Facial Plast Surg 2021; 37(04): 490-499
DOI: 10.1055/s-0041-1725129
Original Article

Management of Acute Facial Nerve and Parotid Injuries

Tyler J. McElwee
1  Department of Otolaryngology—Head and Neck Surgery, LSU Health Sciences Center New Orleans, Baton Rouge, Louisiana
,
John N. Poche
2  College of Medicine, LSU Health Sciences Center New Orleans, Baton Rouge, Louisiana
,
Justin C. Sowder
1  Department of Otolaryngology—Head and Neck Surgery, LSU Health Sciences Center New Orleans, Baton Rouge, Louisiana
3  Department of Otolaryngology Head and Neck Surgery, Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana
,
Laura T. Hetzler
3  Department of Otolaryngology Head and Neck Surgery, Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana
4  Department of Otolaryngology—Head and Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana
› Author Affiliations

Abstract

Acute soft tissue trauma to the head and neck is a common reason for emergency department presentation and should be appropriately evaluated by a facial plastic surgeon. The evaluation of a patient who has suffered facial trauma should always include a comprehensive facial nerve exam and carry a low threshold of suspicion for parotid duct injury when involving the cheek. Injuries to the facial nerve and parotid duct can result in significant long-term functional, cosmetic, and emotional morbidity, particularly when diagnosis is delayed. In the repair of facial nerve transection, neurorrhaphy technique is primarily based on the ability to obtain tension-free anastomosis and outcomes are in large part related to timing of repair. Parotid duct injuries are generally repaired based on the site of ductal injury. In this article, we present a guide to the relevant anatomy of the facial nerve branches and the parotid duct, the important factors guiding treatment decisions alongside their related risks and benefits, as well as the management of complications of facial nerve neurorrhaphy and parotid duct injuries and repair.



Publication History

Publication Date:
01 March 2021 (online)

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