Intraoperative Facial Nerve Monitoring by Monopolar Low Constant Current Stimulation and Postoperative Facial Function in Acoustic Tumor Surgery

1994 ◽  
pp. 316-318
Author(s):  
T. Yokoyama ◽  
K. Uemura ◽  
H. Ryu ◽  
K. Sugiyama ◽  
S. Nishizawa ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Constant Current ◽  
Tumor Surgery ◽  
Nerve Monitoring ◽  
Facial Nerve Monitoring ◽  
Constant Current Stimulation ◽  
Acoustic Tumor ◽  
Facial Function

Facial Nerve Monitoring in Acoustic Tumor Surgery

1991 ◽  
Vol 104 (6) ◽  
pp. 814-817 ◽  
Author(s):  
Jed A. Kwartler ◽  
William M. Luxford ◽  
James Atkins ◽  
Clough Shelton
Keyword(s):  
Facial Nerve ◽  
Tumor Surgery ◽  
Nerve Monitoring ◽  
Facial Nerve Monitoring ◽  
Acoustic Tumor

Intra-operative facial nerve monitoring. Its predictive value after skull base surgery

1997 ◽  
Vol 111 (8) ◽  
pp. 715-718 ◽  
Author(s):  
Giuseppe Magliulo ◽  
Francesco Zardo
Keyword(s):  
Facial Nerve ◽  
Skull Base ◽  
Predictive Value ◽  
Skull Base Surgery ◽  
Evoked Response ◽  
Nerve Function ◽  
Nerve Monitoring ◽  
Facial Nerve Monitoring ◽  
Stimulation Current ◽  
Facial Function

AbstractPurposeFacial nerve monitoring can be used to predict post-operative facial function after skull base surgery. In this study three methods of prediction of facial function were compared. These methods utilize various parameters of the evoked electromyographic monitoring.Material and methodsTwenty-three patients who underwent surgery for skull base diseases were retrospectively reviewed. Amplitude of ongoing electromyographic activity, stimulation current thresholds and amplitude of evoked response were analysed. The predictive value of the three methods was correlated with post-operative facial nerve function.ResultsThe method that used only the stimulation thresholds predicted the final post-operative facial function in 86.9 per cent of the patients. The second employed a mathematical ratio which combined the amplitude of evoked response and the stimulation current thresholds and confirmed the prediction of the facial function in 91.3 per cent of the patients. The last method does not consider the stimulation thresholds greater than 0.05 mA and failed to predict the final VIIth nerve function in patients in whom the stimulation was greater than 0.05 mA.ConclusionAnalysis of prognostic value demonstrates that the first two methods had the smaller degree of variation showing the better sensitivity.

Resection of large vestibular schwannomas: facial nerve preservation in the context of surgical approach and patient-assessed outcome

2005 ◽  
Vol 102 (4) ◽  
pp. 643-649 ◽  
Author(s):  
Douglas E. Anderson ◽  
John Leonetti ◽  
Joshua J. Wind ◽  
Denise Cribari ◽  
Karen Fahey
Keyword(s):  
Facial Nerve ◽  
Vestibular Schwannomas ◽  
Facial Nerve Paralysis ◽  
Nerve Paralysis ◽  
Nerve Monitoring ◽  
Content Type ◽  
Nerve Preservation ◽  
Facial Nerve Monitoring ◽  
Facial Function ◽  
Fine Print

Object. Vestibular schwannoma surgery has evolved as new therapeutic options have emerged, patients' expectations have risen, and the psychological effect of facial nerve paralysis has been studied. For large vestibular schwannomas for which extirpation is the primary therapy, the goals remain complete tumor resection and maintenance of normal neurological function. Improved microsurgical techniques and intraoperative facial nerve monitoring have decreased the complication rate and increased the likelihood of normal to near-normal postoperative facial function. Nevertheless, the impairment most frequently reported by patients as an adverse effect of surgery continues to be facial nerve paralysis. In addition, patient assessment has provided a different, less optimistic view of outcome. The authors evaluated the extent of facial function, timing of facial nerve recovery, patients' perceptions of this recovery and function, and the prognostic value of intraoperative facial nerve monitoring following resection of large vestibular schwannomas; they then analyzed these results with respect to different surgical approaches. Methods. The authors retrospectively reviewed a database of 67 patients with 71 vestibular schwannomas measuring 3 cm or larger in diameter. The patients had undergone surgery via translabyrinthine, retrosigmoid, or combined approaches. Clinical outcomes were analyzed with respect to intraoperative facial nerve activity, responses to intraoperative stimulation, and time course of recovery. Eighty percent of patients obtained normal to near-normal facial function (House—Brackmann Grades I and II). Patients' perceptions of facial nerve function and recovery correlated well with the clinical observations. Conclusions. Trends in the data lead the authors to suggest that a retrosigmoid exposure, alone or in combination with a translabyrinthine approach, offers the best chance of facial nerve preservation in patients with large vestibular schwannomas.

scholarly journals Incidence of postoperative facial weakness in parotid tumor surgery: a tumor subsite analysis of 794 parotidectomies

BMC Surgery ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Hokyung Jin ◽  
Bo Young Kim ◽  
Heejung Kim ◽  
Eunkyu Lee ◽  
Woori Park ◽  
...  
Keyword(s):  
Risk Factors ◽  
Facial Nerve ◽  
Old Age ◽  
Malignant Tumors ◽  
Tumor Surgery ◽  
Parotid Tumor ◽  
Facial Weakness ◽  
Nerve Monitoring ◽  
Deep Lobe ◽  
Facial Nerve Monitoring

