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Blasi M, Ribera À, de la Fuente J, Ayté T, Malagón P, Carrasco Lopez C, Higueras C. Masseteric Nerve Ultrasound Identification for Dynamic Facial Reanimation Purposes. Plast Reconstr Surg 2024; 154:175e-181e. [PMID: 37337339 DOI: 10.1097/prs.0000000000010871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
BACKGROUND The masseteric nerve is one of the main options to neurotize free muscle flaps in irreversible long-term facial paralysis. Several preoperative skin-marking techniques for the masseteric nerve have been proposed to limit the surgical dissection area, shorten the surgical time, and enable a safer dissection. However, these have shown variability among them, and cannot visualize the nerve preoperatively. The authors designed an observational study to validate a high-frequency ultrasound (HFUS) nerve identification technique. METHODS A systematic HFUS examination was designed and performed to visualize the masseteric nerve in 64 hemifaces of healthy volunteers. One-third were randomly selected to undergo an additional HFUS-guided needle electrostimulation to validate the HFUS image. RESULTS The masseteric nerve was identified by HFUS in 96.9% of hemifaces (95% CI, 0.89 to >0.99) and showed almost perfect agreement with direct needle stimulation as calculated with Cohen kappa coefficient (0.95; 95% CI, 0.85 to 1.00). The masseteric nerve was found within the masseter muscle, in between the deeper muscle bellies, at 18.3 mm (SD ±2.2) from the skin. Only in 12.9% of cases (95% CI, 0.06 to 0.24) did its course become adjacent to the mandible periosteum. Other important features, such as disposition in relation to the parotid gland, or if the nerve was covered directly by a thick intramuscular aponeurosis, could be well observed by HFUS. CONCLUSION HFUS enables masseteric nerve identification and can provide the surgeon with specific information on anatomical relations for each examined individual before surgery.
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Affiliation(s)
- Marc Blasi
- From the Department of Plastic Surgery, Hospital Germans Trias i Pujol
| | - Àngels Ribera
- Physical Medicine and Rehabilitation Department, Hospital Universitari Germans Trias i Pujol
| | | | - Tomás Ayté
- From the Department of Plastic Surgery, Hospital Germans Trias i Pujol
| | - Paloma Malagón
- From the Department of Plastic Surgery, Hospital Germans Trias i Pujol
| | | | - Carmen Higueras
- From the Department of Plastic Surgery, Hospital Germans Trias i Pujol
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Pistoia F, Camerino PL, Ioppi A, Picasso R, Zaottini F, Caprioli S, Mocellin D, Ascoli A, Pansecchi M, Carobbio ALC, Parrinello G, Marchi F, Peretti G, Martinoli C. High-resolution US of the facial vessels with new facial vein landmarks for reconstructive surgery and dermal injection. Eur Radiol Exp 2023; 7:49. [PMID: 37691033 PMCID: PMC10493206 DOI: 10.1186/s41747-023-00363-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 06/12/2023] [Indexed: 09/12/2023] Open
Abstract
BACKGROUND Accurate knowledge of vessel anatomy is essential in facial reconstructive surgery. The technological advances of ultrasound (US) equipment with the introduction of new high-resolution probes improved the evaluation of facial anatomical structures. Our study had these objectives: the primary objective was to identify new surgical landmarks for the facial vein and to verify their precision with US, the secondary objective was to evaluate the potential of high-resolution US examination in the study of both the facial artery and vein. METHODS Two radiologists examined a prospective series of adult volunteers with a 22-8 MHz hockey-stick probe. Two predictive lines of the facial artery and vein with respective measurement points were defined. The distance between the facial vein and its predictive line (named mandibular-orbital line) was determined at each measurement point. The distance from the skin and the area of the two vessels were assessed at every established measurement point. RESULTS Forty-one volunteers were examined. The median distance of the facial vein from its predictive line did not exceed 2 mm. The facial vein was visible at every measurement point in all volunteers on the right side, and in 40 volunteers on the left. The facial artery was visible at every measurement point in all volunteers on the right and in 37 volunteers on the left. CONCLUSIONS The facial vein demonstrated a constant course concerning the mandibular-orbital line, which seems a promising clinical and imaging-based method for its identification. High-resolution US is valuable in studying the facial artery and vein. RELEVANCE STATEMENT High-resolution US is valuable for examining facial vessels and can be a useful tool for pre-operative assessment, especially when combined with the mandibular-orbital line, a new promising imaging and clinical technique to identify the facial vein. KEY POINTS • High-resolution US is valuable in studying the facial artery and vein. • The facial vein demonstrated a constant course concerning its predictive mandibular-orbital line. • The clinical application of the mandibular-orbital line could help reduce facial surgical and cosmetic procedure complications.
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Affiliation(s)
- Federico Pistoia
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, Genoa, Italy.
