Iatrogenic Neurologic Complications

The nerve supply to the major salivary glands exists in an overcrowded anatomic area. The head and neck area is replete with a vast cramped neurologic network. Therefore, operating within the limited anatomic confines of the head and neck, not in the immediate vicinity of the major salivary glands, the surgeon may inadvertently injure a neurologic structure as it travels to a salivary gland. Disruption in normal gland function is the end result. Damage to the chorda tympani nerve during stapes surgery will cause a decrease in submandibular and sublingual gland salivary volume. Furthermore, salivary gland surgical procedures that involve the parotid gland may disrupt a nerve’s ability to stimulate the parotid gland (auriculotemporal syndrome) or the paraglandular musculature (facial nerve palsy).