O'Regan B, Bharadwaj G et al. Br J Oral Maxillofac Surg 2007; 45: 101–107

Traditional parotidectomy for benign tumours is currently under question. Antegrade facial nerve dissection from the trunk forwards also presents difficulties in some cases. Retrograde dissection has been suggested as a useful technique. Patients in this study included 51 with pleomorphic adenoma, 42 with sialoadenitis, and the remainder with 7 other conditions. Nerves were monitored during surgery.

At 1 week, 34% of patients were fully recovered, but 66% had some facial nerve paresis, with the degree slight in about 4/5. At 1 month, 62% were fully recovered, and at 3 months, 84%. At 6 and 12 months only one patient had a minor permanent paresis of the marginal mandibular nerve. The authors consider that the retrograde technique has several advantages for the procedure.