Facial Nerve Grafting in the Cerebellopontine Angle

2004 ◽  
Vol 114 (4) ◽  
pp. 782-785 ◽  
Author(s):  
Mario Sanna ◽  
Yogesh Jain ◽  
Maurizio Falcioni ◽  
Fernando Mancini ◽  
Guglielmo Romano
Keyword(s):  
Facial Nerve ◽  
Cerebellopontine Angle ◽  
Nerve Grafting

scholarly journals Rekonstruktivna hirurgija povreda facijalisa

2003 ◽  
Vol 50 (1) ◽  
pp. 63-67
Author(s):  
Vladimir Bascarevic ◽  
Miroslav Samardzic ◽  
Lukas Rasulic ◽  
Vesna Simic
Keyword(s):  
Facial Nerve ◽  
Skull Base ◽  
Surgical Procedures ◽  
Functional Recovery ◽  
Cerebellopontine Angle ◽  
Motor Nerve ◽  
Nerve Grafting ◽  
Cerebellopontine Angle Tumors ◽  
The Face ◽  
Nerve Anastomosis

The facial nerve is main motor nerve of the face and its injury leads to total ipsilateral paralysis. There are several surgical procedures in reconstruction of the facial nerve, and the most frequent one is hypoglosso-facial anastomosis. In this study were analysed a series of 69 patients operated on Institute of neurosurgery from 1981 to 2000 year. The most frequent cause of injury was the operation of cerebellopontine angle tumors, as well as the skull base fractures. Hypoglosso-facial anastomosis was done in 57 patients, in 5 cases we performed nerve grafting in the cerebellopontine angle, and in 7 patients the facial nerve was operated peripherally. Results were analyzed in 27 of 57 patients with hipoglosso-facial nerve anastomosis. Functional recovery was achived in 22 (81,4%) patients.

Stitchless Fibrin Glue-Aided Facial Nerve Grafting After Cerebellopontine Angle Schwannoma Removal

2015 ◽  
Vol 36 (3) ◽  
pp. 498-502 ◽  
Author(s):  
Danielle Seabra Ramos ◽  
Damien Bonnard ◽  
Valérie Franco-Vidal ◽  
Dominique Liguoro ◽  
Vincent Darrouzet
Keyword(s):  
Facial Nerve ◽  
Fibrin Glue ◽  
Cerebellopontine Angle ◽  
Nerve Grafting

Early Nerve Grafting for Facial Paralysis After Cerebellopontine Angle Tumor Resection With Preserved Facial Nerve Continuity

2016 ◽  
Vol 18 (1) ◽  
pp. 54-60 ◽  
Author(s):  
Monirah Albathi ◽  
Sam Oyer ◽  
Lisa E. Ishii ◽  
Patrick Byrne ◽  
Masaru Ishii ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Facial Paralysis ◽  
Cerebellopontine Angle ◽  
Tumor Resection ◽  
Nerve Grafting ◽  
Cerebellopontine Angle Tumor

Facial Nerve Grafting in the Cerebellopontine Angle

Skull Base ◽  
2005 ◽  
Vol 15 (S 2) ◽  
Author(s):  
Maurizio Falcioni ◽  
A. Russo ◽  
G. Romano ◽  
M. Sanna
Keyword(s):  
Facial Nerve ◽  
Cerebellopontine Angle ◽  
Nerve Grafting

Cerebellopontine Angle Surgery Assisted by Continuous Mapping of the Facial Nerve Via the Ultrasonic Aspirator

2020 ◽  
Author(s):  
Marco Cenzato ◽  
Roberto Stefini ◽  
Francesco Zenga ◽  
Maurizio Piparo ◽  
Alberto Debernardi ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Facial Nerve ◽  
Cerebellopontine Angle ◽  
Continuous Mapping ◽  
Cost Effective ◽  
Current Intensity ◽  
Vestibular Schwannomas ◽  
Constant Current ◽  
Surgical Workflow ◽  
Ultrasonic Aspirator

Abstract Background Cerebellopontine angle (CPA) surgery carries the risk of lesioning the facial nerve. The goal of preserving the integrity of the facial nerve is usually pursued with intermittent electrical stimulation using a handheld probe that is alternated with the resection. We report our experience with continuous electrical stimulation delivered via the ultrasonic aspirator (UA) used for the resection of a series of vestibular schwannomas. Methods A total of 17 patients with vestibular schwannomas, operated on between 2010 and 2018, were included in this study. A constant-current stimulator was coupled to the UA used for the resection, delivering square-wave pulses throughout the resection. The muscle responses from upper and lower face muscles triggered by the electrical stimulation were displayed continuously on multichannel neurophysiologic equipment. The careful titration of the electrical stimulation delivered through the UA while tapering the current intensity with the progression of the resection was used as the main strategy. Results All operations were performed successfully, and facial nerve conduction was maintained in all patients except one, in whom a permanent lesion of the facial nerve followed a miscommunication to the neurosurgeon. Conclusion The coupling of the electrical stimulation to the UA provided the neurosurgeon with an efficient and cost-effective tool and allowed a safe resection. Positive responses were obtained from the facial muscles with low current intensity (lowest intensity: 0.1 mA). The availability of a resection tool paired with a stimulator allowed the surgeon to improve the surgical workflow because fewer interruptions were necessary to stimulate the facial nerve via a handheld probe.

