IN the 18th and 19th centuries, the surgeon tackling a tumor in the parotid region did not particularly concern himself about the facial nerve. For him, the main problem was to stop the bleeding from the big vessels in the region. The coarse methods of blood-staunching which he employed, usually cauterization, were undoubtedly injurious to the facial nerve.
When surgical technique had been developed and anesthesia introduced, the facial nerve became a major problem in connection with operations of the parotid gland. Most surgeons tried to avoid the nerve and limited the operations as much as possible. This resort quite certainly increased the risk of an accidental continuity injury on the nerve. It also resulted in incomplete operations on tumors, which in turn led to poor results even in the case of benign tumors. In order to improve the results, out of this aspect radiological treatment was added, and for
LAAGE-HELLMAN JE. Facial Nerve in Parotidectomies. Arch Otolaryngol. 1965;81(5):527–533. doi:10.1001/archotol.1965.00750050540023
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