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facial nerve monitoring

Ashraf Raslan, Gerd Fabian Volk, Martin Möller, Vincent Stark, Nikolas Eckhardt, Orlando Guntinas-Lichius
OBJECTIVES/HYPOTHESIS: To examine by intraoperative electric stimulation which peripheral facial nerve (FN) branches are functionally connected to which facial muscle functions. STUDY DESIGN: Single-center prospective clinical study. METHODS: Seven patients whose peripheral FN branching was exposed during parotidectomy under FN monitoring received a systematic electrostimulation of each branch starting with 0.1 mA and stepwise increase to 2 mA with a frequency of 3 Hz...
October 18, 2016: Laryngoscope
Graziano Taddei, Alfonso Marrelli, Donatella Trovarelli, Alessandro Ricci, Renato J Galzio
OBJECTIVE: Even though advances in surgical techniques have improved facial nerve outcomes, functional preservation is still an issue because injury to the facial nerve has significant physical and psychological consequences for the patient. We retrospectively review our data in VS surgery to compare the facial outcome in intraoperative facial monitored versus not-monitored patients. MATERIALS AND METHODS: 51 consecutive patients with unilateral vestibular schwannoma in the period from 2005 to 2010 were treated in our Institution...
October 2016: Asian Journal of Neurosurgery
T Linder, S Mulazimoglu, T El Hadi, V Darrouzet, D Ayache, T Somers, S Schmerber, C Vincent, M Mondain, E Lescanne, D Bonnard
OBJECTIVES: To give an insight into why, when and where iatrogenic facial nerve (FN) injuries may occur and to explain how to deal with them in an emergency setting. DESIGN AND SETTING: Multicentre retrospective study in eight tertiary referral hospitals over 17 years. PARTICIPANTS: Twenty patients with partial or total FN injury during surgery for chronic otitis media (COM) were revised. MAIN OUTCOME MEASURES: Indication and type of surgery, experience of the surgeon, intra- and postoperative findings, value of CT scanning, patient management and final FN outcome were recorded...
September 23, 2016: Clinical Otolaryngology
Bilge Kagan Aysal, Abdulkerim Yapici, Yalcin Bayram, Fatih Zor
Facial nerve is the main cranial nerve for the innervation of facial expression muscles. Main trunk of facial nerve passes approximately 1 to 2 cm deep to tragal pointer. In some patients, where a patient has multiple operations, fibrosis due to previous operations may change the natural anatomy and direction of the branches of facial nerve. A 22-year-old male patient had 2 operations for mandibular reconstruction after gunshot wound. During the second operation, there was a possible injury to the marginal mandibular nerve and a nerve stimulator was used intraoperatively to monitor the nerve at the tragal pointer because the excitability of the distal segments remains intact for 24 to 48 hours after nerve injuries...
October 2016: Journal of Craniofacial Surgery
Nam-Gyu Ryu, Jin Kim
Unexpected iatrogenic facial nerve paralysis not only affects facial disfiguration, but also imposes a devastating effect on the social, psychological, and economic aspects of an affected person's life at once. The aims of this study were to postulate where surgeons had mistakenly drilled or where obscured by granulations or by fibrous bands and to look for surgical approach with focused on the safety of facial nerve in mastoid surgery. We had found 14 cases of iatrogenic facial nerve injury (IFNI) during mastoid surgery for 5 years in Korea...
September 2016: Journal of Audiology & Otology
Stanislas Ballivet-de Régloix, Julia Grinholtz-Haddad, Olga Maurin, Louise Genestier, Quentin Lisan, Yoann Pons
INTRODUCTION: We present a retrospective two-center study series and discussion of the current literature to assess the benefits of facial nerve monitoring during parotidectomy. MATERIALS AND METHODS: From 2007 to 2012, 128 parotidectomies were performed in 125 patients. Of these, 47 procedures were performed without facial nerve monitoring (group 1) and 81 with facial nerve monitoring (group 2). The primary endpoint was the House-Brackmann classification at 1 month and 6 months...
July 2016: Iranian Journal of Otorhinolaryngology
Ji Y Buethe, Salim Abboud, Kristie Brock, Greg Nizialek, Rod Rezaee, Jay Wasman, Jonathan Frankel, Dean A Nakamoto
PURPOSE: To evaluate the imaging, histologic changes and safety of computed tomography (CT)-guided cryoablation of the parotid glands in a porcine model. MATERIALS AND METHODS: Unilateral CT-guided parotid gland cryoablation was performed in 5 juvenile miniature pigs. The ablated parotid glands underwent 2 cycles of 10-minute freeze and 5-minute thaw using three 17-g cryoprobes. The animals were monitored daily for complications including pain, frostbite, infection, and sialocele or fistula formation...
