Convergence Technique is the Easy and Reliable Landmark for Identification of the Facial Nerve in Parotid Surgery

Aim and objective: The aim and objective of this study was to evaluate the consistency, accuracy, and safety of the convergence technique in identifying the facial nerve during parotid surgery.
Patients and methods: A prospective study was carried out between January 2012 to December 2022 at the Tertiary care hospital in Bangladesh. 120 patients were included in the study; amongst them 80 (67%) were males and 40 (33%) were females with a mean age of 43.52±15.63 years. Patients presented with pleomorphic adenoma (85), chronic sialectasis (05), parotid cyst (02), parotid sinus (01), mucoepidermoid carcinoma (24) adenoid cystic carcinoma (02) and squamous cell carcinoma (01) were subjected to superficial parotidectomy and total parotidectomy. Surgical procedures were done by using the convergence technique for identification of the facial nerve trunk.
Results: All 120 patients underwent superficial and total parotidectomy. Facial nerve trunk was successfully identified in all the patients with no intra-operative complications. Operative time ranged from 50 to 180 minutes with a mean time 90.70±15.68 minutes. Facial nerve deficit of the marginal mandibular nerve (MMN) was noted in 5 patient (3.8 %), 02 had difficulty in eye closure (1.5%). No patient reported with surgical site infection, skin flap necrosis and hematoma in all the patients.
Conclusion: Convergence technique is the reliable landmark in the triangle technique for the identification of facial nerve trunk with relative ease, safety and accuracy during parotid surgical procedure. This can be a very useful method to minimize the facial nerve injury during parotid surgery.

Keywords: Facial nerve trunk; Styloid process; Convergence technique; Parotid surgery