{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T02:47:02Z","timestamp":1782182822123,"version":"3.54.5"},"reference-count":35,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp;amp; Neck"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Parotidectomy for benign tumors requires meticulous facial nerve preservation, yet the optimal dissection technique between anterograde dissection (AD) and retrograde dissection (RD) remains uncertain, prompting this updated meta\u2010analysis comparing their outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twenty\u2010one studies (1632 patients) were included. Outcomes comprised operative parameters, postoperative complications, and facial nerve recovery. Pooled effects were estimated using odds ratios (ORs) and mean differences with 95% confidence intervals (CIs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>RD significantly reduced transient facial nerve palsy versus AD (OR, 0.73; 95% CI, 0.54\u20130.98), with no difference in permanent palsy. Recovery was similar at 1, 6, and 12\u2009months, although AD showed faster recovery at 3\u2009months. Other complications were comparable. RD was associated with shorter operative time, less blood loss, and smaller resected tissue volume. Subgroup analysis indicated reduced transient palsy mainly in superficial parotidectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>RD offers advantages over AD, particularly in superficial parotidectomy, though further randomized trials are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.70371","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T02:00:37Z","timestamp":1782180037000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Antegrade Versus Retrograde Facial Nerve Dissection in Benign Parotid Surgery: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","author":[{"given":"Do Hyun","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W.","family":"Jang","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery &amp; Communication Sciences Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2838-7820","authenticated-orcid":false,"given":"Se Hwan","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1002\/hed.24496","article-title":"Complications After Surgery for Benign Parotid Gland Neoplasms: A Prospective Cohort Study","volume":"39","author":"Ruohoalho J.","year":"2017","journal-title":"Head & Neck"},{"key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1016\/j.bjorl.2015.08.024","article-title":"Facial Paralysis After Superficial Parotidectomy: Analysis of Possible Predictors of This Complication","volume":"82","author":"Bittar R. F.","year":"2016","journal-title":"Brazilian Journal of Otorhinolaryngology"},{"key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1177\/0003489414542089","article-title":"Predictors of Adverse Events After Parotidectomy: A Review of 2919 Cases","volume":"124","author":"Kim B. 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A Meta\u2010Analysis","volume":"13","author":"Mashrah M. A.","year":"2018","journal-title":"PLoS One"},{"key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"1623","DOI":"10.1007\/s00405-018-4982-8","article-title":"Antero\u2010 vs. Retrograde Nerve Dissection in Parotidectomy: A Systematic Review and Meta\u2010Analysis","volume":"275","author":"Stankovic P.","year":"2018","journal-title":"European Archives of Oto\u2010Rhino\u2010Laryngology"},{"key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18787\/jr.2025.00019","article-title":"Usefulness of the ID\u2010Migraine Screening Tool for Diagnosing Migraines in Patients With Headache and Facial Pain: A Systematic Review and Meta\u2010Analysis","volume":"33","author":"Kim D. H.","year":"2026","journal-title":"Journal of Rhinology"},{"key":"e_1_2_11_11_1","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1111\/coa.70076","article-title":"The Effects of Pain Controlling Agents on Paediatric Tonsillectomy: A Systematic Review and Network Meta\u2010Analysis","volume":"51","author":"Kim D. H.","year":"2026","journal-title":"Clinical Otolaryngology"},{"key":"e_1_2_11_12_1","doi-asserted-by":"crossref","first-page":"120","DOI":"10.21053\/ceo.2025-00252","article-title":"The Efficacy of Intranasal Insulin in the Treatment of Post Viral Persistent Olfactory Dysfunction: A Systematic Review","volume":"19","author":"Kim D. H.","year":"2026","journal-title":"Clinical and Experimental Otorhinolaryngology"},{"key":"e_1_2_11_13_1","first-page":"22","article-title":"Retrograde Facial Nerve Dissection in Superficial Parotidectomy Versus Standard Approach: A Comparative Study","volume":"15","author":"Al\u2010Na'ssan W.","year":"2008","journal-title":"Journal of the Royal Medical Services"},{"key":"e_1_2_11_14_1","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1097\/SCS.0b013e3181a86ead","article-title":"Retrograde Parotidectomy for Pleomorphic Adenoma of the Parotid Gland: A Conservative and Effective Approach","volume":"20","author":"Scarpini M.","year":"2009","journal-title":"Journal of Craniofacial Surgery"},{"key":"e_1_2_11_15_1","doi-asserted-by":"crossref","first-page":"2092","DOI":"10.1016\/j.joms.2009.09.075","article-title":"Superficial Parotidectomy Versus Retrograde Partial Superficial Parotidectomy in Treating Benign Salivary Gland Tumor (Pleomorphic Adenoma)","volume":"68","author":"Emodi O.","year":"2010","journal-title":"Journal of Oral and Maxillofacial Surgery"},{"issue":"2","key":"e_1_2_11_16_1","first-page":"117","article-title":"Postparotidectomy Facial Nerve Paralysis: Peripheral Versus Proximal Identification","volume":"6","author":"Mahmood K. 