Function of the great auricular nerve following surgery for benign parotid disorders

INTRODUCTION: The main concern in benign parotid surgery is complete removal of the lesion whilst avoiding any harm to the facial nerve. Some time ago, surgeons also began to spare other structures including the great auricular nerve. The purpose of this paper was to study these procedures prospectively and to evaluate the sensory recovery of this nerve. MATERIAL: Fourteen patients undergoing parotid surgery with preservation of the great auricular nerve (group A) have been studied and compared with 10 patients whose operations involved sacrificing the nerve (group B). METHODS: The function of the great auricular nerve has been tested (qualitatively and quantitatively) before the operation, and postoperatively during the first few days and at 3, 6, 9 and 12 months. RESULTS: Twelve months postoperatively, no area of anaesthesia was found in group A, whilst all patients in group B had some degree of sensory loss. In group A, the qualitative and quantitative tests documented complete recovery of various types of surface sensitivity in 80% of cases, with the remaining 20% showing only a moderate reduction in comparison with the unoperated side. CONCLUSION: From this study, it seems reasonable to spare the great auricular nerve during parotid surgery for benign disease because the procedure takes very little time, but guarantees a major improvement of postoperative sensitivity of the region innervated by the great auricular nerve.