Marginal mandibular nerve injury during neck dissection of level IIa, and the influence of different types of dissection: diathermy versus cold knife

Otolaryngol Pol. 2018 Jun 12;72(4):21-25. doi: 10.5604/01.3001.0012.0483.

Abstract

Introduction: Post-operative injury of the marginal mandibular branch of the facial nerve is consider a complication in neck dissection and can be related to different factors including traction, devascularisation or the conduction block due to diathermy.

Material and methods: Prospective, crossover study including patients treated bilateral selective neck dissection of level IIa during a 12 months-period, was performed to evaluate the efficacy of the Hayes-Martin manoeuvre to prevent nerve injury during the use of cold or monopolar diathermy dissection.

Results: 20 patients met the inclusion criteria (40 neck dissections). Just one case of a right temporal MMN weakness in the post-operative period was observed (1/40 = 2,5%). There were no cases of permanent marginal mandibular nerve weakness using the Hayes-Martin manoeuvre Conclusion: The Hayes-Martin manoeuvre is a safe way to preserve MMN during neck dissection of level IIa, regardless of the type of dissection.

Keywords: Cold Knife.; Diathermy; Dissection; Marginal Mandibular Nerve; Neck.

MeSH terms

  • Adult
  • Aged
  • Cross-Over Studies
  • Female
  • Humans
  • Male
  • Mandibular Nerve / surgery*
  • Middle Aged
  • Neck Dissection / adverse effects*
  • Prospective Studies
  • Trigeminal Nerve Injuries / etiology*