Clinical significance of preserving the great auricular nerve in parotidectomy:A Meta-analysis

OBJECTIVE:To evaluate the influence of parotidectomy that retained great auricular nerve on postoperative morbidity by meta-analysis,and to explore its clinical value.METHODS:A literature search was performed using the PubMed,Wanfang database and other databases from April 1997to April 2013by parotid,great auricular nerve,complications as keywords.The included studies using Review manager 5.0software for meta-analysis according to the inclusion and exclusion criteria.RESULTS:In the 12articles involved with the postoperative sensory disturbance,366cases had symptoms the overall incidence rate was 50.76%.In experimental group(preserve great auricular nerve)there were113cases and accounted for 27.56%.In the control group(removal of great auricular nerve)there were 253cases and accounted 81.35%.The incidence of sensory disturbance in experimental group was decreased by 53.79% compared with control group,odds ratio(OR)and 95%confidence intervals(95%CI)was 0.09(0.06-0.13),z was 11.99,P0.01;6articles involved with gustatory sweating syndrome,symptoms in 74cases accounted for.18.73%of the total number of cases,15cases were in experimental group and accounted for 7.50%,59cases were in control group and accounted for30.26%,the former was lower than the latter by 22.76%.OR values and their 95%CI was 0.18(0.10-0.35),z value was 5.18,P0.01;13studies involved complications which affect the quality of life.There were different symptoms of complications in 243cases,The overall incidence rate was 31.93%.the experimental group of 62cases accounted for for 14.22%,in the control group 181cases accounted for 55.69%,In experiment group it was significantly reduced by41.47%;OR values and 95%CI was 0.12(0.08-0.18),z was 10.77,P0.01.CONCLUSION:Benign parotid surgery through rational selection and operation,can really preserve GAN,which not only can reduce the incidence of postoperative transient paresthesia auricular region and gustatory sweating syndrome,but also control other complications thereby to improve the quality of life for patients after surgery.