische Ressourcen ist gegebenenfalls nur via VPN oder Shibboleth (DFN-AAI) möglich.
mehr Informationen...
Facial nerve monitoring during parotid gland surgery: a systematic review and meta-analysis
Ist Teil von
European archives of oto-rhino-laryngology, 2021-04, Vol.278 (4), p.933-943
Ort / Verlag
Berlin/Heidelberg: Springer Berlin Heidelberg
Erscheinungsjahr
2021
Link zum Volltext
Quelle
SpringerLink
Beschreibungen/Notizen
Introduction
Facial nerve injury remains the most severe complication of parotid gland surgery. However, the use of intraoperative facial nerve monitoring (IFNM) during parotid gland surgery among Otolaryngologist—Head and Neck Surgeons continues to be a matter of debate.
Materials and methods
A systematic review and meta-analysis of the literature was conducted including articles from 1970 to 2019 to try to determine the effectiveness of intraoperative facial nerve monitoring in preventing immediate and permanent postoperative facial nerve weakness in patients undergoing primary parotidectomy. Acceptable studies included controlled series that evaluated facial nerve function following primary parotidectomy with or without intraoperative facial nerve monitoring.
Results
Ten articles met inclusion criteria, with a total of 1069 patients included in the final meta-analysis. The incidence of immediate and permanent postoperative weakness following parotidectomy was significantly lower in the IFNM group compared to the unmonitored group (23.4% vs. 38.4%;
p
= 0.001) and (5.7% vs. 13.6%;
p
= 0.001) when all studies were included. However, when we analyze just prospective data, we are not able to find any significant difference.
Conclusion
Our study suggests that IFNM may decrease the risk of immediate post-operative and permanent facial nerve weakness in primary parotid gland surgery. However, due to the low evidence level, additional prospective-randomized trials are needed to determine if these results can be translated into improved surgical safety and improved patient satisfaction.