scholarly journals Three-Dimensional Sheath Inked Rapid Acquisition with Refocused Echoes Imaging (SHINKEI) MRI for Delineating the Intraparotid Facial Nerve Branches and Their Anatomical Relationship with Parotid Tumors

2021 ◽  
Vol 18 (3) ◽  
Author(s):  
Yanwei Jiang ◽  
Cheng Sun ◽  
Wei Zhou ◽  
Lianpin Yu ◽  
Weidong Zhang ◽  
...  
Keyword(s):  
Parotid Gland ◽  
Facial Nerve ◽  
Three Dimensional ◽  
Parotid Tumor ◽  
Main Trunk ◽  
Rapid Acquisition ◽  
Parotid Tumors ◽  
Facial Nerves ◽  
Anatomical Relationship ◽  
The Relationship

Background: Accurate imaging of the anatomical relationship between the intraparotid facial nerve branches and parotid tumor can be helpful for surgical planning and effective protection of the facial nerve during surgery. Three-dimensional sheath inked rapid acquisition with refocused echoes imaging (3D-SHINKEI) is a new MRI sequence with a high tissue contrast resolution, which has been used for imaging the peripheral nerves in several organs. Objectives: To evaluate the value of 3D-SHINKEI sequence in representing the intraparotid facial nerve branches and their anatomical relationship with neoplasms of the parotid gland. Patients and Methods: Thirty-six patients with parotid tumors underwent MRI with 3D-SHINKEI and 3D-T2-fast field echo (3D-T2-FFE) sequences in the coronal plane. The contrast-to-noise ratios (CNRs) and signal intensity ratios (SIRs) of the facial nerves in the two sequences were compared. The relationship between the intraparotid facial nerve branches and parotid tumor was also analyzed in 36 patients, and the results were compared with the intraoperative anatomy and postoperative pathological findings. Results: The image quality score of the 3D-SHINKEI sequence for anatomical representation of the intraparotid facial nerve branches was significantly higher than that of the 3D-T2-FFE sequence (Z = −6.197, P < 0.01). The SIRs and CNRs of the facial nerves were significantly higher in the SHINKEI images as compared to the 3D-T2-FFE images (t = 10.772, P < 0.01 and t = 11.586, P < 0.01, respectively). The delineation accuracy of the anatomy of the main trunk of the facial nerve and its first-level branches and their relationship with tumors was significantly higher with the 3D-SHINKEI sequence than with the 3D-T2-FFE sequence (P < 0.01). Besides, the relationship between parotid tumors and the main trunk of the facial nerve and its first-level branches was classified into six types. Conclusion: A high-resolution 3D-SHINKEI sequence could accurately represent the relationship between the intraparotid facial nerve branches and parotid gland neoplasms. It was also found to be more accurate than the 3D-T2-FFE sequence.

scholarly journals Superficial Parotidectomy by Retrograde Facial Nerve Dissection

2017 ◽  
Vol 10 (1) ◽  
pp. 25-27
Author(s):  
Narendra Vikram Gurung ◽  
D Shrestha ◽  
A Acharya ◽  
A Gurung ◽  
S Shrestha ◽  
...  
Keyword(s):  
Salivary Gland ◽  
Parotid Gland ◽  
Facial Nerve ◽  
Head And Neck Neoplasms ◽  
Complication Rate ◽  
Gland Tumor ◽  
Superficial Parotidectomy ◽  
Salivary Fistula ◽  
Parotid Tumors ◽  
Parotid Gland Tumor

Introduction: Tumors of the salivary gland are relatively uncommon and represent less than two percentage of all head and neck neoplasms. Parotid gland tumor comprises 85% of the salivary gland tumors of which 80% are being benign. Superficial parotidectomy is the commonest procedure done for parotid tumors which can be performed by either anteretrograde or retrograde facial nerve dissection technique.Methods: Outcome of 60 patients after superficial parotidectomy with retrograde facial nerve dissection has been studied.Results: Total of 60 patients had been studied. Complications like facial nerve weakness, Freys syndrome, salivary fistula, and wound infection were taken into account. Among them, 13.33% patients developed temporary facial nerve weakness, followed by temporary salivary fistula, 1.6%. None of the patients developed any severe complication.Conclusion: Superficial parotidectomy by retrograde facial nerve dissection is an easy technique to carry out with low complication rate and without compromising surgical outcome.Journal of Gandaki Medical CollegeVol. 10, No. 1, 2017, page: 25-27

scholarly journals Transoral Excision of a Large Accessory Parotid Gland Tumor

2021 ◽  
pp. 014556132110362
Author(s):  
Rohith S. Voora ◽  
Joshua Stramiello ◽  
Emily Funk ◽  
Joseph Califano
Keyword(s):  
Parotid Gland ◽  
Facial Nerve ◽  
Surgical Excision ◽  
Transoral Approach ◽  
Malignant Neoplasms ◽  
Gland Tumor ◽  
Parotid Gland Tumor ◽  
Facial Nerves ◽  
Endoscopic Assistance ◽  
Accessory Parotid Gland

