Clin Exp Otorhinolaryngol.  2024 Aug;17(3):263-271. 10.21053/ceo.2024.00094.

Functional Outcomes of Single-Stage Facial Reanimation Surgery With Radical Parotidectomy

• Ji JY
• Kim SD
• Park MK
• Suh MW
• Ahn SH
• Chung EJ

• KMID: 2558843
• DOI: http://doi.org/10.21053/ceo.2024.00094

Abstract

Objectives
. Facial nerve sacrifice during radical parotidectomy can impair quality of life. This study assessed the effectiveness of single-stage facial reanimation surgery performed concurrently with radical parotidectomy in restoring facial function.
Methods
. A retrospective analysis was conducted on patients who underwent single-stage facial reanimation combined with radical parotidectomy. The techniques employed included selective reinnervation and orthodromic temporalis tendon transfer. Outcomes were evaluated using the modified House-Brackmann and Terzis grading systems, Emotrics facial assessment, and the Facial Disability Index (FDI).
Results
. Among the 13 patients studied (median age, 54 years; 69% male), 10 underwent selective reinnervation. Of these, nine patients demonstrated improvement, achieving House-Brackmann grade III and Terzis grade 4 or 5. The other three patients underwent tendon transfer and achieved moderate functional outcomes. Emotrics analysis revealed balanced facial symmetry in the selective reinnervation group. Furthermore, FDI scores indicated satisfactory physical and social/well-being functions.
Conclusion
. Single-stage facial reanimation effectively restores facial function in patients undergoing radical parotidectomy. This approach offers meaningful benefits in the early recovery of facial function.

Keyword

Facial Nerve; Nerve Transfer; Facial Paralysis; Parotid Cancer; Facial Reanimation

Figure

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  Fig. 1. Selective (triple) reinnervation. (A) Schematic illustration of triple reinnervation. (B) Intraoperative view following selective reinnervation. (1) An interposition graft connects the main trunk of the facial nerve to the nerve innervating the orbicularis oculi muscle. (2) The masseteric nerve is coapted to the nerve of the zygomaticus muscle. (3) The ansa cervicalis nerve is coapted to the nerve of the orbicularis oris muscle.

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  Fig. 2. Orthodromic temporalis tendon transfer. (A) Schematic illustration of orthodromic temporalis tendon transfer. (B) Intraoperative view after orthodromic temporalis tendon transfer.

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  Fig. 3. Postoperative Emotrics results for the selective reinnervation (A) and orthodromic temporalis tendon transfer (OTTT; B) groups.

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