Abstract Background The reported incidence of facial weakness immediately after parotid tumor surgery ranges from 14 to 65%. The purpose of this study was to evaluate the incidence of postoperative facial weakness related to parotidectomy with use of preoperative computed tomography (CT), intraoperative facial nerve monitoring, and surgical magnification. Also, we sought to elucidate additional information about risk factors for postoperative facial weakness in parotid tumor surgery, particularly focusing on the tumor subsites. Methods We retrospectively reviewed 794 cases with parotidectomy for benign and malignant tumors arising from the parotid gland (2009–2016). Patients with pretreatment facial palsy were excluded from the analyses. Tumor subsites were stratified based on their anatomical relations to the facial nerve as superficial, deep, or both. Multivariable logistic regression analyses were conducted to identify risk factors for postoperative facial weakness. Results The overall incidences of temporary and permanent (more than 6 months) facial weakness were 9.2 and 5.2% in our series utilizing preoperative CT, intraoperative facial nerve monitoring, and surgical magnification. Multivariable analysis revealed that old age, malignancy, and recurrent tumors (revision surgery) were common independent risk factors for both temporary and permanent postoperative facial weakness. In addition, tumor subsite (tumors involving superficial and deep lobe) was associated with postoperative facial weakness, but not tumor size. Extent of surgery was strongly correlated with tumor pathology (malignant tumors) and tumor subsite (tumors involving deep lobe). Conclusion Aside from risk factors for facial weakness in parotid tumor surgery such as old age, malignant, or recurrent tumors, the location of tumors was found to be related to postoperative facial weakness. This study result may provide background data in a future prospective study and up-to-date information for patient counseling.

scholarly journals Correlation between Electrophysiological Change and Facial Function in Parotid Surgery Patients

2021 ◽  
Vol 10 (24) ◽  
pp. 5730
Author(s):  
Feng-Yu Chiang ◽  
Chih-Chun Wang ◽  
Che-Wei Wu ◽  
I-Cheng Lu ◽  
Pi-Ying Chang ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Facial Weakness ◽  
Nerve Monitoring ◽  
Facial Region ◽  
Facial Nerve Monitoring ◽  
Parotid Surgery ◽  
High Incidence ◽  
Visual Confirmation ◽  
Amplitude Decrease ◽  
Facial Function

This observational study investigated intraoperative electrophysiological changes and their correlation with postoperative facial expressions in parotidectomy patients with visual confirmation of facial nerve (FN) continuity. Maximal electromyography(EMG) amplitudes of the facial muscles corresponding to temporal, zygomatic, buccal and mandibular branches were compared before/after FN dissection, and facial function at four facial regions were evaluated before/after parotidectomy in 112 patients. Comparisons of 448 pairs of EMG signals revealed at least one signal decrease after FN dissection in 75 (67%) patients. Regional facial weakness was only found in 13 of 16 signals with >50% amplitude decreases. All facial dysfunctions completely recovered within 6 months. EMG amplitude decreases often occur after FN dissection. An amplitude decrease >50% in an FN branch is associated with a high incidence of dysfunction in the corresponding facial region. This study tries to establish a standard facial nerve monitoring (FNM) procedure and a proper facial function grading system for parotid surgery that will be useful for the future study of FNM in parotid surgery.

Intraoperative Facial Nerve Monitoring: Prognostic Aspects during Acoustic Tumor Removal

1991 ◽  
Vol 104 (6) ◽  
pp. 780-782 ◽  
Author(s):  
Douglas L. Beck ◽  
James S. Atkins ◽  
James E. Benecke ◽  
Derald E. Brackmann
Keyword(s):  
Facial Nerve ◽  
Tumor Removal ◽  
Nerve Monitoring ◽  
Facial Nerve Monitoring ◽  
Acoustic Tumor

Improved Preservation of Facial Nerve Function in the Infratemporal Approach to the Skull Base

1989 ◽  
Vol 101 (1) ◽  
pp. 74-78 ◽  
Author(s):  
John P. Leonetti ◽  
Derald E. Brackmann ◽  
Richard L. Prass
Keyword(s):  
Facial Nerve ◽  
Skull Base ◽  
Jugular Foramen ◽  
Early Postoperative Period ◽  
Modified Technique ◽  
Nerve Monitoring ◽  
Lateral Skull Base ◽  
Facial Nerve Monitoring ◽  
Infratemporal Approach ◽  
Facial Function

Although the infratemporal approach described by Fisch provides excellent exposure of the jugular foramen, intrapetrous carotid artery, and lateral skull base, the anterior displacement of the seventh cranial nerve often results In temporary facial paralysis. The use of a modified technique for facial nerve mobilization resulted In significant improvement of both early and final facial function. Since that earlier report, continuous intraoperative electrical facial nerve monitoring has been used during the infratemporal approach in 20 additional cases. Immediate postoperative facial function was normal in 93% of the monitored coses and In 70% of the cases in the unmonitored group. More Importantly, no patients in the monitored group developed grade V or VI weakness after surgery, whereas 48% of the unmonitored patients had grade V or VI weakness during the early postoperative period. This article will describe how intraoperative facial nerve monitoring is used during infratemporal surgery and will compare early facial function in 31 unmonitored patients with early facial function in 20 monitored procedures.

Intraoperative Facial Nerve Monitoring

1991 ◽  
Vol 24 (3) ◽  
pp. 709-725 ◽  
Author(s):  
Herbert Silverstein ◽  
Seth Rosenberg
Keyword(s):  
Facial Nerve ◽  
Nerve Monitoring ◽  
Facial Nerve Monitoring
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