• Robert Lee Witt.
• Department of Surgery, Christiana Care Health Center, Wilmington, DE 19806, USA. RobertLWitt@aol.com
• J Voice. 2006 Sep 1; 20 (3): 461-5.

SummaryHypothesisThe long-term recovery rate of immediate postoperative facial nerve dysfunction with an electrophysiologically and anatomically intact facial nerve is higher than the long-term recovery rate of immediate postoperative vocal fold immobility with an electrophysiologically and anatomically intact recurrent laryngeal nerve.MethodsA retrospective review of parotid and thyroid surgery with electrophysiologic monitoring of the facial and recurrent laryngeal nerves, respectively.ResultsForty-five consecutive patients had electrophysiologic and anatomic integrity of the facial nerve at the conclusion of the parotidectomy. Eight of 45 (18%) patients developed a postoperative facial nerve dysfunction. All eight patients with facial nerve dysfunction had complete return of facial nerve function within 3 months. A total of 102 consecutive patients underwent dissection of the recurrent laryngeal nerve during thyroid surgery. Seven of 102 (7%) had immediate unilateral vocal fold dysfunction. All 102 had electrophysiologic and anatomic integrity of the recurrent laryngeal nerve at the conclusion of the procedure. Two of 102 (2%) have clinically complete permanent vocal fold dysfunction. Five of seven (71%) with immediate complete vocal fold immobility had complete return of mobility.ConclusionsA higher immediate postoperative rate of transient facial nerve dysfunction is reported compared with vocal fold immobility in parotid and thyroid surgery, respectively (P < 0.05). Immediate postoperative facial nerve dysfunction with an electrophysiologically response at 1 mA and an anatomically intact facial nerve during parotid surgery resulted in a complete return of function in all cases in this series. Immediate postoperative vocal fold immobility with an electrophysiological response at 1 mA and an anatomically intact recurrent laryngeal nerve had a 30% rate of being permanent in this series.

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