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Keywords = facial nerve monitoring (FNM)

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10 pages, 4869 KB  
Review
Proposals for Standardization of Intraoperative Facial Nerve Monitoring during Parotid Surgery
by Feng-Yu Chiang, Ching-Feng Lien, Chih-Chun Wang, Chien-Chung Wang, Tzer-Zen Hwang, Yu-Chen Shih, Hsin-Yi Tseng, Che-Wei Wu, Yaw-Chang Huang and Tzu-Yen Huang
Diagnostics 2022, 12(10), 2387; https://doi.org/10.3390/diagnostics12102387 - 30 Sep 2022
Cited by 11 | Viewed by 5389
Abstract
Intraoperative facial nerve monitoring (FNM) has been widely accepted as an adjunct during parotid surgery to facilitate identification of the facial nerve (FN) main trunk, dissection of FN branches, confirmation of FN function integrity, detection of FN injury and prognostication of facial expression [...] Read more.
Intraoperative facial nerve monitoring (FNM) has been widely accepted as an adjunct during parotid surgery to facilitate identification of the facial nerve (FN) main trunk, dissection of FN branches, confirmation of FN function integrity, detection of FN injury and prognostication of facial expression after tumor resection. Although the use of FNM in parotidectomy is increasing, little uniformity exists in its application from the literature. Thus, not only are the results of many studies difficult to compare but the value of FNM technology is also limited. The article reviews the current literature and proposes our standardized FNM procedures during parotid surgery, such as standards in FNM setup, standards in general anesthesia, standards in FNM procedures and application of stimulus currents, interpretation of electrophysiologic signals and prediction of the facial expression outcome and pre-/post-operative assessment of facial expressions. We hope that the FNM standardized procedures will provide greater uniformity, improve the quality of applications and contribute to future research. Full article
(This article belongs to the Special Issue Salivary Gland Disorders: Diagnosis, Prognosis, and Treatment)
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13 pages, 2485 KB  
Article
Correlation between Electrophysiological Change and Facial Function in Parotid Surgery Patients
by Feng-Yu Chiang, Chih-Chun Wang, Che-Wei Wu, I-Cheng Lu, Pi-Ying Chang, Yi-Chu Lin, Ching-Feng Lien, Chien-Chung Wang, Tzu-Yen Huang and Tzer-Zen Hwang
J. Clin. Med. 2021, 10(24), 5730; https://doi.org/10.3390/jcm10245730 - 7 Dec 2021
Cited by 9 | Viewed by 4241
Abstract
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 [...] Read more.
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. Full article
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