Abstract
Background: The parotid (PG), submandibular (SMG), and sublingual (SLG) glands constitute the three major salivary glands, in addition to numerous minor salivary glands. Surgical management of major salivary gland disease is a cornerstone of oral and maxillofacial as well as otolaryngologic practice. This study was aimed at examining nerve injury patterns in salivary glands following surgery over a five-year period at a tertiary facility in Hail, Saudi Arabia.
Methods: A retrospective observational study was conducted at the Oral and Maxillofacial Surgery department of King Salman Specialty Hospital in Hail, Saudi Arabia. The study included all patients who underwent surgical procedures on major salivary glands (parotid, submandibular, or sublingual) during the study period. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 28
Results: A total of 21 patients underwent major salivary gland surgery during the study period. The overall incidence of postoperative nerve injury was 19% (n=4), while 81% (n=17) of patients experienced no nerve damage. The most commonly injured nerve was the marginal branch of the facial nerve (n=2). Superficial parotidectomy was associated with a 10% nerve injury rate, while submandibular gland removal had a 20% injury rate. Sublingual gland removal and tumor excision procedures each resulted in nerve injury in 100% of cases, although the numbers were small. A statistically significant association was observed between the type of gland operated upon and the specific pattern of nerve injury (p-value=0.001). All procedures were performed by consultant-level surgeons, yet nerve injuries still occurred, underscoring the role of anatomical risk factors.
Conclusion: The study showed that major salivary gland procedures are generally safe; however, nerve injuries, though uncommon, can cause lasting functional and psychosocial morbidity. The findings highlighted the importance of meticulous surgical technique, careful anatomic dissection, and thorough patient counselling.

Key words: Post-surgical nerve injury, major salivary gland surgeries, retrospective study, Hail, Saudi Arabia