Since most parotidectomies at our hospital are performed using the Shaw hemostatic scalpel, I read with interest the article titled "The Shaw Scalpel and Development of Facial Nerve Paresis After Superficial Parotidectomy" by Ramadan et al1 in the ARCHIVES. The authors observed a 54% rate of temporary facial nerve paresis in patients who underwent superficial parotidectomy with the Shaw scalpel. Multivariate analysis showed there were no other risk factors for facial paresis including the surgeon performing the procedure. Because of this, they do not recommend use of the Shaw scalpel near the facial nerve. The 54% incidence of facial paresis reported by Ramadan et al is much higher than the rate of 31% reported by Fee and Handen2 and also our experience with the Shaw scalpel for superficial parotidectomy. To explain this difference, one must consider that Ramadan et al may have used the Shaw scalpel differently; specifically, they may have delivered more thermal energy to the facial nerve with it.
Eisele DW. The Shaw Hemostatic Scalpel in Parotid Surgery. Arch Otolaryngol Head Neck Surg. 1999;125(1):119. doi: