Management of Facial Nerve Paresis After Nerve-Preserving Parotidectomy: A Review
4 affiliations
- 1Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, 80131 Naples, Italy
- 2Department of Life Science, Health and Health Professions, Università Degli Studi “Link”, 00165 Rome, Italy
- 3Department of Maxillofacial Surgery, “S. Maria” Hospital, 05100 Terni, Italy
- 4Maxillofacial Surgery Unit, University Hospital of Sassari, 07100 Sassari, Italy
Abstract
Background/Objectives: Postoperative facial nerve paresis remains clinically relevant after nerve-preserving parotidectomy. This scoping review aimed to identify, map, and characterize reported therapeutic strategies and summarize clinical recovery outcomes. Methods: Following Joanna Briggs Institute guidance and PRISMA-ScR, the protocol was deposited on Figshare before data extraction. PubMed, Embase, and Scopus were searched through 24 August 2026. English-language original studies of treatments initiated after the recognition of paresis were eligible. Two reviewers independently selected and appraised studies; one reviewer charted the data and another verified the extraction. Results: Eight studies involving 211 patients were included; reported ages were 17–86 years. Procedures included partial, superficial, subtotal, total, and revision parotidectomy, as well as parotid lobectomy for benign or malignant disease. Immediate or early weakness predominated; two reports described delayed-onset palsy. Evidence comprised two randomized trials, one case–control study, one multicenter cohort, and four case reports. Interventions included corticosteroids, corticosteroid–antiviral therapy, home or supervised exercises, Kabat rehabilitation, neuromuscular retraining, Matrix Rhythm Therapy (MRT), and proprioceptive neuromuscular facilitation with electrical stimulation. The trials found no benefit of prednisolone over placebo and no statistically significant difference between supervised rehabilitation and home exercises; equivalence was not established. Observational findings could not be separated from spontaneous recovery or co-treatment. Conclusions: No intervention has established superiority. Standardized protocols, validated outcomes, and adequately powered comparative studies are needed.
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BibTeX
@article{maglitto2026management,
title = {{Management of Facial Nerve Paresis After Nerve-Preserving Parotidectomy: A Review}},
author = {Fabio Maglitto and Giovanni Salzano and Serena Trotta and Eutilia Manzo and Valentino Vellone and Umberto Committeri and Luigi Angelo Vaira and Giovanni Dell’Aversana Orabona},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15218417},
url = {https://www.mdpi.com/2077-0383/15/21/8417},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Management of Facial Nerve Paresis After Nerve-Preserving Parotidectomy: A Review
AU - Fabio Maglitto
AU - Giovanni Salzano
AU - Serena Trotta
AU - Eutilia Manzo
AU - Valentino Vellone
AU - Umberto Committeri
AU - Luigi Angelo Vaira
AU - Giovanni Dell’Aversana Orabona
PY - 2026
DA - 2026/10/29
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15218417
UR - https://www.mdpi.com/2077-0383/15/21/8417
AB - Background/Objectives: Postoperative facial nerve paresis remains clinically relevant after nerve-preserving parotidectomy. This scoping review aimed to identify, map, and characterize reported therapeutic strategies and summarize clinical recovery outcomes. Methods: Following Joanna Briggs Institute guidance and PRISMA-ScR, the protocol was deposited on Figshare before data extraction. PubMed, Embase, and Scopus were searched through 24 August 2026. English-language original studies of treatments initiated after the recognition of paresis were eligible. Two reviewers independently selected and appraised studies; one reviewer charted the data and another verified the extraction. Results: Eight studies involving 211 patients were included; reported ages were 17–86 years. Procedures included partial, superficial, subtotal, total, and revision parotidectomy, as well as parotid lobectomy for benign or malignant disease. Immediate or early weakness predominated; two reports described delayed-onset palsy. Evidence comprised two randomized trials, one case–control study, one multicenter cohort, and four case reports. Interventions included corticosteroids, corticosteroid–antiviral therapy, home or supervised exercises, Kabat rehabilitation, neuromuscular retraining, Matrix Rhythm Therapy (MRT), and proprioceptive neuromuscular facilitation with electrical stimulation. The trials found no benefit of prednisolone over placebo and no statistically significant difference between supervised rehabilitation and home exercises; equivalence was not established. Observational findings could not be separated from spontaneous recovery or co-treatment. Conclusions: No intervention has established superiority. Standardized protocols, validated outcomes, and adequately powered comparative studies are needed.
SN - 2077-0383
ER -