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M.","year":"2018","journal-title":"International Surgery Journal"},{"key":"e_1_2_11_22_1","first-page":"30","article-title":"Superficial Parotidectomy: Anterograde Compared With Modified Retrograde Dissection of the Facial Nerve in Benign Parotid Tumors","volume":"16","author":"Issa M.","year":"2018","journal-title":"University of Thi\u2010Qar Journal of Medicine"},{"issue":"8","key":"e_1_2_11_23_1","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1016\/j.bjoms.2018.08.002","article-title":"Indications for Partial Parotidectomy Using Retrograde Dissection of the Marginal Mandibular Branch of the Facial Nerve for Benign Tumours of the Parotid Gland","volume":"56","author":"Suzuki K.","year":"2018","journal-title":"British Journal of Oral & Maxillofacial Surgery"},{"key":"e_1_2_11_24_1","doi-asserted-by":"crossref","first-page":"81","DOI":"10.21608\/asjs.2019.178104","article-title":"Comparative Study Between Antegrade and Retrograde Facial Nerve Dissection in Superficial Parotidectomy","volume":"20","author":"Mahfouz M.","year":"2019","journal-title":"Ain Shams Journal of Surgery"},{"key":"e_1_2_11_25_1","doi-asserted-by":"crossref","first-page":"73","DOI":"10.5387\/fms.2020-06","article-title":"Indications for Partial Superficial Parotidectomy for Benign Parotid Gland Tumors Using the Retrograde Approach","volume":"66","author":"Suzuki M.","year":"2020","journal-title":"Fukushima Journal of Medical Science"},{"key":"e_1_2_11_26_1","first-page":"83","article-title":"Comparing Antegrade and Retrograde Parotidectomy: Surgical Parameters and Complications","volume":"34","author":"Khazaeni K.","year":"2022","journal-title":"Iranian Journal of Otorhinolaryngology"},{"key":"e_1_2_11_27_1","first-page":"152","article-title":"Management of Benign Parotid Tumors. What Can We Learn From Our Experience?","volume":"93","author":"Ungari C.","year":"2022","journal-title":"Annali Italiani di Chirurgia"},{"key":"e_1_2_11_28_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s12070-023-03476-z","article-title":"Centripetal Versus Centrifugal Facial Nerve Dissection in Superficial Parotidectomy: Comparison of the Two Methods at a Tertiary Care Center","volume":"75","author":"Deva F.","year":"2023","journal-title":"Indian Journal of Otolaryngology and Head & Neck Surgery"},{"key":"e_1_2_11_29_1","doi-asserted-by":"crossref","first-page":"510","DOI":"10.4103\/ejs.ejs_315_23","article-title":"Different Techniques for Identification of Facial Nerve During Superficial Parotidectomy","volume":"43","author":"Kamel P.","year":"2024","journal-title":"Egyptian Journal of Surgery"},{"key":"e_1_2_11_30_1","first-page":"1749","article-title":"Comparison of Antegrade Versus Retrograde Facial Nerve Dissection in Cases of Superficial Parotidectomy for Pleomorphic Adenoma of Parotid Gland","volume":"5","author":"Ekka M.","year":"2025","journal-title":"International Journal of Pharmaceutical Quality Assurance"},{"issue":"1","key":"e_1_2_11_31_1","doi-asserted-by":"crossref","first-page":"104582","DOI":"10.1016\/j.amjoto.2024.104582","article-title":"Nerve Dissection Technique for Excision of Parotid Tumors: Outcomes Controlling for Tumor Size and Location","volume":"46","author":"Smith J. D.","year":"2024","journal-title":"American Journal of Otolaryngology"},{"issue":"3","key":"e_1_2_11_32_1","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/j.anl.2025.04.004","article-title":"Comparison of Surgical Outcomes Between Anterograde and Retrograde Approaches for Partial Superficial Parotidectomy in Pleomorphic Adenoma: A New Surgical Technique of the Retrograde Approach Guided by the Zygomatic Branch","volume":"52","author":"Tarui A.","year":"2025","journal-title":"Auris, Nasus, Larynx"},{"key":"e_1_2_11_33_1","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1002\/ohn.70112","article-title":"Perioperative Outcomes in Antegrade, Retrograde, and Extracapsular Approaches to Parotidectomy in Benign and Malignant Neoplasms","volume":"174","author":"Prince A. D. 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R.","year":"2004","journal-title":"Laryngoscope"}],"container-title":["Head &amp; Neck"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hed.70371","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hed.70371","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hed.70371","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T02:00:42Z","timestamp":1782180042000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hed.70371"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,22]]},"references-count":35,"alternative-id":["10.1002\/hed.70371"],"URL":"https:\/\/doi.org\/10.1002\/hed.70371","archive":["Portico"],"relation":{},"ISSN":["1043-3074","1097-0347"],"issn-type":[{"value":"1043-3074","type":"print"},{"value":"1097-0347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,22]]},"assertion":[{"value":"2026-03-31","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"hed.70371"}}