scholarly journals A New and Reliable Landmark in Parotid Surgery: Tragomastoid Groove (Akil Groove)

2020 ◽  
Author(s):  
vefa kınış ◽  
ferit akıl ◽  
ümit yılmaz ◽  
mehmet akdağ ◽  
muhammed ayral ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Facial Paralysis ◽  
High Ratio ◽  
Stylomastoid Foramen ◽  
Parotid Surgery ◽  
The Mean ◽  
Relationship Of ◽  
First Time ◽  
Type Of Surgery

Abstract Background: Parotid surgery is a frequently performed surgery in otorhinolaryngology practice with many possible complications. Due to the high ratio of facial paralysis during parotid surgery, we defined a new landmark for identifying and protecting the facial nerve as early as possible during surgery. Materials and Methods: The study was designed as a prospective anatomical method. The important details and relationship of the tragomastoid groove to the facial nerve truncus were examined during surgery on 30 patients. In addition, the demographics of the patients, the type of surgery and the pathological results of surgeries were evaluated.Results: The mean distance of the tragomastoid groove to the facial nerve truncus was 20.53±1.71 mm, the mean deepness of the tragomastoid groove was 1.91+-0.26 mm, and the mean superficial part of the tragomastoid groove was 0.83±0.23 mm. The tragomastoid groove was situated either across from the facial nerve at the place where the facial nerve truncus exits the stylomastoid foramen or just inferior to the truncus in all patients. Conclusion: The tragomastoid groove was defined for the first time in the literature as a reliable landmark for identifying the facial nerve truncus easily during parotid surgery.

scholarly journals The depth of the facial nerve in the mastoid bone

2018 ◽  
Vol 4 (3) ◽  
pp. 666
Author(s):  
B. Y. Praveen Kumar ◽  
K. T. Chandrashekhar ◽  
M. K. Veena Pani ◽  
Sunil K. C. ◽  
Anand Kumar S. ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Temporal Bone ◽  
Significant Variation ◽  
Canal Wall ◽  
Stylomastoid Foramen ◽  
Cortical Mastoidectomy ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
The Mean ◽  
Temporal Bones

<p class="abstract"><strong>Background:</strong> The hallmark of the temporal bone is variation. Various important structures like the facial nerve run in the temporal bone at various depths which can be injured during mastoidectomy.</p><p class="abstract"><strong>Methods:</strong> Twenty wet cadaveric temporal bones were dissected. A cortical mastoidectomy was performed followed by a canal wall down mastoidectomy and the depth of the vertical segment of the facial nerve in the mastoid was determined.  </p><p class="abstract"><strong>Results:</strong> The mean depth of the second genu was 13.82 mm. The mean depth of the stylomastoid foramen was 12.75 mm and the mean distance from the annulus at 6’0 clock to the stylomastoid foramen was 10.22 mm.</p><p><strong>Conclusions:</strong> There is significant variation in the average depth of the facial nerve in the mastoid. </p>

scholarly journals Intraoperative Distance Between the Main Trunk of the Facial Nerve and Surgical Landmarks Used in Parotidectomy: A Prospective Study

2014 ◽  
Vol 29 (1) ◽  
pp. 16-19
Author(s):  
Daniel Jose C. Mendoza ◽  
Samantha S. Castañeda ◽  
Antonio H. Chua
Keyword(s):  
Standard Deviation ◽  
Facial Nerve ◽  
Prospective Study ◽  
Facial Paralysis ◽  
Descriptive Study ◽  
Suture Line ◽  
Anatomic Landmarks ◽  
Main Trunk ◽  
The Mean ◽  
A Prospective Study

Objective: to determine the mean distance of the main trunk of the facial nerve from two commonly employed surgical landmarks (tragal pointer and tympanomastoid suture line) among a sample of Filipino adults undergoing parotidectomy.   Methods Study Design:            Prospective Descriptive Study Setting:                       Tertiary Government Training Hospital Subjects:                    22 patients without facial paralysis undergoing surgery for parotid neoplasms were evaluated intraoperatively.   Results: The main trunk of the facial nerve was found to be 9.0mm (standard deviation of 2.8mm) from the tragal pointer and 6.1mm (standard deviation of 2.0mm) from the tympanomastoid suture line.   Conclusion:  The mean distance from the main trunk of the facial nerve to two of the most commonly utilized landmarks in identification of the nerve during parotidectomy was 9.0mm (standard deviation of 2.8mm) from the tragal pointer and 6.1mm (standard deviation of 2.0mm) from the tympanomastoid suture line. These may serve as reference values for surgeons in safer identification and preservation of the facial nerve during parotidectomy.   Keywords: facial nerve, parotidectomy, tragal pointer, tympanomastoid suture line, anatomic landmarks

