Facial Nerve Identification during Parotidectomy by a Safe and Reliable Convergence Technique

Abstract

Introduction:Parotidectomy is the technically challenging surgery where identification of facial nerve becomes utmost important to avoid aesthetic and functional complications. In our study we aim to describe a reliable and easy triangle technique to identify the facial nerve trunk.

Materials and methods: A prospective observational study was carried out in the department of ENT at a tertiary care centre from February 2023 to February 2025. 30 patients presenting with parotid swelling to the department were evaluated and taken up for parotidectomy (superficial/total) based on clinical, radiological findings. Surgical procedures were done by using the convergence technique for identification of the facial nerve trunk. Pre-op and post-op facial nerve function was monitored clinically using House Brackmann grading.

Results:30 patients were selected for the study. Majority of the patients were males [21;70%]. Mean operative time was 80 ± 6.1mins. Most of the patients underwent superficial parotidectomy (76.67%). Pleomorphic adenoma (63.3%) was the most common tumour of parotid gland. The facial nerve was identified by convergence technique in all cases. Postoperatively temporary palsy of marginal mandibular nerve was present in 3 cases.

Conclusion:Convergence technique is a safe & reliable landmark for the identification of facial nerve trunk during parotid surgery. It can help in reducing facial nerve injury during parotidectomy.