Accessory parotid gland (APG) tumors account for 1% to 7% of all parotid gland neoplasms but are more likely to be malignant than main parotid gland tumors. Management of APG neoplasms entails surgical excision. Four primary approaches to resection have been described in the literature with varying facial nerve outcomes. We report a case of a 4-cm APG pleomorphic adenoma utilizing a transoral approach for excision without postoperative facial nerve injury. A transoral approach is known to mitigate patients’ cosmetic concerns; however, prior reports utilized endoscopic assistance on patients with smaller tumors. We conclude that large APG tumors can be excised through a transoral approach without undue risk to the distal facial nerves, though this transoral approach ultimately may not be appropriate for malignant neoplasms or difficult dissections.

scholarly journals Adenoid cystic carcinoma of the parotid gland: Anastamosis of the facial nerve with the great auricular nerve after radical parotidectomy

2008 ◽  
Vol 41 (02) ◽  
pp. 201-205 ◽  
Author(s):  
Bahadir Osman ◽  
Livaoglu Murat ◽  
Ural Ahmet
Keyword(s):  
Parotid Gland ◽  
Facial Nerve ◽  
Adenoid Cystic Carcinoma ◽  
Radical Neck Dissection ◽  
Facial Asymmetry ◽  
Nerve Reconstruction ◽  
Main Trunk ◽  
Great Auricular Nerve ◽  
Adenoid Cystic ◽  
Distal Branch

ABSTRACTAdenoid cystic carcinoma of the parotid gland is a rare and slowly growing, but highly malignant tumor. Surgical resection of a malignant parotid tumor should include resection of the facial nerve when the nerve is involved in the tumor. Facial nerve reconstruction is required after nerve resection. A 14 year-old female presented with complaints of painless enlargement of the right parotid gland and facial asymmetry. Physical examination revealed a firm mass in the region of the parotid gland as well as right facial paralysis. Biopsy obtained from the mass showed an adenoid cystic carcinoma of the parotid gland. A radical parotidectomy with a modified radical neck dissection was carried out. Grafting material for the facial reconstruction was harvested from the great auricular nerve. The proximal main trunk and each distal branch of the facial nerve were coapted with the greater auricular nerve. The patient received radiotherapy after surgery and was seen to achieve grade IV facial function one year after surgery. Thus, the great auricular nerve is appropriate grafting material for coaptation of each distal branch of the facial nerve.

Facial Paralysis Following Core Needle Biopsy of a Deep Lobe Parotid Tumor: A Case Report

2019 ◽  
Vol 128 (4) ◽  
pp. 357-359 ◽  
Author(s):  
William J. Moss ◽  
Jesse R. Qualliotine ◽  
Andrey Finegersh ◽  
Kevin T. Brumund ◽  
Charles S. Coffey
Keyword(s):  
Case Report ◽  
Facial Nerve ◽  
Facial Paralysis ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Additional Patient ◽  
Parotid Tumor ◽  
Main Trunk ◽  
Core Needle ◽  
Deep Lobe

Objectives: To report a case of total facial paralysis as the result of a core needle biopsy. Methods: Case report and literature review. Results: A 70-year-old man was diagnosed with a deep lobe parotid tumor on computed tomography. During a core needle biopsy, he developed complete facial paralysis. The cause was discovered to be a direct stab injury to the main trunk of the facial nerve. Conclusions: When biopsying parotid lesions adjacent to the main trunk of the facial nerve, the use of smaller-gauge needles and additional patient counseling should be considered.

Parotidectomy

2018 ◽  
Author(s):  
John A. Ridge ◽  
Francis Si Wai Zih
Keyword(s):  
Parotid Gland ◽  
Facial Nerve ◽  
Nerve Injury ◽  
Main Trunk ◽  
Nerve Monitoring ◽  
Salivary Fistula ◽  
Facial Nerve Injury ◽  
Gustatory Sweating ◽  
Parotid Neoplasm ◽  
Parotid Surgery

When a patient presents with a mass at the angle of the mandible, a neoplasm within the parotid gland is a strong consideration. The parotid is the largest of the salivary glands. Terminal branches of the facial nerve are found within the gland. Their functional preservation is an important goal of parotid surgery. Risks of facial nerve injury rise in reoperative procedures and resection of cancers. Surgical principles apply in parotidectomy. In addition to facial nerve injury, a numb earlobe, contour deficit, salivary fistula, and gustatory sweating should be discussed with the patient before an operation. Most lesions can be removed after identification of the main trunk of the facial nerve, but a retrograde approach after finding a peripheral branch may be required. No randomized trials support a benefit from nerve monitoring. An intact facial nerve will usually begin to function, but months of recovery time may be needed. Permanent paralysis is rare. Salivary fistulae are usually self-limited. Many methods to ameliorate the cosmetic changes after parotidectomy have been described. None has gained ascendency. This review contains 6 figures and 61 references. Key words: facial nerve, facial paralysis, Frey syndrome, gustatory sweating, nerve monitoring, parotid gland, parotid neoplasm, parotidectomy, salivary fistula 