Awake CT-guided percutaneous stylomastoid foramen puncture and radiofrequency ablation of facial nerve for treatment of hemifacial spasm

2021 ◽  
pp. 1-7
Author(s):  
Bing Huang ◽  
Ming Yao ◽  
QiLiang Chen ◽  
Huidan Lin ◽  
Xindan Du ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Minimally Invasive ◽  
Facial Nerve ◽  
Hemifacial Spasm ◽  
Invasive Procedure ◽  
Minimally Invasive Procedure ◽  
Ct Guided ◽  
Stylomastoid Foramen ◽  
History Of ◽  
First Time

OBJECTIVE Hemifacial spasm (HFS) is a debilitating neuromuscular disorder with limited treatment options. The current study describes a novel minimally invasive procedure that provided effective and sustained relief for patients with HFS. The authors provide a detailed description of the awake CT-guided percutaneous radiofrequency ablation (RFA) of the facial nerve for treatment of HFS, and they examine its clinical efficacy. This is the first time in the literature that this procedure has been applied and systematically analyzed for HFS. METHODS Patients with a history of HFS were recruited between August 2018 and April 2020. Those with a history of cerebellopontine lesions, coagulopathy, ongoing pregnancy, cardiac pacemaker or defibrillator implants, or who declined the procedure were excluded from the study. Fifty-three patients who met the study criteria were included and underwent awake CT-guided RFA. Under minimal sedation, a radiofrequency (RF) needle was used to reach the stylomastoid foramen on the affected side under CT guidance, and the facial nerve was localized using a low-frequency stimulation current. Patients were instructed to engage facial muscles as a proxy for motor monitoring during RFA. Ablation stopped when the patients’ hemifacial contracture resolved. Patients were kept for inpatient monitoring for 24 hours postoperatively and were followed up monthly to monitor resolution of HFS and complications for up to 19 months. RESULTS The average duration of the procedure was 32–34 minutes. Postoperatively, 91% of the patients (48/53) had complete resolution of HFS, whereas the remaining individuals had partial resolution. A total of 48 patients reported mild to moderate facial paralysis immediately post-RFA, but most resolved within 1 month. No other significant complication was observed during the study period. By the end of the study period, 5 patients had recurrence of mild HFS symptoms, whereas only 2 patients reported dissatisfaction with the treatment results. CONCLUSIONS The authors report for the first time that awake CT-guided RFA of the facial nerve at the stylomastoid foramen is a minimally invasive procedure and can be an effective treatment option for HFS.

scholarly journals Hypoglossal-facial nerve side-to-end anastomosis for preservation of hypoglossal function: results of delayed treatment with a new technique

1996 ◽  
Vol 1 (2) ◽  
pp. E8 ◽  
Author(s):  
Yutaka Sawamura ◽  
Hiroshi Abe
Keyword(s):  
Facial Nerve ◽  
Facial Paralysis ◽  
Hypoglossal Nerve ◽  
Mastoid Process ◽  
Mastoid Cavity ◽  
Distal Stump ◽  
Delayed Treatment ◽  
Stylomastoid Foramen ◽  
Facial Reanimation ◽  
Nerve Anastomosis

This report describes a new surgical technique to improve the results of conventional hypoglossal-facial nerve anastomosis that does not necessitate the use of nerve grafts or hemihypoglossal nerve splitting. Using this technique, the mastoid process is partially resected to open the stylomastoid foramen and the descending portion of the facial nerve in the mastoid cavity is exposed by drilling to the level of the external genu and then sectioning its most proximal portion. The hypoglossal nerve beneath the internal jugular vein is exposed at the level of the axis and dissected as proximally as possible. One-half of the hypoglossal nerve is transected: use of less than one-half of the hypoglossal nerve is adequate for approximation to the distal stump of the atrophic facial nerve. The nerve endings, the proximally cut end of the hypoglossal nerve, and the distal stump of the facial nerve are approximated and anastomosed without tension. This technique was used in four patients with long-standing facial paralysis (greater than 24 months), and it provided satisfactory facial reanimation, with no evidence of hemitongue atrophy or dysfunction. Because it completely preserves glossal function, the hemihypoglossal-facial nerve anastomosis described here constitutes a successful approach in patients with long-standing facial paralysis who do not wish to have tongue function compromised.

