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This is a literature review of 16 papers using the PRISMA protocol. In comparing the two techniques, not surprisingly, they found that the extracapsular dissection had a reduced facial nerve paralysis, Frey syndrome and operation time but also a reduced recurrence rate. It was noted that rupture and spillage was the main risk factor for recurrence. They deduced that whilst it has been shown that continuous facial nerve monitoring may reduce facial nerve paralysis, only two of the studies use such monitoring if required by the surgeon. They therefore feel that the use or non-use of facial nerve monitoring does not appear to affect the outcome of facial nerve weakness. Their conclusion is that extra-capsular dissection is the superior method and could be the gold standard technique but outlining the significant selection bias in this statement.

Superficial parotidectomy versus extracapsular dissection: literature review and search for a gold standard technique  
Martin H, Jayasinghe J, Lowe T.  
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Stuart Clark

Manchester Royal Infirmary, Manchester, UK.

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