We read with interest the comments by Eisele. Our 54% incidence of facial paresis is very well in line with rates reported in the literature. More specifically, Eisele mentioned that Fee and Handen had a 31% incidence but that was in only one arm; however, if you look at the other arm, it was a 43% incidence. Eisele mentioned that the temperature setting that was used by us was similar to what they used, so it does not seem that the hemostat is the cause. The only difference was the size of the blade. It is an interesting thought that the increased contact of the No. 10 blade compared with the No. 15 blade may have been responsible for the high rate of the temporary facial nerve paresis. We agree that the amount of heat delivered should be appropriate to the type of dissection being performed. We agree fully that the improved visualization of the operative field that resulted from accurate and safe hemostasis is important and makes the Shaw scalpel a good instrument for head and neck surgery; however, we still would be reluctant to use it close to the facial nerve.
Ramadan HH. The Shaw Hemostatic Scalpel in Parotid Surgery. Arch Otolaryngol Head Neck Surg. 1999;125(1):119. doi: