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

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.