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Comment on Kehrer et al. Using High-Resolution Ultrasound to Assess Post-Facial Paralysis Synkinesis—Machine Settings and Technical Aspects for Facial Surgeons. Diagnostics 2022, 12, 1650
 
 
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Reply

Reply to Nduka et al. Comment on “Kehrer et al. Using High-Resolution Ultrasound to Assess Post-Facial Paralysis Synkinesis—Machine Settings and Technical Aspects for Facial Surgeons. Diagnostics 2022, 12, 1650”

by
Andreas Kehrer
,
Lukas Prantl
,
Samuel Knoedler
and
Leonard Knoedler
*
Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
*
Author to whom correspondence should be addressed.
Diagnostics 2022, 12(10), 2432; https://doi.org/10.3390/diagnostics12102432
Submission received: 18 September 2022 / Accepted: 29 September 2022 / Published: 8 October 2022
(This article belongs to the Special Issue Evidence-Based Diagnosis and Management of Facial Nerve Disorders)
Versions Notes
We thank Dr. Nduka et al. for this interesting article [1]. We very much enjoyed reading the detailed Instructions for Sonography of the Mimic Musculature [2]. We found the schematic, yet practice-orientated drawings helpful for visualizing the complex facial anatomical relationships and different planes. We see our structured working protocol as add-on to their work [3].
Together with other advancements in clinical facial palsy (FP) diagnostics and basic scientific translational efforts, such as automated grading systems or axon quantification, high-resolution ultrasound (HRUS) enlarges the FP surgeon’s arsenal and understanding of FP disease [4,5,6,7,8,9].
Reading both publications, FP surgeons with basic levels of knowledge of facial HRUS may enhance their clinical workflow and refine their diagnostic setting in FP patients. Such an evidence-based approach might promote FP patient care, scientific data acquisition, and cost-effectiveness.
In future studies, the combination of facial HRUS and machine learning should explore the feasibility of automatizing this diagnostic step. Overall, facial HRUS represents a promising research field for both basic and clinical studies, and we are looking forward to future developments in facial HRUS.

Author Contributions

Investigation, A.K. and L.K.; writing—original draft preparation, A.K. and L.K.; writing—review and editing, L.P. and S.K. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Conflicts of Interest

The authors declare no conflict of interest.

References

  1. Nduka, C.; Kannan, R.Y.; Volk, G.F.; Guntinas-Lichius, O. Comment on Kehrer et al. Using High-Resolution Ultrasound to Assess Post-Facial Paralysis Synkinesis—Machine Settings and Technical Aspects for Facial Surgeons. Diagnostics 2022, 12, 1650. Diagnostics 2022, 12, 2431. [Google Scholar] [CrossRef]
  2. Azizzadeh, B.; Nduka, C. (Eds.) Appendix—Instructions for sonography of the mimic musculature. In Management of Post-Facial Paralysis Synkinesis; Elsevier: Amsterdam, The Netherlands, 2022; pp. 109–133. [Google Scholar]
  3. Kehrer, A.; Ruewe, M.; da Silva, N.P.B.; Lonic, D.; Heidekrueger, P.I.; Knoedler, S.; Jung, E.M.; Prantl, L.; Knoedler, L. Using High-Resolution Ultrasound to Assess Post-Facial Paralysis Synkinesis—Machine Settings and Technical Aspects for Facial Surgeons. Diagnostics 2022, 12, 1650. [Google Scholar] [CrossRef] [PubMed]
  4. Engelmann, S.; Ruewe, M.; Geis, S.; Taeger, C.D.; Kehrer, M.; Tamm, E.R.; Bleys, R.L.A.; Zeman, F.; Prantl, L.; Kehrer, A. Rapid and Precise Semi-Automatic Axon Quantification in Human Peripheral Nerves. Sci. Rep. 2020, 10, 1935. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  5. Ruewe, M.; Engelmann, S.; Huang, C.W.; Klein, S.M.; Anker, A.M.; Lamby, P.; Bleys, R.L.A.W.; Tamm, E.R.; Prantl, L.; Kehrer, A. Microanatomy of the Frontal Branch of the Facial Nerve: The Role of Nerve Caliber and Axonal Capacity. Plast. Reconstr. Surg. 2021, 148, 1357–1365. [Google Scholar] [CrossRef] [PubMed]
  6. Kehrer, A.; Ruewe, M.; Engelmann, S.; Anker, A.; Taeger, C.; Geis, S.; Prantl, L. From bench-to-bedside: Implications for facial reanimation surgery gained from axonal load quantification and nerve morphometry of a cadaver study in 106 facial halves. In Proceedings of the Annual Meeting of the American Society for Reconstructive Microsurgery, Fort Lauderdale, FL, USA, 10–14 January 2020. [Google Scholar]
  7. Kehrer, A.; Engelmann, S.; Ruewe, M.; Geis, S.; Taeger, C.; Kehrer, M.; Prantl, L.; Tamm, E.; Bleys, R.R.; Mandlik, V. Anatomical study of the zygomatic and buccal branches of the facial nerve: Application to facial reanimation procedures. Clin. Anat. 2019, 32, 480–488. [Google Scholar] [CrossRef] [PubMed]
  8. Sommerauer, L.; Engelmann, S.; Ruewe, M.; Anker, A.; Prantl, L.; Kehrer, A. Effects of electrostimulation therapy in facial nerve palsy. Arch. Plast. Surg. 2021, 48, 278–281. [Google Scholar] [CrossRef] [PubMed]
  9. Kehrer, A.; Mandlik, V.; Taeger, C.; Geis, S.; Prantl, L.; Jung, E.-M. Postoperative control of functional muscle flaps for facial palsy reconstruction: Ultrasound guided tissue monitoring using contrast enhanced ultrasound (CEUS) and ultrasound elastography. Clin. Hemorheol. Microcirc. 2017, 67, 435–444. [Google Scholar] [CrossRef] [PubMed]
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MDPI and ACS Style

Kehrer, A.; Prantl, L.; Knoedler, S.; Knoedler, L. Reply to Nduka et al. Comment on “Kehrer et al. Using High-Resolution Ultrasound to Assess Post-Facial Paralysis Synkinesis—Machine Settings and Technical Aspects for Facial Surgeons. Diagnostics 2022, 12, 1650”. Diagnostics 2022, 12, 2432. https://doi.org/10.3390/diagnostics12102432

AMA Style

Kehrer A, Prantl L, Knoedler S, Knoedler L. Reply to Nduka et al. Comment on “Kehrer et al. Using High-Resolution Ultrasound to Assess Post-Facial Paralysis Synkinesis—Machine Settings and Technical Aspects for Facial Surgeons. Diagnostics 2022, 12, 1650”. Diagnostics. 2022; 12(10):2432. https://doi.org/10.3390/diagnostics12102432

Chicago/Turabian Style

Kehrer, Andreas, Lukas Prantl, Samuel Knoedler, and Leonard Knoedler. 2022. "Reply to Nduka et al. Comment on “Kehrer et al. Using High-Resolution Ultrasound to Assess Post-Facial Paralysis Synkinesis—Machine Settings and Technical Aspects for Facial Surgeons. Diagnostics 2022, 12, 1650”" Diagnostics 12, no. 10: 2432. https://doi.org/10.3390/diagnostics12102432

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