Electromyography during parotidectomy: a high cost-benefit resource in public hospitals
Abstract
Facial nerve injury is a fairly frequent complication during parotidectomy, leaving sequelae, such as facial paralysis, which has a very significant impact from the point of view of body image and self-esteem, and sometimes functional. In 1944 Erlanger and Spencer Gasser received a Nobel Prize in medicine and physiology, performing a work of stimulation of nerve fibers through the amplification of electrical signals; however, since a little less than a century ago, in 1929 Adrian and Bronk introduced conventional electromyography, giving an impulse to the routine use of electromyography, which led to the virtual disappearance of this complication in most cases; however, the high cost of electromyographic monitor has limited its routine use in public hospitals in the region. The purpose of this work is to demonstrate the value of electromyography in a parotidectomy performed in a state hospital, where this procedure was performed at no cost to the patient and with excellent results, allowing him to have the chance to access the treatment, guaranteeing a better quality of life. It was concluded that the intraoperative monitoring of the facial nerve with electromyography plus the results of the complementary preoperative examinations and an adequate diagnosis, increase the probabilities of obtaining very favorable postoperative results, allowing a patient in a public hospital to have the opportunity to enjoy the treatment, avoiding sequels.Downloads
References
Abdulwahid S, Hiwa B, Yadgar S, Aso M, Fahmi K, Shvan M, et al. Pattern of facial nerve palsy during parotidectomy: a single-center experience. J Int Med Res. 2022;50(7):1–9.
Kinoshita I, Kawata R, Higashino M, Nishikawa S, Terada T, Haginomori SI. Effectiveness of intraoperative facial nerve monitoring and risk factors related to postoperative facial nerve paralysis in patients with benign parotid tumors: A 20-year study with 902 patients. Auris Nasus Larynx. 2021;48(3):361–7.
Chiesa Estomba CM, Echaniz O, Sistiaga Suarez JA, González García JA, Larruscain E, Altuna X, et al. Machine Learning Models for Predicting Facial Nerve Palsy in Parotid Gland Surgery for Benign Tumors. J Surg Res. 2021;262:57–64.
Zieliński M, Sowa P, Adamczyk-Sowa M, Szlȩzak M, Misiołek M. Prospective Assessment of Intraoperative Facial Nerve Monitoring in Patients Undergoing Partial Parotidectomy. Biomed Res Int. 2022;2022.
Jin H, Kim BY, Kim H, Lee E, Park W, Choi S, et al. Incidence of postoperative facial weakness in parotid tumor surgery: A tumor subsite analysis of 794 parotidectomies. BMC Surg. 2019;19(1):28–30.
Chiesa Estomba CM, Larruscain Sarasola E, Lechien JR, Mouawad F, Calvo Henriquez C, Diom ES, et al. Facial nerve monitoring during parotid gland surgery: a systematic review and meta-analysis. Eur Arch Oto-Rhino-Laryngology. 2021;278(4):933–43.
Huang H, Jiang H, Liu J, Chen J, Qiu L, Wang J, et al. Facial Nerve Monitoring under Different Levels of Neuromuscular Blockade with Cisatracurium Besilate in Parotid Tumour Surgery. Biomed Res Int. 2021;2021.
De Bonnecaze G, Vergez S, Chaput B, Vairel B, Serrano E, Chantalat E, et al. Variability in facial-muscle innervation: A comparative study based on electrostimulation and anatomical dissection. Clin Anat. 2019;32(2):169–75.
Ouattassi N, Alami M, Hammas N, El Alami MNEA. Spontaneous regression of pseudotumor inflammatory parotitis: case presentation and literature review. Egypt J Otolaryngol. 2022 Dec 1;38(1).
El-Hafez TAERA, Khalil YAEW, El Noaman M, Zayan AH, El-Demerdash AA. Total conservative parotidectomy for management of benign parotid neoplasms. Egypt J Otolaryngol. 2020 Dec 1;36(1).
Lee DS, Lee CG, Keum KC, Chung SY, Kim T, Wu HG, et al. Treatment outcomes of patients with salivary duct carcinoma undergoing surgery and postoperative radiotherapy. Vol. 59, Acta Oncologica. Taylor and Francis Ltd; 2020. p. 565–8.
Thölken R, Jering M, Mayer M, Schiele S, Müller G, Zenk J. Prospective study on complications using different techniques for parotidectomy for benign tumors. Laryngoscope Investig Otolaryngol. 2021 Dec 1;6(6):1367–75.
Chiang FY, Wang CC, Wu CW, Lu IC, Chang PY, Lin YC, et al. Correlation between electrophysiological change and facial function in parotid surgery patients. J Clin Med. 2021 Dec 1;10(24).
Reerds STH, Gerdsen M, van den Hoogen FJA, Takes RP, van den Broek GB, Vallen HGGJ, et al. Surgical management of deep lobe parotid tumours with and without involvement of the parapharyngeal space. Int J Oral Maxillofac Surg. 2022 Jun 1;51(6):762–7.
Pessoa DR, Costa DR, Prianti B de M, Costa DR, Delpasso CA, Arisawa E LS, et al. Association of facial massage, dry needling, and laser therapy in Temporomandibular Disorder: case report. CoDAS. 2018 Nov 29;30(6):e20170265.
Thielker J, Wahdan A, Buentzel J, Kaftan H, Boeger D, Mueller AH, et al. Long-Term Facial Nerve Outcome in Primary Parotid Cancer Surgery: A Population-Based Analysis. Laryngoscope. 2021 Dec 1;131(12):2694–700.
Lassaletta L, Morales-Puebla JM, Altuna X, Arbizu Á, Arístegui M, Batuecas Á, et al. Facial paralysis: Clinical practice guideline of the Spanish Society of Otolaryngology. Acta Otorrinolaringol Esp. 2020 Mar 1;71(2):99–118.
Deschler DG, Kozin ED, Kanumuri V, Devore E, Shapiro C, Koen N, et al. Single-surgeon parotidectomy outcomes in an academic center experience during a 15-year period. Laryngoscope Investig Otolaryngol. 2020 Dec 1;5(6):1096–103.
Melong JC, Rigby MH, Corsten M, Trites JRB, Bulter A, Taylor SM. Prospective outcomes following drainless superficial parotidectomy with sternocleidomastoid flap reconstruction. J Otolaryngol - Head Neck Surg. 2020 Oct 6;49(1).
Albosaily A, Aldrees T, Doubi A, Aldhwaihy L, Al-Gazlan NS, Alessa M, et al. Factors associated with facial weakness following surgery for benign parotid disease: A retrospective multicenter study. Ann Saudi Med. 2020 Sep 1;40(5):408–16.
Copyright (c) 2023 FACSALUD-UNEMI
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Todos los artículos de la Revista FACSalud UNEMI son difundidos bajo licencia internacional Creative Commons Reconocimiento-NoComercial-SinObrasDerivadas 4.0.
Los autores mantienen los derechos de autor, y, por lo tanto, son libres de compartir, copiar, distribuir, ejecutar y comunicar públicamente la obra bajo las condiciones siguientes: Reconocer los créditos de la obra especificada por el autor e indicar si se realizaron cambios (puede hacerlo de cualquier forma razonable, pero no de una manera que sugiera que el autor respalda el uso que hace de su obra. No utilizar la obra para fines comerciales. En caso de remezcla, transformación o desarrollo, no puede distribuirse el material modificado.