Suprascapular nerve as a donor for extracranial facial nerve reanimation procedures: a cadaveric feasibility study

2008 ◽  
Vol 108 (1) ◽  
pp. 145-148 ◽  
Author(s):  
R. Shane Tubbs ◽  
Robert G. Louis ◽  
Christopher T. Wartmann ◽  
Marios Loukas ◽  
Mohammadali M. Shoja ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Head Rotation ◽  
Suprascapular Nerve ◽  
Suprascapular Notch ◽  
Splitting Technique ◽  
Stylomastoid Foramen ◽  
The Face ◽  
Human Cadavers ◽  
The Mean ◽  
Neurovascular Structures

Object Facial nerve injury with resultant facial muscle paralysis is disfiguring and disabling. To the auhtors' knowledge, neurotization of the facial nerve using a branch of the brachial plexus has not been previously performed. Methods In an attempt to identify an additional nerve donor candidate for facial nerve neurotization, 5 fresh adult human cadavers (10 sides) underwent dissection of the suprascapular nerve distal to the suprascapular notch where it was transected. The facial nerve was localized from the stylomastoid foramen onto the face, and the cut end of the suprascapular nerve was tunneled to this location. Measurements were made of the length and diameter of the supra-scapular nerve. In 2 of these specimens prior to transection of the nerve, a nerve-splitting technique was used. Results All specimens were found to have a suprascapular nerve with enough length to be tunneled, tension free, superiorly to the extracranial facial nerve. Connections remained tensionless with left and right head rotation of up to 45°. The mean length of this part of the suprascapular nerve was 12.5 cm (range 11.5–14 cm). The mean diameter of this nerve was 3 mm. A nerve-splitting technique was also easily performed. No gross evidence of injury to surrounding neurovascular structures was identified. Conclusions To the authors' knowledge, the suprascapular nerve has not been previously explored as a donor nerve for facial nerve reanimation procedures. Based on the results of this cadaveric study, the authors believe that use of the suprascapular nerve may be considered for surgical maneuvers.

Congenital facial nerve agenesis

2001 ◽  
Vol 115 (1) ◽  
pp. 53-54 ◽  
Author(s):  
P. N. Jervis ◽  
P. D. Bull
Keyword(s):  
Surgical Treatment ◽  
Parotid Gland ◽  
Facial Nerve ◽  
Facial Paralysis ◽  
Facial Palsy ◽  
Surgical Procedure ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Stylomastoid Foramen ◽  
Unrelated Condition

We present a case of a seven-year-old child with a congenital facial palsy, diagnosed at birth, who subsequently developed a non-tuberculous mycobacterial (NTM) infection of the ipsilateral parotid gland. This required parotid exploration to treat the NTM disease with the intention of identifying and protecting the facial nerve to preserve any residual facial nerve function. At operation, thorough exploration revealed the complete absence of the nerve both at the stylomastoid foramen and more peripherally within the substance of the parotid gland. Exploration of the facial nerve for congenital facial paralysis is not normally indicated. Surgical treatment, if required, tends to involve the use of techniques such as cross facial nerve and free vascularized muscle grafting. To our knowledge this is the first reported case of complete congenital facial nerve agenesis, diagnosed incidentally during a surgical procedure for an unrelated condition.

scholarly journals Dissection and Exposure of the Whole Course of Deep Nerves in Human Head Specimens after Decalcification

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Longping Liu ◽  
Robin Arnold ◽  
Marcus Robinson
Keyword(s):  
Facial Nerve ◽  
Human Head ◽  
Chorda Tympani ◽  
Tympanic Cavity ◽  
Chorda Tympani Nerve ◽  
Stylomastoid Foramen ◽  
Greater Petrosal Nerve ◽  
Facial Nerves ◽  
Pterygoid Canal ◽  
The Mean

The whole course of the chorda tympani nerve, nerve of pterygoid canal, and facial nerves and their relationships with surrounding structures are complex. After reviewing the literature, it was found that details of the whole course of these deep nerves are rarely reported and specimens displaying these nerves are rarely seen in the dissecting room, anatomical museum, or atlases. Dissections were performed on 16 decalcified human head specimens, exposing the chorda tympani and the nerve connection between the geniculate and pterygopalatine ganglia. Measurements of nerve lengths, branching distances, and ganglia size were taken. The chorda tympani is a very fine nerve (0.44 mm in diameter within the tympanic cavity) and approximately 54 mm in length. The mean length of the facial nerve from opening of internal acoustic meatus to stylomastoid foramen was 52.5 mm. The mean length of the greater petrosal nerve was 26.1 mm and nerve of the pterygoid canal was 15.1 mm.

scholarly journals Patient’s Expectation of Orthodontic Treatment at a Tertiary Health Facility in Lagos, Nigeria

2016 ◽  
Vol 6 (1) ◽  
pp. 12-17
Author(s):  
Oyapero Afolabi ◽  
Ogunbiyi B Ogunbanjo ◽  
Kikelomo O Adegbite ◽  
Olawande A Ajisafe
Keyword(s):  
Orthodontic Treatment ◽  
University Teaching ◽  
State University ◽  
Aesthetic Outcome ◽  
Patient Cooperation ◽  
The Mean ◽  
Relationship Of ◽  
First Time ◽  
Patient’S Expectation ◽  
Structured Questionnaire