Preoperative identification of the facial nerve in patients with large cerebellopontine angle tumors using high-density diffusion tensor imaging

2012 ◽  
Vol 116 (4) ◽  
pp. 697-702 ◽  
Author(s):  
Neil Roundy ◽  
Johnny B. Delashaw ◽  
Justin S. Cetas
Keyword(s):  
Diffusion Tensor Imaging ◽  
Facial Nerve ◽  
Cerebellopontine Angle ◽  
Diffusion Tensor ◽  
Tumor Resection ◽  
High Density ◽  
Imaging Method ◽  
Study Objective ◽  
Nerve Preservation ◽  
Imaging Results

Object Facial nerve paresis can be a devastating complication following resection of large (> 2.5 cm) cerebellopontine angle (CPA) tumors. The authors have developed and used a new high-density diffusion tensor imaging (HD-DT imaging) method, aimed at preoperatively identifying the location and course of the facial nerve in relation to large CPA tumors. Their study objective was to preoperatively identify the facial nerve in patients with large CPA tumors and compare their HD-DT imaging method with a traditional standard DT imaging method and correlate with intraoperative findings. Methods The authors prospectively studied 5 patients with large (> 2.5 cm) CPA tumors. All patients underwent preoperative traditional standard- and HD-DT imaging. Imaging results were correlated with intraoperative findings. Results Utilizing their HD-DT imaging method, the authors positively identified the location and course of the facial nerve in all patients. In contrast, using a standard DT imaging method, the authors were unable to identify the facial nerve in 4 of the 5 patients. Conclusions The HD-DT imaging method that the authors describe and use has proven to be a powerful, accurate, and rapid method for preoperatively identifying the facial nerve in relation to large CPA tumors. Routine integration of HD-DT imaging in preoperative planning for CPA tumor resection could lead to improved facial nerve preservation.

scholarly journals Sensitivity and Negative Predictive Value of Motor Evoked Potentials of the Facial Nerve

2021 ◽  
Author(s):  
Nicolas Bovo ◽  
Shahan Momjian ◽  
Renato Gondar ◽  
Philippe Bijlenga ◽  
Karl Schaller ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Evoked Potentials ◽  
Negative Predictive Value ◽  
Patient Group ◽  
Vestibular Schwannoma ◽  
Predictive Value ◽  
Cerebellopontine Angle ◽  
Motor Evoked Potentials ◽  
Vestibular Schwannomas ◽  
Predictive Values

Abstract Objective The objective of this study was to determine the performance of the standard alarm criterion of motor evoked potentials (MEPs) of the facial nerve in surgeries performed for resections of vestibular schwannomas or of other lesions of the cerebellopontine angle. Methods This retrospective study included 33 patients (16 with vestibular schwannomas and 17 with other lesions) who underwent the resection surgery with transcranial MEPs of the facial nerve. A reproducible 50% decrease in MEP amplitude, resistant to a 10% increase in stimulation intensity, was applied as the alarm criterion during surgery. Facial muscular function was clinically evaluated with the House–Brackmann score (HBS), pre- and postsurgery at 3 months. Results In the patient group with vestibular schwannoma, postoperatively, the highest sensitivity and negative predictive values were found for a 30% decrease in MEP amplitude, that is, a criterion stricter than the 50% decrease in MEP amplitude criterion, prone to trigger more warnings, used intraoperatively. With this new criterion, the sensitivity would be 88.9% and the negative predictive value would be 85.7%. In the patient group with other lesions of the cerebellopontine angle, the highest sensitivity and negative predictive values were found equally for 50, 60, or 70% decrease in MEP amplitude. With these criteria, the sensitivities and the negative predictive values would be 100.0%. Conclusion Different alarm criteria were found for surgeries for vestibular schwannomas and for other lesions of the cerebellopontine angle. The study consolidates the stricter alarm criterion, that is, a criterion prone to trigger early warnings, as found previously by others for vestibular schwannoma surgeries (30% decrease in MEP amplitude).

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