Aim: This study was undertaken to compare the proximal and distal facial nerve exploration approach during superficial parotidectomy. Materials and Methods: A retrospective analysis of patients who underwent superficial parotidectomy at our tertiery referal center was conducted. Cases were divided into those who underwent superficial parotidectomy using distal facial nerve exploration and those who underwent standard proximal facial nerve exploration. Statistical comparisons of intraoperative blood loss and margin status (negative, focally, positive) were conducted between these two approaches. Results: A total of 42 patients underwent superficial parotidectomy at our Tertiary referal center between May 2015 and April 2019. The technique used in most of the cases was conventional proximal nerve exploration technique (30 cases). Distal exploration of the buccal branch was undertaken only in 12 cases, on account of difficulty in locating the main trunk intraoperatively due to the presence of postinflammatory fibrosis. The average patient age was 38 years with a female preponderance (64%). Distal nerve exploration technique consumed almost average operative time less than 2 hours (1.6 hrs) and average intraoperative blood loss 25 ml but in proximal nerve exploration technique have average operative time more than 2 hours (2.2 hrs) intra operative average blood loss 70 ml was recorded. No significant difference in surgical margin status was noticed between the two techniques (p > 0.05). Conclusion: Both the techniques are efficient without compromising the surgical margins, but the average intraoperative blood loss and surgical operative time are less in distal facial nerve exploration technique.

Keywords: Distal; Facial nerve; Proximal; Superficial parotidectomy