Intraoperative facial nerve monitoring on operative duration in parotidectomy: a systematic review and meta-analysis.
8 affiliations
- 1Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, 222, Maijin Rd., Anle Dist., Keelung City, 204, Taiwan.
- 2College of Medicine, Chang Gung University, Taoyuan, Taiwan.
- 3Department of Radiation Oncology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
- 4Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.
- 5Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung, Taiwan.
- 6Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
- 7Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, 222, Maijin Rd., Anle Dist., Keelung City, 204, Taiwan. [email protected].
- 8College of Medicine, Chang Gung University, Taoyuan, Taiwan. [email protected].
Abstract
Background
Intraoperative facial nerve monitoring (IONM) can be used during parotidectomy. However, its effect on operative duration remains controversial. This systematic review and meta-analysis aimed to evaluate the association between IONM use and operative duration in parotidectomy.Methods
A systematic search of MEDLINE, Embase, and the Cochrane Library was conducted for studies published up to January 2026. Studies reporting operative duration for parotidectomy performed with and without IONM were included. Data extraction and quality assessment were performed independently by reviewers. Random-effects meta-analyses were conducted to calculate mean differences (MDs) with corresponding 95% confidence intervals (CIs) for operative duration and tumor size. Subgroup, sensitivity, and publication bias analyses were also performed.Results
Eight studies comprising 1677 patients were included. Overall, IONM use was associated with a statistically significant reduction in operative duration (MD, - 5.62 min; 95% CI, - 11.02 to - 0.23). In procedure-specific analyses, operative duration was significantly shorter with IONM in superficial parotidectomy (MD, - 9.09 min; 95% CI, - 17.49 to - 0.70), whereas no significant difference was observed in total parotidectomy. Pooled analyses showed no significant differences in tumor size between IONM and non-IONM groups in either the overall cohort or the superficial parotidectomy group.Conclusions
IONM use is associated with a reduction in operative duration in parotidectomy overall and in superficial parotidectomy. These findings suggest a potential procedural efficiency benefit of IONM in selected parotidectomy cases.
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BibTeX
@article{chen2026intraoperative,
title = {{Intraoperative facial nerve monitoring on operative duration in parotidectomy: a systematic review and meta-analysis.}},
author = {Jheng-Liang Chen and I-Chen Lin and Eric Yi-Liang Shen and Cheng-Ming Luo and Yao-Te Tsai and Shih-Chi Su and Li-Jen Hsin and Yi-Chan Lee},
journal = {Head \& face medicine},
year = {2026},
month = jul,
doi = {10.1186/s13005-026-00645-7},
url = {https://europepmc.org/article/MED/42907851},
note = {CC BY},
}
RIS
TY - JOUR
TI - Intraoperative facial nerve monitoring on operative duration in parotidectomy: a systematic review and meta-analysis.
AU - Jheng-Liang Chen
AU - I-Chen Lin
AU - Eric Yi-Liang Shen
AU - Cheng-Ming Luo
AU - Yao-Te Tsai
AU - Shih-Chi Su
AU - Li-Jen Hsin
AU - Yi-Chan Lee
PY - 2026
DA - 2026/07/01
JO - Head & face medicine
DO - 10.1186/s13005-026-00645-7
UR - https://europepmc.org/article/MED/42907851
AB - Background Intraoperative facial nerve monitoring (IONM) can be used during parotidectomy. However, its effect on operative duration remains controversial. This systematic review and meta-analysis aimed to evaluate the association between IONM use and operative duration in parotidectomy.Methods A systematic search of MEDLINE, Embase, and the Cochrane Library was conducted for studies published up to January 2026. Studies reporting operative duration for parotidectomy performed with and without IONM were included. Data extraction and quality assessment were performed independently by reviewers. Random-effects meta-analyses were conducted to calculate mean differences (MDs) with corresponding 95% confidence intervals (CIs) for operative duration and tumor size. Subgroup, sensitivity, and publication bias analyses were also performed.Results Eight studies comprising 1677 patients were included. Overall, IONM use was associated with a statistically significant reduction in operative duration (MD, - 5.62 min; 95% CI, - 11.02 to - 0.23). In procedure-specific analyses, operative duration was significantly shorter with IONM in superficial parotidectomy (MD, - 9.09 min; 95% CI, - 17.49 to - 0.70), whereas no significant difference was observed in total parotidectomy. Pooled analyses showed no significant differences in tumor size between IONM and non-IONM groups in either the overall cohort or the superficial parotidectomy group.Conclusions IONM use is associated with a reduction in operative duration in parotidectomy overall and in superficial parotidectomy. These findings suggest a potential procedural efficiency benefit of IONM in selected parotidectomy cases.
SN - 1746-160X
ER -