Parotid Gland Tumors in Infants and Children

1977 ◽  
Vol 63 (2) ◽  
pp. 195-198 ◽  
Author(s):  
Vinicio C. Catania ◽  
Federico Bozzetti ◽  
Agatino Santangelo ◽  
Bruno Salvadori
Keyword(s):  
Surgical Treatment ◽  
Parotid Gland ◽  
Parotid Tumor ◽  
Lymphoepithelial Lesion ◽  
Parotid Gland Tumors ◽  
Parotid Tumors ◽  
Results Of Treatment ◽  
Benign Lymphoepithelial Lesion ◽  
Mixed Tumors ◽  
In Infants And Children

Eleven cases of parotid tumors in children under 16 years of age are considered. The series accounts for 1.6 % of 657 cases of parotid tumor of all ages observed during the Period 1930–1975 and consists of 6 mixed tumors, 2 mucoepidermoid tumors, 2 angiomas, and 1 benign lymphoepithelial lesion. All the patients underwent surgical treatment, 6 radical and 5 limited. The results of treatment point out that mixed tumors require radical parotidectomy. The attitude towards pediatric parotid tumors is discussed.

scholarly journals Enhancement patterns of the normal facial nerve on three-dimensional T1W fast spin echo MRI

2021 ◽  
pp. 20201025
Author(s):  
Richard Warne ◽  
Olivia Mary Carney ◽  
George Wang ◽  
Steve Connor
Keyword(s):  
Facial Nerve ◽  
Skull Base ◽  
Spin Echo ◽  
Three Dimensional ◽  
Fast Spin Echo ◽  
Rank Test ◽  
Signed Rank ◽  
Facial Nerves ◽  
Signed Rank Test ◽  
Fast Spin

Objectives: With increasing neuroimaging applications of contemporary three-dimensional T1W fast spin echo (3D T1W FSE) sequences, it was aimed to reappraise the normal patterns of skull base facial nerve gadolinium enhancement. Methods: Pre- and post-gadolinium 3D T1W fast spin echo imaging studies (n = 64) were retrospectively analysed in patients without suspected facial nerve pathology. Two independent observers scored the signal at each of six skull base facial nerve segments. Wilcoxon signed-rank test was used to compare changes in signal between pre- and post-gadolinium sequences at each location, and how this differed between proprietary sequences or between the pairs of facial nerves. Results: There was significant enhancement at the fundal canalicular (16%), geniculate ganglion (96%), tympanic (45%) and mastoid (38%) facial nerve segments (p < 0.05). Two different proprietary sequences demonstrated similar patterns of enhancement and there was symmetry between the two sides. Conclusions: There is a differing pattern of normal facial nerve enhancement on contemporary 3D T1W FSE sequences compared to previous studies of 2D T1W SE imaging and fundal canalicular enhancement may be physiological. Advances in knowledge: This is the first study to evaluate patterns of normal facial nerve enhancement using contemporary 3D T1W FSE MRI sequences.

Microscopic measurement of the facial nerve root exit zone from central glial myelin to peripheral Schwann cell myelin

2003 ◽  
Vol 99 (1) ◽  
pp. 121-124 ◽  
Author(s):  
Masato Tomii ◽  
Hisashi Onoue ◽  
Masaharu Yasue ◽  
Shogo Tokudome ◽  
Toshiaki Abe
Keyword(s):  
Facial Nerve ◽  
Transitional Zone ◽  
Exit Point ◽  
En Bloc ◽  
Content Type ◽  
Medial Side ◽  
Root Exit Zone ◽  
Facial Nerves ◽  
The Relationship ◽  
Fine Print

Object. The authors have attempted to define the exact borders of the root exit zone (RExZ) of the facial nerve, measure the distribution of myelin histologically, and examine the relationship between contact vessels and the RExZ. Methods. Seventy-five facial nerves were obtained from brainstems excised from 44 adult patients at autopsy. The arteries and veins associated with the facial nerve were counted and measured. The facial nerves, associated vasculature, and adjoining portions of the brainstem were then removed en bloc. These tissues were serially sectioned and stained, and a photomicrograph of each section was obtained. The distribution of myelin on each section was measured from the upper edge of the supraolivary fossette, and the relationship between contact vessels and the RExZ was examined. The lateral transitional zone of the facial nerve began 8 mm distal to the upper edge of the supraolivary fossette (root exit point [RExP]) and had a mean length of 1.9 mm. The root detachment point (RDP) of the facial nerve at the medial side was located very close to the beginning of the medial transitional zone. In more than 80% of the nerves that were examined, vascular structures compressed the central glial myelin of the nerve. Conclusions. The authors propose the use of the terms “RExP,” “RDP,” and “transitional zone,” instead of RExZ, which cannot be well defined. The RDP appears to be a good landmark for use during microvascular decompression.

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