Is it necessary to preserve the posterior branch of the great auricular nerve in parotidectomy?

OBJECTIVES

To evaluate the necessity of preserving the posterior branch of the great auricular nerve during parotidectomy.

STUDY DESIGN AND SETTING

Forty-six patients undergoing parotidectomy were prospectively analyzed. Twenty-four patients had preservation of the posterior branch of the great auricular nerve; in the remaining 22 patients the nerve was sacrificed. A sensory index score was defined as the area involved multiplied by the intensity grade of sensory loss. Quality-of-life was evaluated with a questionnaire.

RESULTS

The sensory index score was significantly higher in the sacrificed group as compared with the preserved group at both 1 week (41.87 vs 62.11) and 1 month (24.91 vs 46.11) after parotidectomy. The sensory deficit improved over time in both groups, and after 12 months only minimal sensory loss remained. Quality-of-life was not significantly different between the groups.

CONCLUSIONS

Irrespective of preservation of the posterior branch of the great auricular nerve, sensory deficit improved over time. Therefore, preservation of the posterior branch of the great auricular nerve might not be necessary during parotidectomy.