Objective  Facial nerves can be dissected using anterograde and retrograde approaches. The optimal technique for the facial nerve dissection of a patient with benign parotid tumor has not yet been determined. This study focused on facial nerve dysfunction and recovery rate after anterograde and retrograde facial-nerve dissections.

  Methods  The data of 110 patients with benign carotid adenoma from the Head and Neck Department of this hospital who were hospitalized between January 2011 and January 2013 were collected. These patients were divided into groups A (n=52) and B (n=58). Anterograde and retrograde dissections of the facial nerve were performed on group A and group B patients, respectively. Based on the preferential order of dissection, group B was divided into groups B1, B2, and B3 representing the zygomatic, buccal, and marginal mandibular branches, respectively. The patients were postoperatively observed to check for potential symptoms, such as facial paralysis along with its severity and recovery. The House-Brackmann grading system was used to assess all patients.

  Results  The operation could be successful, with better nerve exposure, using these approaches. Statistical differences were observed in the nerve injury and recovery rates between the groups, with group A better than group B, and group B2 better than the other two groups (P < 0.05).

  Conclusion  Anterograde facial nerve dissection should be routinely used in benign parotid tumor, and the buccal branch of facial nerve dissection should be preferentially considered when no other option apart from retrograde dissection is available.