Impact of great auricular nerve sacrifice on sensory disturbance after parotidectomy.

PURPOSE: To investigate the association between great auricular nerve (GAN) sacrifice during parotidectomy and postoperative sensory disturbance. MATERIALS AND METHODS: Patients who underwent parotidectomy between November 2016 and May 2020 at a single academic institution were included in this retrospective chart review. Operative notes were reviewed to determine incidence of GAN sacrifice. Prevalence of patient-reported sensory complaints in the GAN distribution and time to spontaneous resolution of symptoms were assessed. RESULTS: Of 305 parotidectomy patients, 111 (36.4%) endorsed complaints of postoperative sensory disturbances in the GAN distribution typically characterized by numbness or shooting pains. GAN sacrifice was present in 9 (8.1%) of 111 patients who experienced sensory disturbances compared to 9 (4.6%) who reported no sensory disturbances (p > 0.05). Twenty-five patients (32.5%) experienced spontaneous resolution of symptoms at their most recent follow-up at a mean of 6.2 months after onset of symptoms. Of those that experienced a sensory disturbance, GAN preservation was not significantly associated with likelihood of spontaneous recovery (p > 0.05). CONCLUSIONS: We report the largest series to date of post-operative sensory disturbance in parotidectomy patients as it relates to intraoperative GAN sacrifice. Although the relationship between GAN sacrifice and the incidence of postoperative sensory disturbance and its subsequent resolution were not significant, we continue to advocate for GAN preservation to reduce incidence of postoperative sensory disturbances.

Arsenic Speciation and Availability in Orchard Soils Historically Contaminated with Lead Arsenate.

Lead arsenate is an environmentally hazardous contaminant that was applied as a pesticide in orchards during the early 1900s. Elevated arsenic (As) concentrations persist in soils where lead arsenate was applied. To assess the risk associated with historic lead arsenate contamination, the retention, bioavailability, and speciation of soil As were evaluated in three historically contaminated orchard soils. Stirred-flow desorption studies and in vitro physiologically based extractions were used to assess the mobility and relative bioavailability of soil As, respectively. Synchrotron-based X-ray absorption spectroscopy was used to determine soil As speciation. Arsenic concentrations in former orchard soils ranged from 11.8 to 59.0 mg kg. Less than 22% of total As was considered bioavailable according to in vitro extractions. Up to 15% of soil As was desorbed in 10 mM KCl, but desorption with phosphate solutions resulted in release of up to 70% of total As dependent on soil type. Desorption data suggest that arsenate is primarily sorbed via inner-sphere complexation, and elevated concentrations of competing ions in soil solution may increase mobility of soil As. Arsenic was primarily present in the As(V) oxidation state, the less mobile form of As. Combined results from X-ray absorption spectroscopy and desorption studies indicate that As primarily exists as sorbed species, likely to ubiquitously present Fe- and Al-oxides in soils. Results demonstrate that soil As from these historically contaminated orchards is mostly in stable, nonhazardous forms, but factors such as Fe- and Al-oxide content and land management practices have a significant effect on As transport and bioavailability.