{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T05:04:00Z","timestamp":1769922240549,"version":"3.49.0"},"reference-count":41,"publisher":"Georg Thieme Verlag KG","issue":"11","license":[{"start":{"date-parts":[[2023,11,30]],"date-time":"2023-11-30T00:00:00Z","timestamp":1701302400000},"content-version":"vor","delay-in-days":29,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq Neuropsiquiatr"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background:\u2003Facial nerve dysfunction is the principal postoperative complication related to parotidectomy.<\/jats:p><jats:p>\n          Objective:\u2003To test the hypothesis that the modified Sunnybrook Facial Grading System (mS-FGS) is superior to the original S-FGS in the assessment of facial nerve function following parotidectomy.<\/jats:p><jats:p>\n          Methods:\u2003Prospective, longitudinal study evaluating patients with primary or metastatic parotid neoplasms undergoing parotidectomy with facial nerve-sparing between 2016 and 2020. The subjects were assessed twice, on the first postoperative day and at the first outpatient evaluation, 20-30 days post-surgery. Facial assessments were performed using the original and modified (plus showing the lower teeth) versions of the Sunnybrook System and documented by pictures and video recordings. Intra- and inter-rater agreements regarding the assessment of the new expression were analyzed.<\/jats:p><jats:p>\n          Results:\u2003101 patients were enrolled. In both steps, the results from the mS-FGS were significantly lower (p\u2009&lt;\u20090.001). Subjects with a history of previous parotidectomy and those who underwent neck dissection had more severe facial nerve impairment. The mandibular marginal branch was the most frequently injured, affecting 68.3% of the patients on the first postoperative day and 52.5% on the first outpatient evaluation. Twenty patients (19.8%) presented an exclusive marginal mandibular branch lesion. The inter-rater agreement of the new expression assessment ranged from substantial to almost perfect. The intra-rater agreement was almost perfect (wk\u2009=\u20090.951).<\/jats:p><jats:p>\n          Conclusion:\u2003The adoption of the Modified Sunnybrook System, which includes evaluation of the mandibular marginal branch, increases the accuracy of post-parotidectomy facial nerve dysfunction appraisal.<\/jats:p>","DOI":"10.1055\/s-0043-1777003","type":"journal-article","created":{"date-parts":[[2023,11,30]],"date-time":"2023-11-30T23:51:36Z","timestamp":1701388296000},"page":"970-979","source":"Crossref","is-referenced-by-count":4,"title":["Post-parotidectomy facial nerve function: comparison between original and modified Sunnybrook Facial Grading Systems"],"prefix":"10.1055","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5025-8240","authenticated-orcid":false,"given":"M\u00e1rcia Gon\u00e7alves e Silva","family":"Targino da Costa","sequence":"additional","affiliation":[{"name":"Hospital do C\u00e2ncer I, Instituto Nacional de C\u00e2ncer, Departamento de Fisioterapia, Rio de Janeiro RJ, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2030-547X","authenticated-orcid":false,"given":"P\u00e9ricles de Andrade","family":"Maranh\u00e3o-Filho","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio de Janeiro, Hospital Universit\u00e1rio Clementino Fraga Filho, Departamento de Neurologia, Rio de Janeiro RJ, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6426-2419","authenticated-orcid":false,"given":"Izabella Costa","family":"Santos","sequence":"additional","affiliation":[{"name":"Hospital do C\u00e2ncer I, Instituto Nacional de C\u00e2ncer, Departamento de Cirurgia de Cabe\u00e7a e Pesco\u00e7o, Rio de Janeiro RJ, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8543-0434","authenticated-orcid":false,"given":"Carolina Rocha Aquino","family":"Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Hospital do C\u00e2ncer I, Instituto Nacional de C\u00e2ncer, Departamento de Fisioterapia, Rio de Janeiro RJ, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0365-8508","authenticated-orcid":false,"given":"Carlos Henrique Stohler de","family":"Almeida","sequence":"additional","affiliation":[{"name":"Hospital do C\u00e2ncer I, Instituto Nacional de C\u00e2ncer, Departamento de Fisioterapia, Rio de Janeiro RJ, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7784-9905","authenticated-orcid":false,"given":"Ronir Raggio","family":"Luiz","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio de Janeiro, Instituto de Estudos em Sa\u00fade Coletiva, Rio de Janeiro RJ, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,11,30]]},"reference":[{"issue":"03","key":"ref1","first-page":"174","article-title":"Treatment of complications of parotid gland surgery","volume":"25","author":"R Marchese-Ragona","year":"2005","journal-title":"Acta Otorhinolaryngol Ital"},{"issue":"11","key":"ref2","doi-asserted-by":"publisher","first-page":"2034","DOI":"10.1097\/01.mlg.0000147943.13052.62","article-title":"Facial nerve in parotidectomy: a topographical analysis","volume":"114","author":"C R Cannon","year":"2004","journal-title":"Laryngoscope"},{"issue":"02","key":"ref3","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1002\/hed.23287","article-title":"Predictors and timing of recovery in patients with immediate facial nerve dysfunction after parotidectomy","volume":"36","author":"B-K Tung","year":"2014","journal-title":"Head 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