Comparative Study of Sensation with or without Preservation of Great Auricular Nerve during Parotidectomy

Yang, Hyung Chae; Lee, Sung Soo; Jo, Si Young; Lee, Chang Joon; Kim, Rok Young; Lee, Joon Kyoo

Abstract

BACKGROUND AND OBJECTIVES
Whether to sacrifice the posterior branch of great auricular nerve (GAN) during parotidectomy is disputatious. This study was to provide a guideline for decision-making.
SUBJECTS AND METHOD
Thirty-two patients who underwent parotidectomy due to parotid mass were randomized into two groups. Three patients who underwent further treatment were excluded. Fourteen patients underwent classic parotidectomy by sacrificing GAN whereas 15 patients underwent surgery that preserved the nerve. A two-point discrimination test, sensation of light touch, sharp instrument, blunt instrument and temperature were evaluated preoperatively, and at 7 days, 1, 3, 6, 12 months and 45 months, postoperatively. Patients' preference for the operation time to preserve the nerve was also evaluated.
RESULTS
The mean preservation time was 156 seconds. There was no difference in touch sensation, preoperatively, between the two groups. The two-point discrimination test of the infra-auricular area showed significant differences at 1 week postoperatively (p<0.05). The two-point discrimination test of lobule showed significant differences at 1 month (p<0.05), but these differences disappeared at 1 and 3 months. All measured data had no statistically significant differences at 3 and 6 months. At one year, light touch sensation of lobule and temperature sensation of infra-auricular area showed significant differences (p<0.05). Differences in temperature were found at 45 months of follow-up. Of the patients, 95% wanted to preserve the nerve.
CONCLUSION
The authors suggest that the posterior branch of GAN was preserved according to patients' preference for the sensation of temperature in the infra-auricular area.