August 24, 2016: Journal of Vascular and Interventional Radiology: JVIR
Sanjiv K Bhimrao, Trung N Le, Charles C Dong, Serge Makarenko, Sarin Wongprasartsuk, Brian D Westerberg, Ryojo Akagami
OBJECTIVE: To determine whether transcranial electrical stimulation-induced facial motor-evoked potential (FMEP) monitoring of the facial nerve (FN) during vestibular schwannoma (VS) tumor resection can predict both immediate and 1 year postoperative FN functional outcome. DESIGN: Prospective consecutive non-comparative observational case series. SETTING: Tertiary referral center. MAIN OUTCOME MEASURES: Facial function, immediate post operation and at 1 year using House-Brackmann (HB) grading scale...
September 2016: Otology & Neurotology
Terrence L Trentman, Christopher Thunberg, Andrew Gorlin, Antoun Koht, Richard S Zimmerman, Bernard Bendok
Acoustic neuroma resection is an example of a neurosurgical procedure where the brainstem and multiple cranial nerves are at risk for injury. Electrode placement for monitoring of the glossopharyngeal and hypoglossal nerves during acoustic neuroma resection can be challenging. The purpose of this report is to illustrate the use of a device for intra-oral electrode placement for intraoperative monitoring of the glossopharyngeal and hypoglossal nerves. A 60-year-old male presented for acoustic neuroma resection...
July 5, 2016: Journal of Clinical Monitoring and Computing
X Huang, K Y Ji, J Xu, C H Shao, W Wang, M Xu, D Q Chen, M Y Chen, P Zhong
OBJECTIVE: To discuss the surgical technique and common complications from the microsurgical treatment of giant intracranial vestibular schwannoma via suboccipital retrosigmoid approach and to propose strategies for minimizing such complications. METHODS: Surgical outcomes and complications were evaluated in a consecutive series of 657 unilateral giant vestibular schwannomas treated in Shanghai Huashan Hospital via suboccipital retrosigmoid approach from 1999 to 2014...
June 7, 2016: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
Mustapha Bensghir, Abdelghafour Elkoundi, Redouane Ahtil, Mohammed Meziane, Charki Haimeur
BACKGROUND: Parotid surgery is a common ear, nose, and throat procedure. Facial nerve paralysis is the main feared complication following this surgery. To avoid this paralysis, intraoperative facial nerve monitoring is often used, but neuromuscular blocking agents interfere with this technique. Therefore, the neuromuscular blocking agent used should have a short duration of muscle relaxation. With the discovery of sugammadex, a steroidal neuromuscular blocking agent has acquired the potential to be used in place of succinylcholine...
2016: Journal of Medical Case Reports
Ronald Sahyouni, Jay Bhatt, Hamid R Djalilian, William C Tang, John C Middlebrooks, Harrison W Lin
OBJECTIVES/HYPOTHESIS: Permanent facial nerve injury is a difficult challenge for both patients and physicians given its potential for debilitating functional, cosmetic, and psychological sequelae. Although current surgical interventions have provided considerable advancements in facial nerve rehabilitation, they often fail to fully address all impairments. We aim to introduce an alternative approach to facial nerve rehabilitation. STUDY DESIGN: Acute experiments in animals with normal facial function...
June 16, 2016: Laryngoscope
Eleftherios Savvas, Steffen Hillmann, Daniel Weiss, Mario Koopmann, Claudia Rudack, Jürgen Alberty
IMPORTANCE: Electrophysiologic facial nerve monitoring is becoming an established intraoperative aid to assist the surgeon in facial nerve trunk or branch location and dissection. Limited studies have addressed the postoperative outcomes of parotid surgery with and without monitoring. OBJECTIVE: To examine the influence of intraoperative facial nerve monitoring on postoperative facial nerve function and procedure duration in parotid surgery. DESIGN, SETTING, AND PARTICIPANTS: An 8-year retrospective review of parotidectomies performed at the Department of Otorhinolaryngology-Head and Neck Surgery, University of Münster...
