Background: Parotid surgery serves as a standard intervention for addressing various conditions, including both benign and malignant neoplasms and inflammatory and autoimmune conditions. This study aimed to assess the effectiveness of preservation of the Great auricular nerve in parotid surgery in improving sensory dysfunction.

Methods: This prospective randomized clinical trial was conducted in the General Surgery Department at Zagazig University Hospitals. Thirty patients were included with parotid lesions, encompassing benign, malignant neoplasms, and inflammatory and autoimmune conditions. The surgical interventions involved either superficial or total parotidectomy, and all participants underwent Parotid Surgery with the preservation of the Great Auricular Nerve. After surgery, a facial nerve evaluation was conducted within the hospital, and neck US and CT scans were done.

Results: Superficial parotidectomy was performed on 93.33%, while 6.67% underwent total parotidectomy. The mean parotidectomy incision width was 5.06 ± 1.02. Neck dissection due to LN affection occurred in 10% of cases, with a mean incision width of 5.9 ± 0.22. Intraoperative facial affection occurred in 3.33%. Preservation rates for both branches of the GAN were 56.67% for both branches and 43.33% for the posterior branch. In only one case, the posterior branch of GAN was preserved as a branch for the facial nerve. GAN recovery showed 83.33% experiencing near-total rapid recovery and 13.33% experiencing delayed recovery after 3 months. Conclusion: This study underscores the effectiveness of preserving the Great Auricular Nerve during parotid surgery, offering valuable insights into enhancing surgical outcomes and patient well-being.