Lu GN, et al. - Using the American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) database, researchers evaluated the incidence and subtypes of facial nerve reanimation procedures performed concurrently with total parotidectomy and facial nerve sacrifice. They identify that many patients undergoing total parotidectomy with facial nerve sacrifice are not getting a concurrent facial reanimation procedure at the time of tumor resection. Concurrent facial reanimation procedure is significantly more probable in patients undergoing free tissue reconstruction. Findings thus reveal an opportunity for earlier facial reanimation in this patient population.

Methods

• Researchers performed a cross-sectional study including 285 patients who underwent total parotidectomy with facial nerve sacrifice (Current Procedural Terminology code 42425) and evaluated several types of facial reanimation procedures performed concurrently.
• From the ACS-NSQIP database encompassing 603 community and academic hospitals, patients who underwent treatment from January 1, 2010 through December 31, 2015 were identified.
• Analysis of data was done from September 20, 2017 through February 21, 2018.
• They compared nonreanimation and reanimation groups and subgroups of nerve- and sling-type reanimation procedures regarding demographics.

Results

• Researchers identified a total of 285 patients who underwent total parotidectomy with facial nerve sacrifice (61.8% men; mean [SD] age, 64 [15] years); 89 of these (31.2%; 95% CI, 26.0%-37.0%) had at least 1 concurrent facial reanimation procedure.
• Facial nerve procedures performed included nerve-type repairs in 41 patients (46.1%; 95% CI, 36.0%-56.0%), sling-type repairs in 31 patients (34.8%; 95% CI, 26.0%-45.0%), and both types in 17 patients (19.1%; 95% CI, 12.0%-29.0%).
• Significantly younger patients underwent treatment with nerve-type repairs only compared to those treated with sling-type repairs only (mean [SD] age, 57.6 [16.0] vs 72.1 [13.8] years; P < .001).
• Free tissue reconstruction was performed on 49 patients.
• Among these, concurrent facial reanimation procedure(s) was performed on 24 patients (49.0%); this proportion was significantly higher vs those who did not undergo free tissue reconstruction (65 of 236 [28.0%]; P=.003).