목적: Extirpation of aggressive parotid tumors often involves facial nerve sacrifice. Examine functional outcomes in patients undergoing radical parotidectomy and simultaneousfacial nerve reconstrucstion. Identify factors that may affect rehabilitation in these patients. 방법:23 patients underwent radical parotidectomy and had sacrifice of the facial nerve with simultaneous reconstruction with sural nerve(15/23) or greater auricular nerve(8/23). They were prospectively followed for 12 to 24 months. Functional outcomes were assessed with the House-Brackmann grading system at 3,6,9 12, and 18 months after surgery. Affectog factors were analyzed - age, sex, histology of parotid neoplasm, cable graft source, number of damaged branches, administration of postoperative radiotherapy, and rehabilitation period. 결과:Total recovery (≤H-B grade II) occurred in 3 of 23 (13.0%), favorable recovery (H-B grade III) occured in 30.4%, and partial recovery (H-B grade IV) was shown 26.1%. After using multivariate logistic regression analysis for risk factors (sex, age, preoperative palsy, tumor histology,length of nerve defect, and materials of nerve graft, radiation, onset of rehabilitation) were performed. Preoperative facial palsy, length of defect, radiation, and delay of rehabilitation were worse prognostic factors. 결론:More than 70% of patients get benefit from simultaneous facial nerve reconstruction in radical protidectomy. The restoration of facial nerve function after facial nerve reconstruction would be affected by aggresiveness of tumor and relating results such as radiation and delay of rehabilitation.