Aim: The aim of this study is to analyse the incidence and highlight the risk factors associated with facial nerve dysfunction after conservative primary parotidectomy. 
Methods: The study included 41 patients, who were initially with normal facial nerve function and had been treated by 
conservative primary parotidectomy (42 procedures) for parotid neoplasms in Sohag University Hospital, during the period from March 2002 to March 2005. Facial nerve function was assessed on admission before surgery; and then at one day, one month and six months following the parotidectomy. Extent of the surgery, size of the parotid neoplasm, and 
histopathological type of the neoplasm were correlated with the incidence of postoperative facial nerve dysfunction. 
Results: The rate of postoperative facial nerve dysfunction was 35.7% in the first post-operative day, 19% and 4.8% at one month and six months, respectively. Cases treated with total parotidectomy with or without neck dissection showed poorer facial nerve function (p < 0.001), (p < 0.01), and (p < 0.04) at one day, one month, and 6months, respectively. Overall, neoplasms with size ≥ 5 cm had a higher prevalence of facial nerve paresis (p < 0.03 at one day, and 0.04 at one month postoperative). Patients with malignant parotid neoplasms had more tendency to develop facial nerve dysfunction (p < 0.02), ( p < 0.001), and (p < 0.03) at one day, one month, and 6months, respectively. 
Conclusion: In our study, the following were associated with higher risk of facial nerve dysfunction: extensive surgery; large sized neoplasms; parotid cancer, when treated with total parotidectomy or combined with neck dissection; chronic 
sialadenitis; and vascular malformation