Antegrade Versus Retrograde Facial Nerve Dissection in Benign Parotid Surgery: A Systematic Review and Meta‐Analysis
Do Hyun Kim, David W. Jang, Se Hwan HwangABSTRACT
Background
Parotidectomy for benign tumors requires meticulous facial nerve preservation, yet the optimal dissection technique between anterograde dissection (AD) and retrograde dissection (RD) remains uncertain, prompting this updated meta‐analysis comparing their outcomes.
Methods
Twenty‐one studies (1632 patients) were included. Outcomes comprised operative parameters, postoperative complications, and facial nerve recovery. Pooled effects were estimated using odds ratios (ORs) and mean differences with 95% confidence intervals (CIs).
Results
RD significantly reduced transient facial nerve palsy versus AD (OR, 0.73; 95% CI, 0.54–0.98), with no difference in permanent palsy. Recovery was similar at 1, 6, and 12 months, although AD showed faster recovery at 3 months. Other complications were comparable. RD was associated with shorter operative time, less blood loss, and smaller resected tissue volume. Subgroup analysis indicated reduced transient palsy mainly in superficial parotidectomy.
Conclusion
RD offers advantages over AD, particularly in superficial parotidectomy, though further randomized trials are warranted.