Introduction: An understanding of the expectations and attitude of patients is a prerequisite for appropriate behavioural and clinical management.Objective: To assess patients’ expectations of orthodontic treatment and relationship of gender to this expectation among Nigerian patients.Materials & Method: The descriptive study comprised of patients attending the orthodontic clinic at Lagos State University Teaching Hospital (LASUTH), Nigeria for the first time. A structured questionnaire was used to obtain the socio-demographic information and responses to questions on their expectation of orthodontic treatment.Result: Majority of the respondents had higher expectations on aesthetic outcome of orthodontic treatment than the functional outcomes. They expected to have better smile, teeth straightened and have confidence socially. The lowest mean scores were obtained in the domains of improvement in career and making speech easier.  Females had significant higher scores than male participants in all domains explored with the mean highest score in the domain of better smiles; while the highest male mean score was in the domain of straightened teeth.Conclusion: Orthodontics relies heavily on patient cooperation for a successful end result. It is recommended that the orthodontist agrees with the patient on realistic expected treatment outcomes before the treatment commences so that they are not disappointed with the final appearance. Orthodontic Journal of Nepal, Vol. 6 No. 1, June 2016, pp.12-17

scholarly journals Parotidectomy and Facial Paralysis, A Retrospective Review at A Tertiary Care Hospital

2021 ◽  
Vol 10 (3) ◽  
pp. 164-168
Author(s):  
Israr ud Din ◽  
Muhammad Junaid ◽  
Imran Khan ◽  
Arshad Aziz ◽  
Sakhawat Khan ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Facial Paralysis ◽  
Tertiary Care ◽  
Occurrence Rate ◽  
Facial Nerve Paralysis ◽  
Care Hospital ◽  
Female Population ◽  
Nerve Paralysis ◽  
Parotid Tumors ◽  
Parotid Surgery

Background: Facial Nerve is in close proximity with parotid gland and encountered during parotid surgery.  Facial nerve   paralysis   has   15 to 66% occurrence rate after parotidectomies. The objective of this study was to find out the frequency of facial paralysis resulting from superficial or total parotidectomies done for various parotid tumors. Material and Methods: This retrospective study was conducted at the Department of ENT, Khyber Teaching Hospital, Peshawar from January 2018 to May 2020. A total of 203 patients were reviewed for data on demographics, parotidectomies, histopathology and facial paralysis. The information on facial paralysis was compared against various parameters. Results:   The mean age of   the participants was 46.12 ± 11.11 years. The most common parotid tumor was pleomorphic adenoma (68.9%) followed by mucoepidermoid carcinoma. 57 (28.07%) patients showed facial paralysis with a higher rate of occurrence in total parotidectomy (40.90%). Among 57 patients with facial paralysis, 6 (10.53%) showed permanent facial paralysis. Conclusion: Tendency of permanent facial paralysis is high with total parotidectomies. Female population and elderly have a slightly higher rate of facial paralysis. The duration of procedure has no effect on the occurrence of facial paralysis.

Hypoglossal—facial nerve side-to-end anastomosis for preservation of hypoglossal function: results of delayed treatment with a new technique

1997 ◽  
Vol 86 (2) ◽  
pp. 203-206 ◽  
Author(s):  
Yutaka Sawamura ◽  
Hiroshi Abe
Keyword(s):  
Facial Nerve ◽  
Facial Paralysis ◽  
Hypoglossal Nerve ◽  
Mastoid Process ◽  
Mastoid Cavity ◽  
Distal Stump ◽  
Content Type ◽  
Stylomastoid Foramen ◽  
Nerve Anastomosis ◽  
Fine Print

✓ This report describes a new surgical technique to improve the results of conventional hypoglossal—facial nerve anastomosis that does not necessitate the use of nerve grafts or hemihypoglossal nerve splitting. Using this technique, the mastoid process is partially resected to open the stylomastoid foramen and the descending portion of the facial nerve in the mastoid cavity is exposed by drilling to the level of the external genu and then sectioning its most proximal portion. The hypoglossal nerve beneath the internal jugular vein is exposed at the level of the axis and dissected as proximally as possible. One-half of the hypoglossal nerve is transected: use of less than one-half of the hypoglossal nerve is adequate for approximation to the distal stump of the atrophic facial nerve. The nerve endings, the proximally cut end of the hypoglossal nerve, and the distal stump of the facial nerve are approximated and anastomosed without tension. This technique was used in four patients with long-standing facial paralysis (greater than 24 months), and it provided satisfactory facial reanimation, with no evidence of hemitongue atrophy or dysfunction. Because it completely preserves glossal function, the hemihypoglossal—facial nerve anastomosis described here constitutes a successful approach in patients with long-standing facial paralysis who do not wish to have tongue function compromised.

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