The feasibility and significance of preservation of the lobular branch of the great auricular nerve in parotidectomy

This study was designed to evaluate the feasibility and significance of preserving the lobular branch of the great auricular nerve (GAN) during parotidectomy. Ninety-three patients with benign tumour undergoing parotidectomy were separated randomly into three groups. Thirty-one patients underwent a parotidectomy with the main trunk of GAN sacrificed (group A), 29 patients had the posterior-auricular branch preserved (group B), and 33 patients had the lobular branch preserved (group C). The operating times were recorded. Tactile sensitivity and pain sensitivity were evaluated preoperatively and at 1 week, 1 month, 3 months, 6 months and 1 year after surgery. Eighty-three patients were followed-up. Preservation of the lobular branch required no extra operating time. In group C, sensitivity in the lobular region reached preoperative levels by 6 months after surgery. In the other groups, recovery of sensory function in the lobular region was partial. Patients with the lobular branch of GAN preserved had significantly better sensory recovery in the lobular region 1 year after surgery (P < 0.05). These results demonstrate that preservation of the lobular branch of GAN is technically feasible during parotidectomy. The preservation of the lobular branch of GAN guarantees improvement of postoperative sensitivity of the lobular region.