| | - Paola Lovino Camerino
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova, Genoa, Italy
| | - Alessandro Ioppi
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova, Genoa, Italy
| | - Riccardo Picasso
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, Genoa, Italy
| | - Federico Zaottini
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, Genoa, Italy
| | - Simone Caprioli
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, Genoa, Italy
| | - Davide Mocellin
- Department of Otorhinolaryngology, Ospedale S. Paolo, Savona, Italy
| | - Alessandro Ascoli
- Department of Otorhinolaryngology, Ospedale Giovanni Borea, Sanremo, Italy
| | - Michelle Pansecchi
- Department of Health Sciences (DISSAL), Radiology Section, University of Genova, Via Pastore 1, Genoa, Italy
| | - Andrea Luigi Camillo Carobbio
- Department of Neurosciences, Section of Otorhinolaryngology-Head and Neck Surgery, University of Padua "Azienda Ospedaliera Di Padova", 35128, Padua, Italy
| | | | - Filippo Marchi
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, Genoa, Italy
- Department of Internal Medicine (DIMI), University of Genoa, Genoa, Italy
| | - Giorgio Peretti
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, Genoa, Italy
- Department of Internal Medicine (DIMI), University of Genoa, Genoa, Italy
| | - Carlo Martinoli
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, Genoa, Italy
- Department of Health Sciences (DISSAL), Radiology Section, University of Genova, Via Pastore 1, Genoa, Italy
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Rodriguez Betancourt A, Samal A, Chan HL, Kripfgans OD. Overview of Ultrasound in Dentistry for Advancing Research Methodology and Patient Care Quality with Emphasis on Periodontal/Peri-implant Applications. Z Med Phys 2023; 33:336-386. [PMID: 36922293 PMCID: PMC10517409 DOI: 10.1016/j.zemedi.2023.01.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 12/20/2022] [Accepted: 01/11/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Ultrasound is a non-invasive, cross-sectional imaging technique emerging in dentistry. It is an adjunct tool for diagnosing pathologies in the oral cavity that overcomes some limitations of current methodologies, including direct clinical examination, 2D radiographs, and cone beam computerized tomography. Increasing demand for soft tissue imaging has led to continuous improvements on transducer miniaturization and spatial resolution. The aims of this study are (1) to create a comprehensive overview of the current literature of ultrasonic imaging relating to dentistry, and (2) to provide a view onto investigations with immediate, intermediate, and long-term impact in periodontology and implantology. METHODS A rapid literature review was performed using two broad searches conducted in the PubMed database, yielding 576 and 757 citations, respectively. A rating was established within a citation software (EndNote) using a 5-star classification. The broad search with 757 citations allowed for high sensitivity whereas the subsequent rating added specificity. RESULTS A critical review of the clinical applications of ultrasound in dentistry was provided with a focus on applications in periodontology and implantology. The role of ultrasound as a developing dental diagnostic tool was reviewed. Specific uses such as soft and hard tissue imaging, longitudinal monitoring, as well as anatomic and physiological evaluation were discussed. CONCLUSIONS Future efforts should be directed towards the transition of ultrasonography from a research tool to a clinical tool. Moreover, a dedicated effort is needed to introduce ultrasonic imaging to dental education and the dental community to ultimately improve the quality of patient care.
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Affiliation(s)
| | - Ankita Samal
- Department of Radiology, Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Hsun-Liang Chan
- Department of Periodontology and Oral Medicine, Dental School, University of Michigan, Ann Arbor, MI, USA
| | - Oliver D Kripfgans
- Department of Radiology, Medical School, University of Michigan, Ann Arbor, MI, USA
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Fana V, Terslev L. Lacrimal and salivary gland ultrasound - how and when to use in patients with primary Sjögren's syndrome. Best Pract Res Clin Rheumatol 2023; 37:101837. [PMID: 37258318 DOI: 10.1016/j.berh.2023.101837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 04/27/2023] [Indexed: 06/02/2023]
Abstract
This paper addresses how to perform an ultrasound assessment of the salivary and lacrimal glands, how to identify pathological changes, and how to score disease activity, focusing on the use for primary Sjögren's syndrome (pSS). It addresses the role of salivary gland ultrasound for diagnosing and management of patients with pSS and touches upon the use for differential diagnosis, including how and when to perform ultrasound-guided biopsies and injections.
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Affiliation(s)
- Viktoria Fana
- Center for Rheumatology and Spine Diseases, Copenhagen Center for Arthritis Research, Rigshospitalet, Copenhagen, Denmark.
| | - Lene Terslev
- Center for Rheumatology and Spine Diseases, Copenhagen Center for Arthritis Research, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
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Pistoia F, Picasso R, Zaottini F, Sanguinetti S, Caprioli S, Tovt L, Pansecchi M, Martinoli C. High-Resolution Ultrasound of Facial Muscles: Sonoanatomy, Scanning Technique, and Pathological Cases. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:547-557. [PMID: 35670279 DOI: 10.1002/jum.16036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/12/2022] [Accepted: 05/22/2022] [Indexed: 06/15/2023]
Abstract
The aim of the present work is to review the sonographic appearance of facial muscles with high-frequency transducers and to illustrate a step-by-step scanning technique that enables an effective evaluation of them. In addition, we highlighted the clinical application showing some pathological cases demonstrated with ultrasound (US). The recent technological advances have greatly enlarged the potential of high-resolution US in the evaluation of the face. Furthermore, the clinical indications of this technique are expected to increase in the near future.
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Affiliation(s)
- Federico Pistoia
- Department of Experimental Medicine (DIMES), University of Genova, Via Leon Battista Alberti 2, Genoa, Italy
| | - Riccardo Picasso
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, Genoa, Italy
| | - Federico Zaottini
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, Genoa, Italy
| | - Sara Sanguinetti
- Department of Experimental Medicine (DIMES), University of Genova, Via Leon Battista Alberti 2, Genoa, Italy
| | - Simone Caprioli
- Department of Internal Medicine (DIMI), University of Genova, Viale Benedetto XV 6, Genoa, Italy
| | - Luca Tovt
- Department of Health Sciences (DISSAL), Radiology Section, University of Genova, Via Pastore 1, Genoa, Italy
| | - Michelle Pansecchi
- Department of Health Sciences (DISSAL), Radiology Section, University of Genova, Via Pastore 1, Genoa, Italy
| | - Carlo Martinoli
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, Genoa, Italy
- Department of Health Sciences (DISSAL), Radiology Section, University of Genova, Via Pastore 1, Genoa, Italy
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