September 1, 2016: JAMA Otolaryngology—Head & Neck Surgery
Kathryn Y Noonan, Cong Rang, Katherine Callahan, Nathan E Simmons, Kadir Erkmen, James E Saunders
OBJECTIVES: This study compares the functional outcomes of nevus intermedius impairment following surgery, radiation, or observation for the treatment of vestibular schwannoma. STUDY DESIGN: Retrospective cohort study. SETTINGS: Tertiary care medical center. SUBJECTS AND METHODS: We retrospectively examined 141 charts of patients with a vestibular schwannoma seen in the Dartmouth-Hitchcock Acoustic Neuroma Clinic between 2012 and 2014...
October 2016: Otolaryngology—Head and Neck Surgery
Marshall F Wilkinson, Tumul Chowdhury, W Alan Mutch, Anthony M Kaufmann
OBJECTIVE Hemifacial spasm (HFS) is a cranial nerve hyperactivity disorder characterized by unique neurophysiological features, although the underlying pathophysiology remains disputed. In this study, the authors compared the effects of desflurane on facial motor evoked potentials (MEPs) from the spasm and nonspasm sides of patients who were undergoing microvascular decompression (MVD) surgery to test the hypothesis that HFS is associated with a central elevation of facial motor neuron excitability. METHODS Facial MEPs were elicited in 31 patients who were undergoing MVD for HFS and were administered total intravenous anesthesia (TIVA) with or without additional desflurane, an inhaled anesthetic known to centrally suppress MEPs...
May 13, 2016: Journal of Neurosurgery
N N Khamgushkeeva, I A Anikin, A A Korneyenkov
UNLABELLED: The purpose of this research is to improve the safety of surgery for patients with a pathology of the middle and inner ear by preventing damage to the facial nerve by conducting intraoperative monitoring of the facial nerve by needle electromyography with continuous stimulation with a burr. PATIENTS AND METHODS: The clinical part of the prospective study was carried out on 48 patients that were diagnosed with suppurative otitis media. After the surgery with intraoperative monitoring, the facial nerve with an intact bone wall was stimulated electrically in the potentially dangerous places of damage...
January 2016: Il Giornale di Chirurgia
Narotam Kumar Ghezta, Yogesh Bhardwaj, Pooja Rani, Rangila Ram
PURPOSE: The aim of this study was to evaluate the long-term clinical and radiologic results of the retromandibular transparotid approach to displaced extracapsular subcondylar mandibular fractures. PATIENTS AND METHODS: A prospective cohort study was conducted over a period of 5 years on patients surgically treated for displaced extracapsular subcondylar mandibular fractures by the retromandibular transparotid approach. Variables including the type of fracture, degree of mouth opening, fracture displacement, deviation, excursive movements of the mandible, and facial nerve function were monitored before and after treatment...
August 2016: Journal of Oral and Maxillofacial Surgery
Chenxing Wang, Yaneng Ge, Longjiang Li
The formation of arteriovenous fistula beneath the parotid is relatively rare. To the best of our knowledge, the present study reports the first case of a 48-year-old man with a pulsatile mass on the left parotid region, which had been present for >3 years following penetrating wounds. Computed tomography angiography and digital subtraction angiography revealed a fistula between the left external carotid artery and the left jugular vein. The patient was successfully managed through surgical excision without embolization...
May 2016: Oncology Letters
Daniele Marchioni, Davide Soloperto, Luca Bianconi, Maria C Guarnaccia, Elisabetta Genovese, Livio Presutti
HYPOTHESIS: Ossification of the cochlea was once considered to be a contraindication for cochlear implantation. Advances in cochlear implant technology and coding strategies have led to developments in different surgical procedures to manage cochlear ossification. The endoscopic technique allows a direct approach to the round window and the cochlea, especially in remodeled labyrinth, allowing a better vision of scala tympani. BACKGROUND: Tertiary referral ENT center...
April 19, 2016: Auris, Nasus, Larynx
Robert Lee Witt, Piero Nicolai
The most important causes of recurrence of benign pleomorphic adenoma are enucleation with intraoperative spillage and incomplete tumor excision in association with characteristic histologic findings for the lesion (incomplete pseudocapsule and the presence of pseudopodia). Most recurrent pleomorphic adenomas (RPAs) are multinodular. MRI is the imaging method of choice for their assessment. Nerve integrity monitoring may reduce morbidity of RPA surgery. Although treatment of RPA must be individualized, total parotidectomy is generally recommended given the multicentricity of the lesions...
2016: Advances in Oto-rhino-laryngology
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